Abstract
Background: Polycystic ovarian syndrome (PCOS) is an endocrine disorder that predominantly affects women of the reproductive age. Anovulation and abnormal uterine bleeding are caused by hyperprolactinemia, which affects the hypothalamic-pituitary-ovarian axis.
 Aim: In this study, the efficacy of combined Probiotic and Metformin therapy on hyperprolactinemia levels in PCOS patients was compared to Metformin therapy alone.
 Methodology: 102 participants having hyperprolactinemia were enrolled via convenient sampling technique between January 2019 to August 2019. Out of them women having Polycystic Ovarian Syndrome (PCOS) and high serum prolactin levels were randomly assigned to one of two groups: group one received oral Metformin tablet 500 mg T.D. for three months, and group two received oral Metformin tablet 500 mg T.D and Probiotic capsule 180 mg O.D for three months. Serum prolactin levels in both groups were compared before and after treatment.
 Results: 54 (53%) of the 102 hyperprolactinemia women had PCOS. The Combination group showed improvement in reduction in hyperprolactinemia levels after 12 weeks of intervention.
 Conclusion: The addition of Probiotic to Metformin improved prolactin levels in women with polycystic ovarian syndrome with hyperprolactinemia more than Metformin alone.
Highlights
Polycystic ovarian syndrome (PCOS) is not merely a reproductive disorder but an endocrinological disorder affecting women in their reproductive years
At the start of the study, the women were evaluated for hyperprolactinemia levels, there was no significant difference between the two treatment groups (p = 0.07)
The Combination group showed improvement in reduction in hyperprolactinemia levels after 12 weeks of intervention (p = 0.01) whereas Metformin alone showed insignificant improvement and, when the two groups were compared significant change exist between the two groups after treatment (p = 0.000)
Summary
PCOS is not merely a reproductive disorder but an endocrinological disorder affecting women in their reproductive years It is defined by the Rotterdam criteria as a combination of oligo / amenorrhea, clinical or endocrine signs of hyperandrogenism, and polycystic ovaries on ultrasonography [1,2,3]. Out of them women having Polycystic Ovarian Syndrome (PCOS) and high serum prolactin levels were randomly assigned to one of two groups: Zafar et al.; JPRI, 33(47A): 268-274, 2021; Article no.JPRI.75815 group one received oral Metformin tablet 500 mg T.D. for three months, and group two received oral Metformin tablet 500 mg T.D and Probiotic capsule 180 mg O.D for three months. Conclusion: The addition of Probiotic to Metformin improved prolactin levels in women with polycystic ovarian syndrome with hyperprolactinemia more than Metformin alone
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