Metformin as a New Therapeutic Option for Endometriosis: Promise, Limits and Future Directions

Metformin as a New Therapeutic Option for Endometriosis: Promise, Limits and Future Directions DOI: https://doi.org/10.12775/QS.2026.54.70561Keywords Metformin, EndometriosisAbstract Endometriosis is a chronic, estrogent-dependent, inflammatory disease affecting a plethora of women of reproductive age and is a major cause of pelvis pain and subfertility. Current treatments – surgery and hormonal supression are often only partly effective, lead to further fertility issues or have substantial adverse effects, creating an unmet need for a non-hormonal, disease modyfing therapy option (Carvalho, J. C., et al; 2021). Metformin, a biguanide used worldwide as a first-line insulin-sensitizing drug for type 2 diabetes, has emerged as a therapeutic option for endometriosis because of its pleiotropic anti-inflammatory, anti-proliferative, anti-angiogenic and metabolic effects. This paper analyses mechanistic, preclinical and early clinical evidence on metformin use in endometriosis, with particular attention to how the drug interacts with the known pathophysiology of the disease (Kimber-Trojnar, Ż., et al; 2022). Rather than an immediate replacement for standard hormonal therapies, metformin currently appears best positioned as a promising adjuvant or alternative for selected patients – particularly those with co-existing metabolic dysfunction pending high-quality clinical trials (Zhang, H., et al; 2023). References 1. Carvalho, J. C., et al. (2021). Metformin, the rise of a new medical therapy for endometriosis? A systematic review. Frontiers in Medicine, 8, 581311. https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.581311/full 2. Kimber-Trojnar, Ż., et al. (2022). Metformin as a potential treatment option for endometriosis. Cancers, 14(3), 577.MDPI+1 3. Zhang, H., et al. (2023). 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R., et al. (2021). Metformin added to tamoxifen to protect the endometrium: a randomized trial. Gynecologic Oncology. https://www.sciencedirect.com/science/article/abs/pii/S0014482721001919 Downloads Published How to Cite Issue Section License Copyright (c) 2026 Karolina Bartkiewicz, Magdalena Papież, Zofia Jędra, Anna Libera, Maciej Jakub Kozicki, Julia Maria Kostro, Lizaveta Novik, Gabriela Makulec, Karolina Domosud, Damian Zienkiewicz This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Stats Number of views and downloads: 117 Number of citations: 0