A randomized controlled trial comparing the efficacy of resveratrol combined with metformin versus resveratrol monotherapy in the management of polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age characterized by metabolic dysfunction, insulin resistance, and hormonal imbalance. Metformin, a well-known insulin sensitizer, and Resveratrol, an antioxidant polyphenol, have both shown promise in managing the metabolic and reproductive features of PCOS. This study evaluates the effects of Resveratrol alone and in combination with Metformin on clinical, metabolic, endocrine and reproductive parameters in women with PCOS over a 6-month period. A randomized controlled trial was conducted with PCOS women, who were assigned to two groups: one receiving Resveratrol monotherapy (33 participants) and the other receiving a combination of Resveratrol plus Metformin (30 participants). Treatment effects on demographic, anthropometric, clinical, endocrine and metabolic parameters were assessed at baseline, after 3 months and 6 months. Following dropouts and adverse effects, 25 participants were analyzed in each group for the final evaluation. statistical analysis was performed using SPSS version 26., employing t-tests, repeated measures ANOVA, and chi-square test. Where baseline imbalances existed, Analysis of Covariance (ANCOVA) was additionally performed to adjust for pre-treatment differences., with p < 0.05 considered significant. Both treatment groups showed significant within-group improvements over 6 months. Resveratrol monotherapy led to marked improvements in BMI, ovarian volume, Ferriman-Gallwey Score (FGS), LH levels, and quality of life (p < 0.001). The combination of Resveratrol with Metformin showed significantly reductions in fasting glucose (p = 0.002), BMI (p = 0.005), and oxidative stress marker MDA (p < 0.001). Menstrual regularity improved in both groups, with 96% of participants in the Resveratrol group and 85% in the combination group reporting regular cycles at 6 months. Perceived stress levels improved in both groups, with a shift toward lower stress categories. Absolute change revealed significantly higher improvements in quality of life and ovarian morphology in the Resveratrol group, while metabolic parameters improved more in the combination group. Both Resveratrol alone and in combination with Metformin were effective in managing PCOS. Resveratrol monotherapy was superior in improving reproductive parameters and quality of life, whereas the combination therapy offered greater metabolic and antioxidant benefits. These findings highlight the need to tailor treatment strategies according to individual PCOS phenotypes.