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CompletedNCT07811856Updated Sep 10, 2026

Effects of Metformin and Theory-Based Education in Women With Polycystic Ovary Syndrome

A Phase 4 interventional study of MetFORMIN and Matching Placebo in Polycystic Ovary Syndrome (PCOS) Women, sponsored by Jerash Private University. Completed at 1 site in Jordan. Open to female participants aged 18 Years to 40 Years. Per ClinicalTrials.gov, last updated 2026-09-10.

Sponsored by Jerash Private University · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
900
Allocation
Randomized
Ages
18 Years to 40 Years
Sex
Female
01

Study summary

Polycystic ovary syndrome (PCOS) is a common condition associated with metabolic abnormalities, including insulin resistance, impaired glucose regulation, and abnormal lipid levels. Metformin is commonly used to improve metabolic outcomes in women with PCOS, while lifestyle modification and behavioral education are important components of PCOS management. This study evaluates whether metformin, alone or combined with a theory-based behavioral educational program, is associated with changes in metabolic, vitamin B12, iron-status, erythropoietin, and hematological parameters compared with matching placebo.

This is a prospective, three-arm, parallel-group randomized controlled trial conducted among women aged 18-40 years with specialist-confirmed PCOS in Ministry of Health obstetrics and gynecology clinics in Jordan. A total of 900 participants were initially randomized in a 1:1:1 ratio to receive matching placebo, metformin, or metformin combined with a theory-based behavioral educational program. The metformin groups received 1500 mg/day, administered as 500 mg three times daily, for six months. The combined intervention group additionally received five structured educational sessions addressing PCOS self-management, healthy dietary practices, physical activity, weight and waist management, metformin adherence, sleep, stress management, problem solving, and maintenance of healthy behaviors.

Clinical and laboratory outcomes were assessed at baseline and after six months. The primary outcomes include changes in anthropometric, metabolic, vitamin B12, iron-status, erythropoietic, and hematological parameters. Changes in PCOS-related knowledge and lifestyle practices were also evaluated among participants receiving the combined intervention.

Read the detailed description

This study is a prospective, three-arm, parallel-group randomized controlled trial conducted among women diagnosed with polycystic ovary syndrome (PCOS). The study was conducted from August 2025 to February 2026 in obstetrics and gynecology clinics affiliated with the Ministry of Health, Jordan. The intervention and follow-up period lasted six months.

A total of 900 eligible participants were initially randomized in a 1:1:1 ratio to one of three study groups: a matching placebo group, a metformin group, and a combined metformin plus theory-based behavioral educational intervention group. All participants received routine clinical care for PCOS.

Participants assigned to the matching placebo group received routine clinical care together with matching placebo tablets identical to the metformin tablets in appearance, size, and form. Participants in the metformin group received routine clinical care together with metformin at a total daily dose of 1500 mg, administered as 500 mg three times daily, for six months. Participants in the combined intervention group received the same metformin regimen together with a structured theory-based behavioral educational program.

The behavioral educational intervention was grounded in Bandura's Self-Efficacy Theory and incorporated educational and lifestyle domains relevant to PCOS self-management. The program consisted of five structured sessions of approximately 60 minutes each. The sessions addressed understanding PCOS and self-management; healthy dietary practices; physical activity, sedentary behavior, and weight and waist management; metformin adherence, metabolic health, and symptom monitoring; and sleep, stress management, problem solving, and maintenance of behavioral changes. Individualized education, practical examples, achievable goals, self-monitoring, reinforcement, and follow-up contacts were incorporated to support behavioral change.

Clinical and laboratory assessments were performed at baseline and at six months. The primary objective was to compare changes from baseline to six months among the three study groups in anthropometric parameters, metabolic parameters, vitamin B12, iron-status biomarkers, erythropoietin, and hematological indices. Metabolic assessments included measures of glucose regulation and insulin resistance and lipid parameters. Iron-status assessments included serum iron, total iron-binding capacity, transferrin saturation, and ferritin. Hematological assessments included hemoglobin, hematocrit, red blood cell count, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, red cell distribution width, white blood cell count, differential leukocyte counts, and platelet count.

A secondary objective was to evaluate changes in PCOS-related knowledge and lifestyle practices among participants receiving the combined metformin and theory-based behavioral educational intervention. Knowledge domains included the definition of PCOS, causes and risk factors, signs and symptoms, complications, and treatment and management. Lifestyle domains included dietary practices, physical activity, leisure activities, and sleep.

The study was designed to provide a controlled comparison of routine care with matching placebo, metformin therapy, and metformin combined with structured behavioral education. Participants receiving the educational intervention could not be blinded to the educational component because they were aware of their participation in the program. Standardized procedures were used for clinical assessment, laboratory measurements, data collection, and statistical analysis.

02

Conditions studied

  • Polycystic Ovary Syndrome (PCOS) Women

Keywords

  • Metformin
  • PCOS
  • heory-Based Behavioral Education
  • Lifestyle Education
  • Vitamin B12
  • Iron Status
  • Erythropoietin
  • Metabolic Outcomes
  • Hematological Parameters
03

In context

Polycystic Ovary Syndrome

956 studies on the registry are indexed under Polycystic Ovary Syndrome; 176 are open to participants now.

This study's enrollment of 900 is above the median of 70 across 697 interventional studies indexed under Polycystic Ovary Syndrome.

Browse Polycystic Ovary Syndrome studies →

Lead sponsor

Jerash Private University is the lead sponsor of 8 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 40 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Women aged 18-40 years.
  2. Specialist-confirmed diagnosis of polycystic ovary syndrome (PCOS).
  3. Ability and willingness to participate in the six-month study follow-up.
  4. Ability to comply with the study procedures and assessments.

Exclusion criteria

Exclusion Criteria:

  1. Chronic hemolytic anemia.
  2. Chronic kidney disease.
  3. Hepatic disorders.
  4. Other endocrine, metabolic, or cardiovascular conditions that could affect glucose metabolism, vitamin B12 status, iron status, erythropoietin levels, or hematological parameters.
  5. Previous use of insulin-sensitizing medications other than the study metformin.
  6. Current or recent hormonal therapy that could affect the study outcomes.
  7. Current use of iron or vitamin B12 supplements.
  8. Use of medications that could substantially affect glucose metabolism, vitamin B12 status, iron status, erythropoietin levels, or hematological parameters.
  9. Any condition that could interfere with adherence to the intervention or completion of the six-month follow-up.
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
900 participants (actual)

Study arms

  • Active comparator
    Matching Placebo Group

    Participants received routine clinical care together with matching placebo tablets identical to the metformin tablets in appearance, size, and form for six months. They did not receive study-prescribed metformin or the structured theory-based behavioral educational intervention.

    Drug: Matching Placebo

  • Experimental
    Metformin Group

    Participants received routine clinical care together with metformin at a total daily dose of 1500 mg, administered as 500 mg three times daily, for six months. They did not receive the structured theory-based behavioral educational intervention.

    Drug: MetFORMIN

  • Experimental
    Metformin Plus Theory-Based Behavioral Education

    Participants received routine clinical care together with metformin at a total daily dose of 1500 mg, administered as 500 mg three times daily, for six months, plus a structured theory-based behavioral educational program. The program consisted of five structured sessions addressing PCOS self-management, healthy dietary practices, physical activity, sedentary behavior, weight and waist management, metformin adherence, metabolic health, sleep, stress management, problem solving, and maintenance of behavioral changes.

    Drug: MetFORMIN · Behavioral: Theory-Based Behavioral Educational Program

Interventions

  • Metformin was administered at a total daily dose of 1500 mg, given as 500 mg three times daily, for six months.

  • DrugMatching Placebo

    Matching placebo tablets identical to the metformin tablets in appearance, size, and form were administered for six months.

  • BehavioralTheory-Based Behavioral Educational Program

    A structured behavioral educational program grounded in Bandura's Self-Efficacy Theory was provided to participants in the combined intervention group. The program consisted of five structured sessions addressing PCOS self-management, healthy dietary practices, physical activity and sedentary behavior, weight and waist management, metformin adherence, metabolic health, sleep, stress management, problem solving, and maintenance of behavioral changes.

06

What researchers measure

Primary outcomes

  1. Change in Body Mass Index (BMI) From Baseline to 6 Months

    Change in body mass index (BMI) from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  2. Change in Serum Insulin From Baseline to 6 Months

    Change in serum insulin from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  3. Change in HOMA-IR From Baseline to 6 Months

    Change in homeostasis model assessment of insulin resistance (HOMA-IR) from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  4. Change in Total Cholesterol (TC) From Baseline to 6 Months

    Change in total cholesterol (TC) from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  5. Change in Triglycerides (TG) From Baseline to 6 Months

    Change in triglycerides (TG) from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  6. Change in Low-Density Lipoprotein Cholesterol (LDL-C) From Baseline to 6 Months

    Change in low-density lipoprotein cholesterol (LDL-C) from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  7. Change in High-Density Lipoprotein Cholesterol (HDL-C) From Baseline to 6 Months

    Change in high-density lipoprotein cholesterol (HDL-C) from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  8. Change in Serum Vitamin B12 From Baseline to 6 Months

    Change in serum vitamin B12 concentration from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  9. Change in Serum Iron From Baseline to 6 Months

    Change in serum iron concentration from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  10. Change in Serum Ferritin From Baseline to 6 Months

    Change in serum ferritin concentration from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  11. Change in Total Iron-Binding Capacity (TIBC) From Baseline to 6 Months

    Change in total iron-binding capacity (TIBC) from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  12. Change in Transferrin Saturation (TSAT) From Baseline to 6 Months

    Change in transferrin saturation (TSAT) from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  13. Change in Serum Erythropoietin (EPO) From Baseline to 6 Months

    Change in serum erythropoietin (EPO) concentration from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  14. Change in Hemoglobin (Hb) From Baseline to 6 Months

    Change in hemoglobin (Hb) concentration from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  15. Change in Hematocrit (Hct) From Baseline to 6 Months

    Change in hematocrit (Hct) from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  16. Change in Mean Corpuscular Volume (MCV) From Baseline to 6 Months

    Change in mean corpuscular volume (MCV) from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  17. Change in Mean Corpuscular Hemoglobin (MCH) From Baseline to 6 Months

    Change in mean corpuscular hemoglobin (MCH) from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  18. Change in Mean Corpuscular Hemoglobin Concentration (MCHC) From Baseline to 6 Months

    Change in mean corpuscular hemoglobin concentration (MCHC) from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  19. Change in Red Cell Distribution Width (RDW) From Baseline to 6 Months

    Change in red cell distribution width (RDW) from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  20. Change in White Blood Cell (WBC) Count From Baseline to 6 Months

    Change in neutrophil count from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  21. Change in Lymphocyte Count From Baseline to 6 Months

    Change in lymphocyte count from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  22. Change in Eosinophil Count From Baseline to 6 Months

    Change in eosinophil count from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  23. Change in Basophil Count From Baseline to 6 Months

    Change in basophil count from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

  24. Change in Platelet Count From Baseline to 6 Months

    Change in platelet count from baseline to 6 months among participants assigned to the matching placebo, metformin, or metformin plus theory-based behavioral education groups.

    Time frame: Baseline to 6 months

Secondary outcomes

  1. Change in PCOS-Related Knowledge and Lifestyle Practices From Baseline to 6 Months

    Change from baseline to 6 months in PCOS-related knowledge and lifestyle-practice scores among participants receiving metformin combined with the theory-based behavioral educational program. The assessment included PCOS-related knowledge and lifestyle domains covering food habits, physical activity, leisure time, and sleep pattern.

    Time frame: Baseline to 6 months

07

Study locations

1 site
  • Jerash University
    Amman, 009627, Jordan
08

References and documents

Individual participant data

Plan to share: No — Individual participant data (IPD) will not be shared with other researchers. Data will be retained by the research team and used for the purposes of the registered study and related scientific reporting.

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Aug 2026 to primary completion in Aug 2026, 0 months.

Of 41 non-industry phase 4 interventional studies under Polycystic Ovary Syndrome, half reached primary completion within 25 months of starting (the median), counting those still running; a quarter within 8 and three quarters within 45. This study's 0 months is below that.

Counting every sponsor, half of 42 studies reached it within 25 months; a quarter within 11 and three quarters within 45.

How these figures are worked out, and which studies are left out of them.

Registered
Sep 4, 2026
First posted
Sep 10, 2026
StartActual
Aug 1, 2026
Primary completionActual
Aug 1, 2026
CompletionActual
Aug 1, 2026
Last update
Sep 10, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 10, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07811856
Lead sponsor
Jerash Private University
Responsible party
JAWAD AHMAD ABU-SHENNAR (Assistant Professor DOCTOR, Jerash Private University) — Principal investigator
First posted
Sep 10, 2026
Start date
Aug 1, 2026
Primary completion
Aug 1, 2026
Completion
Aug 1, 2026
Last update
Sep 10, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Metformin

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