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. Author manuscript; available in PMC: 2021 Sep 1.
Published in final edited form as: Int J Gynecol Cancer. 2020 May 5;30(9):1331–1339. doi: 10.1136/ijgc-2020-001362

Figure 3.

Figure 3

Hypothesis-generating schema for the interaction between metformin and systemic progestin. Possible pathways for the interaction of progestin and metformin in obesity are shown. Inflammatory cytokines from excess adiposity stimulate endometrial cells for oncogenesis. Metformin inhibits inflammatory cytokines from the adipocytes. Systemic progestin may cause weight gain, resulting in increases in inflammatory cytokines and decreases in the relative effectiveness of metformin. LNG-IUD, levonorgestrel-releasing intrauterine device.