An Update on Contraception in Polycystic Ovary Syndrome

Creative Commons License

Oguz S. H., YILDIZ O. B.

ENDOCRINOLOGY AND METABOLISM, cilt.36, sa.2, ss.296-311, 2021 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 36 Sayı: 2
  • Basım Tarihi: 2021
  • Doi Numarası: 10.3803/enm.2021.958
  • Dergi Adı: ENDOCRINOLOGY AND METABOLISM
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.296-311
  • Anahtar Kelimeler: Polycystic ovary syndrome, Contraceptives, oral, Cardiometabolic risk factors, Obesity, Diabetes mellitus, Hypertension, COMBINED ORAL-CONTRACEPTIVES, HORMONE-BINDING GLOBULIN, PROGESTOGEN-ONLY PILLS, VENOUS THROMBOEMBOLISM, CARDIOVASCULAR-DISEASE, INTRAUTERINE SYSTEM, POSTMENOPAUSAL WOMEN, GLUCOSE-METABOLISM, INSULIN-RESISTANCE, YOUNG-WOMEN
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductive-aged women, characterized by hyperandrogenism, oligo/anovulation, and polycystic ovarian morphology. Combined oral contraceptives (COCs), along with lifestyle modifications, represent the first-line medical treatment for the long-term management of PCOS. Containing low doses of estrogen and different types of progestin, COCs restore menstrual cyclicity, improve hyperandrogenism, and provide additional benefits such as reducing the risk of endometrial cancer. However, potential cardiometabolic risk associated with these agents has been a concern. COCs increase the risk of venous thromboembolism (VTE), related both to the dose of estrogen and the type of progestin involved. Arterial thrombotic events related to COC use occur much less frequently, and usually not a concern for young patients. All patients diagnosed with PCOS should be carefully evaluated for cardiometabolic risk factors at baseline, before initiating a COC. Age, smoking, obesity, glucose intolerance or diabetes, hypertension, dyslipidemia, thrombophilia, and family history of VTE should be recorded. Patients should be re-assessed at consecutive visits, more closely if any baseline cardiometabolic risk factor is present. Individual risk assessment is the key in order to avoid unfavorable outcomes related to COC use in women with PCOS.