Oral contraceptives in polycystic ovary syndrome: Risk-benefit assessment

Yildiz B. O.

SEMINARS IN REPRODUCTIVE MEDICINE, cilt.26, sa.1, ss.111-120, 2008 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 26 Sayı: 1
  • Basım Tarihi: 2008
  • Doi Numarası: 10.1055/s-2007-992931
  • Dergi Adı: SEMINARS IN REPRODUCTIVE MEDICINE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.111-120
  • Anahtar Kelimeler: androgen excess, metabolic risk, insulin, thrombosis, oral contraceptive, cyproterone acetate, drospirenone, dienogest, ESTRADIOL-CYPROTERONE ACETATE, IMPAIRED GLUCOSE-TOLERANCE, TYPE-2 DIABETES-MELLITUS, INSULIN-RESISTANCE, ETHINYL-ESTRADIOL, CARDIOVASCULAR-DISEASE, NONOBESE WOMEN, MYOCARDIAL-INFARCTION, METABOLIC SYNDROME, YOUNG-WOMEN
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Combined oral contraceptive pills (OCPs) have been a key component of the chronic treatment of polycystic ovary syndrome (PCOS) by improving androgen excess and regulating menstrual cycles. Earlier epidemiologic studies with second- and third-generation OCPs in the general population have raised important questions regarding long-term cardiometabolic effects of these agents. In PCOS, there are only a few short-term studies with contradictory results evaluating potential adverse effects of OCPs on cardiovascular risk factors and glucose homeostasis. These studies included a small number of participants and did not take into account several confounding factors that might influence the outcome. Nevertheless, limited available data support the benefits of long-term OCP use in PCOS. By contrast, solid evidence for cardiometabolic adverse outcome with the use of these agents, especially with newer OCPs containing antiandrogenic progestins, is lacking. More studies are needed to resolve controversies regarding the safety of long-term OCP use in PCOS. Meanwhile, assessment of each PCOS patient's personal cardiometabolic risk profile should be an essential component of the evaluation before prescribing OCPs and also during follow-up.