scholarly journals Combined oral contraceptives in the treatment of polycystic ovary syndrome

2005 ◽  
Vol 11 (3) ◽  
pp. 277-291 ◽  
Author(s):  
J. Vrbíková ◽  
D. Cibula
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Oral Contraceptives ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Combined Oral Contraceptives

scholarly journals Polycystic Ovary Syndrome, Combined Oral Contraceptives, and the Risk of Dysglycemia: A Population-Based Cohort Study With a Nested Pharmacoepidemiological Case-Control Study

2021 ◽  
Author(s):  
Balachandran Kumarendran ◽  
Michael W O'Reilly ◽  
Anuradhaa Subramanian ◽  
Dana Šumilo ◽  
Konstantinos Toulis ◽  
...  
Keyword(s):  
Cohort Study ◽  
Polycystic Ovary Syndrome ◽  
Oral Contraceptives ◽  
Case Control Study ◽  
Polycystic Ovary ◽  
Population Based ◽  
Case Control ◽  
Ovary Syndrome ◽  
Combined Oral Contraceptives ◽  
Control Study

<b>Objectives: </b>Irregular menstrual cycles are associated with increased cardiovascular mortality. Polycystic ovary syndrome (PCOS) is characterized by androgen excess and irregular menses; androgens are drivers of increased metabolic risk in women with PCOS. Combined oral contraceptives (COCPs) are used in PCOS both for cycle regulation and to reduce the biologically active androgen fraction. We examined COCP use and risk of dysglycemia (pre-diabetes and type 2 diabetes) in women with PCOS. <p><b>Research Design and Methods: </b>Utilizing a large UK primary care database (The Health Improvement Network, THIN; 3.7 million patients from 787 practices), we carried out a retrospective population-based cohort study to determine dysglycemia risk (64,051 women with PCOS, 123,545 matched controls), as well as a nested pharmaco-epidemiological case-control study to investigate COCP use in relation to dysglycemia risk (2407 women with PCOS with [=cases] and without [=controls] a diagnosis of dysglycemia during follow-up).<b> </b>Cox models were used to estimate the unadjusted and adjusted hazard ratio and conditional logistic regression was used to obtain adjusted odds ratios (aORs). </p> <p><b>Results: </b>The adjusted hazard ratio for dysglycemia in women with PCOS was 1.87 (95% CI 1.78-1.97, p<0.001; adjustment for age, social deprivation, BMI, ethnicity, and smoking), with increased rates of dysglycemia in all BMI subgroups. Women with PCOS and COCP use had a reduced dysglycemia risk (aOR 0.72, 95% CI 0.59 to 0.87).</p> <p><b>Conclusions: </b>In this study limited by its retrospective nature and the use of routinely collected electronic general practice record data, which does not allow to exclude the impact of prescription-by-indication bias, women<b> </b>with PCOS exposed to COCPs had a reduced risk of dysglycemia across all BMI subgroups. Future prospective studies should be considered to further understand these observations and potential causality. </p>

Effects of two forms of combined oral contraceptives on carbohydrate metabolism in adolescents with polycystic ovary syndrome

2006 ◽  
Vol 85 (2) ◽  
pp. 420-427 ◽  
Author(s):  
George Mastorakos ◽  
Carolina Koliopoulos ◽  
Efthymios Deligeoroglou ◽  
Evanthia Diamanti-Kandarakis ◽  
George Creatsas
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Carbohydrate Metabolism ◽  
Oral Contraceptives ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Combined Oral Contraceptives

scholarly journals Polycystic Ovary Syndrome, Combined Oral Contraceptives, and the Risk of Dysglycemia: A Population-Based Cohort Study With a Nested Pharmacoepidemiological Case-Control Study

2021 ◽  
Author(s):  
Balachandran Kumarendran ◽  
Michael W O'Reilly ◽  
Anuradhaa Subramanian ◽  
Dana Šumilo ◽  
Konstantinos Toulis ◽  
...  
Keyword(s):  
Cohort Study ◽  
Polycystic Ovary Syndrome ◽  
Oral Contraceptives ◽  
Case Control Study ◽  
Polycystic Ovary ◽  
Population Based ◽  
Case Control ◽  
Ovary Syndrome ◽  
Combined Oral Contraceptives ◽  
Control Study

<b>Objectives: </b>Irregular menstrual cycles are associated with increased cardiovascular mortality. Polycystic ovary syndrome (PCOS) is characterized by androgen excess and irregular menses; androgens are drivers of increased metabolic risk in women with PCOS. Combined oral contraceptives (COCPs) are used in PCOS both for cycle regulation and to reduce the biologically active androgen fraction. We examined COCP use and risk of dysglycemia (pre-diabetes and type 2 diabetes) in women with PCOS. <p><b>Research Design and Methods: </b>Utilizing a large UK primary care database (The Health Improvement Network, THIN; 3.7 million patients from 787 practices), we carried out a retrospective population-based cohort study to determine dysglycemia risk (64,051 women with PCOS, 123,545 matched controls), as well as a nested pharmaco-epidemiological case-control study to investigate COCP use in relation to dysglycemia risk (2407 women with PCOS with [=cases] and without [=controls] a diagnosis of dysglycemia during follow-up).<b> </b>Cox models were used to estimate the unadjusted and adjusted hazard ratio and conditional logistic regression was used to obtain adjusted odds ratios (aORs). </p> <p><b>Results: </b>The adjusted hazard ratio for dysglycemia in women with PCOS was 1.87 (95% CI 1.78-1.97, p<0.001; adjustment for age, social deprivation, BMI, ethnicity, and smoking), with increased rates of dysglycemia in all BMI subgroups. Women with PCOS and COCP use had a reduced dysglycemia risk (aOR 0.72, 95% CI 0.59 to 0.87).</p> <p><b>Conclusions: </b>In this study limited by its retrospective nature and the use of routinely collected electronic general practice record data, which does not allow to exclude the impact of prescription-by-indication bias, women<b> </b>with PCOS exposed to COCPs had a reduced risk of dysglycemia across all BMI subgroups. Future prospective studies should be considered to further understand these observations and potential causality. </p>

Diagnosis and management of patients with hyperandrogenism in early reproductive age

2021 ◽  
Vol 20 (5) ◽  
pp. 124-130
Author(s):  
E.P. Khashchenko ◽  
◽  
O.I. .Lisitsyna ◽  
E.V. Uvarova ◽  
◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Congenital Adrenal Hyperplasia ◽  
Oral Contraceptives ◽  
Clinical Symptoms ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Adrenal Hyperplasia ◽  
Ovary Syndrome ◽  
Combined Oral Contraceptives ◽  
Diagnosis And Management

Hyperandrogenism is characterized by the presence of clinical symptoms and / or biochemical parameters of high androgen levels. Dermopathy and particularly acne and hirsutism are regarded as the main clinical markers of hyperandrogenism. Cosmetic problems associated with hyperandrogenism are often the reason for young woman to seek medical attention. Body hair growth in atypical areas, acne and trophic skin changes have a significant effect on the emotional state, provoke a sense of imperfection and loss of attractiveness, and reduce the quality of life. Concomitant menstrual disorders (up to 50–75%) complicate the patient’s state and determine an increased risk of gynecological disorders in the future. The causes of hyperandrogenism in early reproductive age can be varied: from more common physiological hyperandrogenism in adolescence, idiopathic hyperandrogenism, polycystic ovary syndrome (PCOS) and the atypical form of congenital adrenal hyperplasia to less common hyperthecosis, acromegaly, hyperprolactinemia, hypothyroidism, Cushing’s disease, and androgen-secreting tumors. The diagnostic search should begin with assessing complaints and clinical symptoms, and a complete physical examination. To confirm biochemical hyperandrogenism, total and free testosterone, and free androgen index are evaluated. Additional methods of examination are used to clarify the diagnosis. Treatment is prescribed in accordance with the established diagnosis. Androgen-secreting tumors require surgical intervention. Other causes of hyperandrogenism are usually treated with medication. According to current recommendations, combined oral contraceptives are the first-line therapy for the most common conditions accompanied by hyperandrogenism (hirsutism, acne vulgaris, PCOS) in early reproductive age. A clinical solution may be a combined administration of microdoses of ethinylestradiol (20 μg) and drospirenone (3 mg), progestagen with antiandrogenic property in the mode 24 + 4 (for instance: Dimia). This article presents clinical cases of diagnosis and management tactics for patients of early reproductive age with hyperandrogenism. Conclusion. The differential diagnosis of physiological and pathological conditions accompanied by hyperandrogenism is one of the current challenges for obstetrician-gynecologist. A properly developed algorithm of examination, interpretation of its results, therapy and prevention of complications are of great importance. Key words: acne, alopecia acreata, congenital adrenal hyperplasia, hyperandrogenism, hirsutism, girls, drospirenone, combined oral contraceptives, contraception, adolescents, early reproductive age, polycystic ovary syndrome, ethinylestradiol

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