Influence of oral contraceptives on anthropomorphometric endocrine and metabolic profiles of anovulatory polycystic ovary syndrome patients

Capsule:
Oral contraceptive pill use is associated with a higher risk of future endometriosis diagnosis in nulliparous women but a lower risk among parous women.

Authors:
Miranda G. Mes-Krowinkel, M.D., Yvonne V. Louwers, Ph.D., Annemarie G.M.G.J. Mulders, Ph.D., Frank H. de Jong, M.D., Ph.D., Bart C.J.M. Fauser, M.D., Ph.D., Joop S.E. Laven, M.D., Ph.D.

Volume 101, Issue 6, Pages 1757–1765.e1

Abstract:

Objective:
To evaluate the influence of oral contraceptive pills (OCPs) on anthromorphometric, endocrine, and metabolic parameters in women with polycystic ovary syndrome (PCOS).

Design:
Retrospective cross-sectional cohort study for the period 1993–2011.

Setting:
Tertiary university hospital.

Patient(s):
PCOS patients, who never, ever, or at time of screening were using OCPs were included. A total of 1,297 patients, of whom 827 were white, were included. All PCOS patients diagnosed according to the Rotterdam 2003 consensus criteria were divided into three groups: current users, (n = 76; 6% of total), ever users (n = 1,018; 78%), and never users (n = 203; 16%). Ever users were subdivided based on the OCP-free interval.

Intervention(s):
None.

Main Outcome Measure(s):
Anthromorphometric (blood pressure, cycle duration) and ultrasound (follicle count, mean ovarian volume) parameters, endocrine (SHBG, testosterone, free androgen index, antimüllerian hormone [AMH]) and lipid profiles.

Result(s):
Current users and ever users were compared with never users. In current users, SHBG was increased and androgen levels decreased. Patients with an OCP-free interval of <1 year had a higher mean follicle count, higher AMH level, and increased serum androgen level compared with never users. SHBG levels remained increased until 5–10 years after cessation of OCP use. Conclusion(s):
OCP use causes a milder phenotypic presentation of PCOS regarding hyperandrogenism. However, it does not alter parameters associated with increased health risks.

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