Comparative efficacy of statins, metformin, spironolactone and combined oral contraceptives in reducing testosterone levels in women with polycystic ovary syndrome: a network meta-analysis of randomized clinical trials

Almalki, Hussain H.; Alshibani, Turki M.; Alhifany, Abdullah A.; Almohammed, Omar A.

doi:10.1186/s12905-020-00919-5

Cited by 16 publications

(20 citation statements)

References 17 publications

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“…In this meta-analysis, we only found a higher level of testosterone in MetS women. High testosterone level has been reported in association with female infertility [ 39 ]. Due to the lack of relevant studies, we failed to investigate the impact of MetS on female reproductive cells.…”

Section: Discussionmentioning

confidence: 99%

Impact of metabolic syndrome on sex hormones and reproductive function: a meta-analysis of 2923 cases and 14062 controls

Zhou

Han

Liu

et al. 2020

Aging

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Current evidence is inconsistent regarding the impact of metabolic syndrome (MetS) on sex hormones and reproductive function, and this meta-analysis aimed to illuminate the association. A literature search was conducted in public databases to identify all relevant studies, and study-specific standardized mean differences (SMD) and 95% confidence intervals (CI) were pooled using a random-effects model. Finally, 21 studies were identified with a total of 2923 MetS cases and 14062 controls. In males, MetS cases had a lower level of testosterone, inhibin B, total sperm count, sperm concentration, sperm normal morphology, sperm total motility, sperm progressive motility and sperm vitality, and a higher level of DNA fragmentation and mitochondrial membrane potential. In females, MetS cases had a higher level of testosterone. No significant difference was detected for follicle-stimulating hormone, luteinizing hormone, oestradiol, prolactin, anti-Müllerian hormone and semen volume in males, and for oestradiol, follicle-stimulating hormone, luteinizing hormone and progesterone in females. In conclusion, this meta-analysis indicated the impact of MetS on sex hormones and reproductive function, and MetS cases had a potential risk of infertility.

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Section: Discussionmentioning

confidence: 99%

Impact of metabolic syndrome on sex hormones and reproductive function: a meta-analysis of 2923 cases and 14062 controls

Zhou

Han

Liu

et al. 2020

Aging

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“…showed a superiority of atorvastatin compared with all other treatments (simvastatin, spironolactone, oral contraceptives and metformin) to reduce total testosterone levels in patients with PCOS. 244…”

Section: Oral Contraceptive Pillsmentioning

confidence: 99%

Assessment of Early Markers of Cardiovascular Risk in Polycystic Ovary Syndrome

Alexandraki¹,

Kandaraki²,

Poulia³

et al. 2021

touchREVIEWS in Endocrinology

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“…These agents have been proposed as a therapeutic option for reducing testosterone levels, either alone or in combination. Compared with other therapeutic strategies, atorvastatin showed greater reduction in testosterone levels in a recent metanalysis [ 179 ]. In addition, statins improve lipid profiles and ameliorate inflammatory reactions [ 180 ].…”

Section: Statinsmentioning

confidence: 99%

Pharmacological Approaches to Controlling Cardiometabolic Risk in Women with PCOS

Cignarella

Mioni

Sabbadin

et al. 2020

IJMS

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Polycystic ovary syndrome (PCOS) is characterized by elevated androgen production and subclinical changes in cardiovascular and metabolic risk markers. Total cholesterol, high-density lipoprotein (HDL) cholesterol, fasting glucose, and fasting insulin appear to increase specifically in PCOS compared with fertile women. PCOS also confers an increased risk of cardiometabolic disease in later life. Novel biomarkers such as serum’s cholesterol efflux capacity and blood-derived macrophage activation profile may assist in more accurately defining the cardiometabolic risk profile in these women. Aldosterone antagonists, androgen receptor antagonists, 5α-reductase inhibitors, and synthetic progestogens are used to reduce hyperandrogenism. Because increased insulin secretion enhances ovarian androgen production, short-term treatment with metformin and other hypoglycemic agents results in significant weight loss, favorable metabolic changes, and testosterone reduction. The naturally occurring inositols display insulin-sensitizing effects and may be also used in this context because of their safety profile. Combined oral contraceptives represent the drug of choice for correction of androgen-related symptoms. Overall, PCOS management remains focused on specific targets including assessment and treatment of cardiometabolic risk, according to disease phenotypes. While new options are adding to established therapeutic approaches, a sometimes difficult balance between efficacy and safety of available medications has to be found in individual women.

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Comparative efficacy of statins, metformin, spironolactone and combined oral contraceptives in reducing testosterone levels in women with polycystic ovary syndrome: a network meta-analysis of randomized clinical trials

Cited by 16 publications

References 17 publications

Impact of metabolic syndrome on sex hormones and reproductive function: a meta-analysis of 2923 cases and 14062 controls

Impact of metabolic syndrome on sex hormones and reproductive function: a meta-analysis of 2923 cases and 14062 controls

Assessment of Early Markers of Cardiovascular Risk in Polycystic Ovary Syndrome

Pharmacological Approaches to Controlling Cardiometabolic Risk in Women with PCOS

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