Consensus statement on the use of oral contraceptive pills in polycystic ovarian syndrome women in India

Abstract

Objective:To provide consensus recommendations for health-care providers on the use of oral contraceptive pills (OCPs) in polycystic ovarian syndrome (PCOS) women in India.Participants:Extensive deliberations, discussions, and brainstorming were done with different fraternities (specialists) being involved. These included endocrinologists, gynecologists, reproductive endocrinologists, dermatologists, public health experts, researchers, and a project manager with a team to develop the guideline.Evidence:Published literature was retrieved through searches of Medline and The Cochrane Database from January 2003 to December 2017 using appropriate-controlled vocabulary (e.g., oral contraceptive pills, polycystic ovarian syndrome, long term outcomes, infertility). Clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies' publications and data were also reviewed to suggest the recommendations.Process:The working group for guideline committee included members from the PCOS Society (India), Indian Society for Assisted Reproduction, The Mumbai Obstetric and Gynecological Society, The Endocrine Society of India, Indian Association of Dermatologists, Venereologists and Leprologists, Cosmetic Dermatology Society (India), Academicians from Medical Colleges, National Institute for Research in Reproductive Health, and a Research Associate. The core team included five reproductive endocrinologists, five gynecologists, five dermatologists, three endocrinologists, two public health experts and one research associate.Conclusions:This consensus statement provides the guidance/recommendations for Indian practitioners regarding the use of OCP in women with PCOS. PCOS is one of the common endocrinopathies encountered in gynecological/endocrine practice. The spectrum of this disorder may range from prepubertal girls with premature pubarche, young girls with hirsutism, acne and anovulatory cycles, married women with infertility, and elderly women. Although obesity is a common feature for most PCOS patients, 'lean PCOS' also exists. For several years, OCPs have played an important role in the symptom management of PCOS women. This is due to the fact that OCPs decrease the luteinizing hormone, reduce androgen production, and increase sex hormone-binding globulin, which binds androgens. Several new formulations of OCPs have been developed to decrease the side effects. This includes use of less androgenic progestins and lower doses of ethinyl estradiol. These consensus recommendations help the health provider to choose the right type of OCPs, which will alleviate the symptoms with least side effects. It also gives insight into the indications, contraindications, and concerns regarding its short, intermediate and long-term use.

Knowledge, attitude, and perceptions about polycystic ovarian syndrome, and its determinants among Pakistani undergraduate students

“…It was revealed in the regression analysis that participants who used contraceptives were 4 times more likely to have PCOS. It is worthwhile mentioning that contraceptives are also used to treat hirsutism [ 34 , 35 ], apart from their use in treatment of PCOS [ 35 ]. This finding may have resulted either due to treatment of hirsutism since three quarter of our sample had some level of hirsutism and/or, as a treatment of PCOS.…”

Oncology and Pharmacogenomics Insights in Polycystic Ovary Syndrome: An Integrative Analysis

“…Progestogen suppresses LH secretion and restrains androgen production by ovarian and adrenal glands. It also competes with androgen receptor and prevents subsequent androgen actions ( 89 , 100 ). After 6 months of OCP treatment, testosterone, glucose, and LH levels were reduced, and hirsutism improvements were seen.…”

Combined oral contraceptive use and adiposity in women with polycystic ovary syndrome. A meta-analysis of randomized clinical trials

“…Overall, these data indicated that patients with PCOS could be linked to the future development of cardiovascular disease (CVD) and venous thromboembolism [5][6][7][8]. Combined oral contraceptives (COCs) have been considered the rst-line therapy for PCOS women with menstrual irregularity and clinical and/or biochemical hyperandrogenism who do not wish to become pregnant [9][10][11]. However, some deleterious metabolic and in ammatory effects have been demonstrated with the association between PCOS and COC use [12][13][14][15].…”