Effect of 12-month treatment with metformin and/or oral contraceptives on health-related quality of life in polycystic ovary syndrome

Abstract

Health-related quality of life (HRQoL) is impaired in polycystic ovary syndrome (PCOS), but the effect of treatment with metformin (M) and/or oral contraceptives (OCP) is undetermined. To assess changes in HRQoL during 12-month randomized treatment with M, OCP or M + OCP in PCOS. Ninety women with PCOS were randomized to treatment with M, OCP or M + OCP. HRQoL was evaluated by a PCOS-specific visual analog scale (PCOS-VAS) regarding 1: Facial hair, 2: Body hair, 3: Acne, 4: Irregular menses, 5: Weight and 6: PCOS in general, and Short Form 36 (SF-36). PCOS-VAS1(facial hair) improved during treatment with OCP (n = 23) compared to M (n = 19), and during M + OCP (n = 23) compared to M treatment, whereas changes in PCOS-VAS2-6 and SF-36 scores were comparable between the three medical intervention groups. Pooled data (n = 65) showed improved PCOS-VAS scores during treatment (all p < .05), but changes in PCOS-VAS were unassociated with changes in BMI or FG-scores despite significant weight-loss during treatment with M (-3.0 kg (-10.3; 0.6)) and M + OCP (-1.9 kg (-4.9; 0.1)) and decreased FG-score during M + OCP treatment (median (quartiles)). PCOS-VAS scores improved significantly and to the same extent during treatment with M, OCP or M + OCP.

Effects of oral contraceptives on the quality of life of women with polycystic ovary syndrome: a crossover randomized controlled trial

“…The carry-over effect was not significant for most outcomes assessed, except for self-image domain at the end of 3 months of therapy (Tables 2-3). [10,26,27], the effect of OCs on psychological health and QOL of PCOS has been investigated only in a limited number of previous studies [11][12][13][14]. Available data showed that treatment with OC was associated with a significant improvement in the QOL in a 16-week randomized controlled trial (RCT) [12], a 12-month RCT [11], and a 6-month observational trial [13].…”

“…Previous studies have been suggested that the management of PCOS can improve both physical and psycho-emotional aspects of QOL [9,11,12]. To assess the effects of OCs on QOL domains, we used a specific questionnaire with a multi-dimensional concept, which was developed for examining the impact of PCOS or its treatment on psychosocial-emotional, self-image, fertility, sexual function, hirsutism, and obesity-menstrual disorders.…”

“…According to the American Association of Clinical Endocrinologists, the American College of Endocrinology, and the Androgen Excess and PCOS Society recommendations for evaluation and treatment of PCOS patients, all women with PCOS should be screened for anxiety and depressive disorders during the initial examination and its use at further stages of treatment and after it [32]. One large prospective study evaluated the effect of using OCs for 6 months on emotional distress, anxiety, and depression in PCOS patients and showed that the level of depression remained unchanged [13], whereas one RCT showed significant improvements in the mental domain of QOL after 12 months of OC therapy with and without metformin treatment [11]. However, these two studies have been assessed the effects of OCs, regardless of progestin type.…”

Effects of oral contraceptives on the quality of life of women with polycystic ovary syndrome: a crossover randomized controlled trial

“…According to the recent International Evidencebased Guidelines for the Assessment and Management of PCOS, all women with PCOS should be screened and monitored for QOL status to prevent, identify, and manage their health concerns. While these guidelines recommended that improving the QOL of the patients should consider as an important goal of treatment [11,35,36], the effect of OCs on psychological health and QOL of PCOS has been investigated only in a limited number of previous studies [12][13][14][15]. Available data showed that treatment with OC was associated with a signi cant improvement in the QOL in a 16-week randomized controlled trial (RCT) [13], a 12-month RCT [12], and a 6-month observational trial [14].…”

“…Despite numerous studies on the association between PCOS and QOL [6][7][8][9][10], a limited number of studies have evaluated the effects of OCs on the QOL of PCOS patients [11][12][13][14]. Besides, to the best our knowledge, there is no study comparing the effectiveness of these pharmacological treatments on the QOL of patients based on their progestin component.…”