Effect of Diane-35, alone or in combination with orlistat or metformin in Chinese polycystic ovary syndrome patients

Ruan, Xiangyan; Jing-hua, Song; Gu, Muqing; Wang, Limin; Wang, Husheng; Mueck, Alfred O.

doi:10.1007/s00404-018-4762-0

Cited by 27 publications

(20 citation statements)

References 19 publications

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“…Adjustments in lifestyle, as the first-line treatment, include dieting, exercise, or weight loss, followed by drug treatment, which needs to be individualized. Clomiphene and letrozole can be chosen to induce ovulation, metformin to improve IR, and oral contraceptives and spironolactone to reduce androgen levels (11,18,21,34,35). In addition, there are also studies suggesting that sex hormone binding globulins (SHBGs) can serve as indicators and therapeutic targets for hyperandrogenism in patients with PCOS (36,37).…”

Section: The Core Mechanism Of Pcos Is Related To the Abnormal Hpo Axismentioning

confidence: 99%

Research Progress on the Effect of Epilepsy and Antiseizure Medications on PCOS Through HPO Axis

Zhang

Wei

et al. 2021

Front. Endocrinol.

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Epilepsy is a common chronic neurological disease that manifests as recurrent seizures. The incidence and prevalence of epilepsy in women are slightly lower than those in men. Polycystic ovary syndrome (PCOS), a reproductive endocrine system disease, is a complication that women with epilepsy are susceptible to, and its total prevalence is 8%–13% in the female population and sometimes as high as 26% in female epilepsy patients. The rate of PCOS increased markedly in female patients who chose valproate (VPA), to 1.95 times higher than that of other drugs. In addition, patients receiving other anti-seizure medications (ASMs), such as lamotrigine (LTG), oxcarbazepine (OXC), and carbamazepine (CBZ), also have reproductive endocrine abnormalities. Some scholars believe that the increase in incidence is related not only to epilepsy itself but also to ASMs. Epileptiform discharges can affect the activity of the pulse generator and then interfere with the reproductive endocrine system by breaking the balance of the hypothalamic–pituitary–ovarian (HPO) axis. ASMs may also cause PCOS-like disorders of the reproductive endocrine system through the HPO axis. Moreover, other factors such as hormone metabolism and related signalling pathways also play a role in it.

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Section: The Core Mechanism Of Pcos Is Related To the Abnormal Hpo Axismentioning

confidence: 99%

Research Progress on the Effect of Epilepsy and Antiseizure Medications on PCOS Through HPO Axis

Zhang

Wei

et al. 2021

Front. Endocrinol.

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“…Thus obesity, which is very frequent in women with PCOS, may be a common etiological factor for decreased sexual function [ 49 , 50 ]. As a consequence, in our clinical practice, we try to treat obesity, especially in women with PCOS who wish for conceive, asking the women to undergo a standardized diet and exercise program and possible also prescribing drugs for the treatment of obesity [ 51 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

Sexual Function in Chinese Women with Polycystic Ovary Syndrome and Correlation with Clinical and Biochemical Characteristics

Tian

Ruan

et al. 2021

Reprod. Sci.

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To investigate sexual function in Chinese women with polycystic ovary syndrome (PCOS) and to explore the correlation with clinical and biochemical characteristics. A cross-sectional study was designed in 1000 PCOS women, aged 18–45 years, via the Chinese version of Female Sexual Function Index (FSFI) evaluating sexual function, with additional questions possibly related to sexual life. Clinical and biochemical characteristics likely to affect sexual function were determined, including anthropometric indicators, serum levels of hormones, luteinizing hormone to follicle-stimulating hormone ratio (LH/FSH ratio), prolactin (PRL), total testosterone (TT), free androgen index (FAI), sex-hormone-binding globulin (SHBG), glucose, and lipid metabolism indicators. Nine hundred ten PCOS women participated in the study, 685 patients were included after screening, and 211 were suitable to detect correlations of clinical and biochemical characteristics with sex function parameters. The mean total FSFI score was 24.19 ± 2.8; 79.56% of the women were at risk of female sexual dysfunction (FSD). Women doing regular aerobic exercise and use of contraception had higher FSFI scores, while those with a desire to conceive and clinical signs of hyperandrogenism had lower FSFI scores. There were negative associations of FSFI scores with age and body fat distribution. No significant associations between FSFI scores and hormonal factors (surprisingly including SHBG) were found, except for total testosterone and satisfaction (OR = 0.976, p = 0.002). HOMA-IR was significantly related to reduced desire score (OR = 0.914, p = 0.004) and lubrication score (OR = 0.964, p = 0.044). PCOS was associated with a high risk of FSD (defined according to FSFI) in about 80% of the women in our study, and clinical characteristics play a more important role.

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“…There has been extensive prior research on the metabolic and weight effects of metformin in PCOS, with conflicting results secondary to varied inclusion criteria and dosing, although as above, meta-analysis is favorable for weight loss in adolescents [40]. Newer data are from studies that included a metformin arm compared to another medication, which show minimal weight loss when added to a COCP [41], or increased weight loss in women with PCOS and obesity who received 1500 mg/day metformin for 6 months (average weight loss of −6.81 (−7.51 to −6.10) kg) [4]. A retrospective study that included ten adolescents with PCOS <18 years found that among the entire cohort, those treated with metformin (850 mg/day) had a 12% prevalence of obesity, compared to 50% of non-treated PCOS and 27% of individuals treated with COCP, although due to the nature of the study design, these should be interpreted with caution [42].…”

Section: Metforminmentioning

confidence: 99%

“…Previous data on orlistat suggest a variable, but significant, BMI reduction in women with PCOS (−0.7 to −8.1%), and head-to-head comparisons of orlistat versus metformin on weight/BMI are mixed [51,52]. In one of the largest RCTs of orlistat in PCOS to date, Ruan et al randomized 240 women in China with overweight/obesity and PCOS open-label to 12 weeks of ethinyl estradiol/cyproterone acetate alone or combined with orlistat, metformin, or orlistat+metformin [41]. Both groups receiving orlistat demonstrated significant reductions in weight, BMI, and systolic blood pressure.…”

Section: Anti-obesity Medicationsmentioning

confidence: 99%

Weight Management in Adolescents with Polycystic Ovary Syndrome

Waldrop

Cree-Green

2021

Curr Obes Rep

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Purpose of Review Polycystic ovary syndrome (PCOS) is a common condition that clinically presents during adolescence. PCOS is associated with increased rates of overweight and obesity, as well as higher rates of metabolic disease, especially type 2 diabetes. Weight loss decreases PCOS symptoms and risk for metabolic disease. The goal of this review is to evaluate recent studies describing the hormonal, metabolic, and weight effects of different weight loss strategies: dietary, physical activity, pharmacotherapy, bariatric surgery, mood modification, and sleep. Recent Findings Calorie restriction continues to be supported as the primary nutrition intervention to achieve weight loss in individuals with PCOS, and a dietary macronutrient composition with lower compared to higher glycemic carbohydrates may be more effective. There is limited data that vitamins, nutraceuticals, and probiotics may improve hormonal and metabolic outcomes. Most types of physical activity are effective in improving outcomes in PCOS and lowering weight. Whereas there are promising data on anti-obesity medications such as glucagon-like peptide-1 receptor agonists in adults with PCOS and adolescents with obesity, further work is needed to know if these therapies are effective in youth with PCOS. Research is lacking on the effectiveness of other anti-obesity medications in PCOS. Bariatric surgery is especially promising for decreasing weight in adults and youth, and reversing type 2 diabetes in youth, though PCOS data are lacking. Treatment of depression in adolescents with insulin resistance and women with PCOS is associated with improved weight loss. Adolescents with PCOS and obesity may have greater sleep-related risks including circadian misalignment and obstructive sleep apnea, interventions for which have not yet been conducted. Summary Clinical trials on weight loss strategies in adolescents with PCOS remain limited, with most information inferred from studies in women with PCOS or adolescents with obesity. However, there are multiple options to optimize weight loss in dietary, activity, pharmacotherapy, bariatric surgery, mood modification, and sleep domains.

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Effect of Diane-35, alone or in combination with orlistat or metformin in Chinese polycystic ovary syndrome patients

Abstract: Diane-35 in combination with orlistat or metformin is more effective in reducing androgen than Diane-35 alone. Orlistat is more effective in reducing body fat percentage than metformin. In addition, orlistat has mild side-effects and is better tolerated compared with metformin.

Cited by 27 publications

References 19 publications

Research Progress on the Effect of Epilepsy and Antiseizure Medications on PCOS Through HPO Axis

Research Progress on the Effect of Epilepsy and Antiseizure Medications on PCOS Through HPO Axis

Sexual Function in Chinese Women with Polycystic Ovary Syndrome and Correlation with Clinical and Biochemical Characteristics

Weight Management in Adolescents with Polycystic Ovary Syndrome

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