Effects of combined oral contraceptives on the clinical and biochemical parameters of hyperandrogenism in patients with polycystic ovary syndrome: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of clinical trials
PubMed 29457756 · doi:10.1080/13625187.2018.1435779
What was done
Authors conducted a systematic review and meta-analysis searching electronic databases (PubMed, Scopus, ScienceDirect, and Web of Science) from 1987 to November 2015. They included clinical trials evaluating the effects of various combined oral contraceptives (COCs) on clinical and biochemical parameters of hyperandrogenism in patients with polycystic ovary syndrome (PCOS), analyzing data with fixed- and random-effects models, subgroup analyses, and meta-regression.
What was found
The abstract reports directions of effect without quantitative effect sizes, confidence intervals, or p-values. COC use for 3 to 12 months was significantly associated with an increase in sex hormone-binding globulin (SHBG) and reductions in Ferriman-Gallwey hirsutism scores, total testosterone, free testosterone, androstenedione, and DHEAS. The type of progestin and duration of treatment had no meaningful impact on biochemical androgen declines. Long-term COC use (6 to 12 months) improved hirsutism more than short-term use, and COCs containing cyproterone acetate for 12 months demonstrated the strongest effect on hirsutism.
Why it matters
This synthesis suggests that while diverse oral contraceptive formulations confer similar biochemical androgen suppression in PCOS, improving clinical hirsutism requires longer treatment durations (6 to 12 months) and may favor cyproterone acetate-containing regimens.
Limits
The abstract provides no numerical estimates, confidence intervals, or total counts for included studies and participants. It does not assess the methodological quality or risk of bias of the included trials, nor does it address safety outcomes or adverse metabolic effects.