Cited by 115Ovarian function and disordersEndometriosis Research and TreatmentReproductive Health and Contraception

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Adverse Effects of the Common Treatments for Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

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Domecq, Juan Pablo, Prutsky, Gabriela, Mullan, Rebecca J., Sundaresh, Vishnu, Wang, Amy T., Erwin, Patricia J., Welt, Corrine, Ehrmann, David, Montori, Victor M., Murad, Mohammad Hassan·2013·The Journal of Clinical Endocrinology & Metabolism

DOI 10.1210/jc.2013-2374PMC PMC5399491

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Abstract

CONTEXT: Polycystic ovary syndrome (PCOS) is common among women of childbearing age and the available pharmacological therapies have different side-effect profiles. OBJECTIVE: We summarized the evidence about the side effects of oral contraceptive pills, metformin, and anti-androgens in women with PCOS. DATA SOURCE: Sources included Ovid Medline, OVID EMBASE, OVID Cochrane Library, Web of Science, Scopus, PsycInfo, and CINAHL from inception through April 2011. STUDY SELECTION: We included comparative observational studies enrolling women with PCOS who received the agents of choice for at least 6 months and reported adverse effects. DATA EXTRACTION: Using a standardized, piloted, and Web-based data extraction form and working in duplicate, we abstracted data from each study and performed meta-analysis when possible. DATA SYNTHESIS: We found 22 eligible studies of which 20 were randomized. No study reported severe side effects (eg, lactic acidosis, thromboembolic episodes, liver toxicity, cancer incidence, or pregnancy loss). Meta-analysis demonstrated no significant change in weight in oral contraceptive pills or flutamide users. Indirect evidence from populations without PCOS demonstrated no increased risk of lactic acidosis with metformin, only case reports of liver toxicity with flutamide (no comparative evidence), and increased relative risk difference of venous thromboembolism with oral contraceptive pills but very low absolute risk. Evidence on mortality, cardiovascular mortality, and cancer was inconclusive. CONCLUSIONS: Drugs commonly used to treat PCOS appear to be associated with very low risk of severe adverse effects although data are extrapolated from other populations.

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Authors: Domecq, J. P., Prutsky, G., Mullan, R. J., Sundaresh, V., Wang, A. T., Erwin, P. J., Welt, C., Ehrmann, D., Montori, V. M., & Murad, M. H.
Affiliations: Mayo Clinic (US)
University of Minnesota (US)
Massachusetts General Hospital (US)
University of Chicago (US)
Corresponding author: Murad, Mohammad Hassan
ORCID: Domecq, Juan Pablo
Sundaresh, Vishnu
Wang, Amy T.
Welt, Corrine
Murad, Mohammad Hassan
Venue: The Journal of Clinical Endocrinology & Metabolism
Publisher: The Endocrine Society
Published: 2013-12
Volume: 98
Issue: 12
Pages: 4646-4654
ISSN: 0021-972X (ISSN-L)
1945-7197
DOI: 10.1210/jc.2013-2374
PMC: PMC5399491
OpenAlex: W1979724250
Cited by: 115
References: 71
Citations by year: 2026: 14 · 2025: 9 · 2024: 9 · 2023: 10 · 2022: 14 · 2021: 2 · 2020: 7 · 2019: 6 · 2018: 5 · 2017: 8 · 2016: 11 · 2015: 10 · 2014: 8 · 2013: 2
FWCI: 12.48
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD065029)
Topics: Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
Keywords: polycystic ovary syndrome, adverse drug reactions, oral contraceptives, metformin, androgen receptor antagonists, flutamide, lactic acidosis, venous thromboembolism, hepatotoxicity, weight change, cardiovascular mortality, cancer risk
MeSH terms: Androgen Antagonists, Contraceptives, Oral, Female, Flutamide, Humans, Hypoglycemic Agents, Metformin, Polycystic Ovary Syndrome, Risk Factors, Evidence-Based Medicine, Venous Thromboembolism

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Adverse Effects of the Common Treatments for Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

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