title: Statins for women with polycystic ovary syndrome not actively trying to conceive.
abstract: BACKGROUND
  Statins, as lipid-lowering agents with pleiotropic actions, are likely not only to improve the dyslipidaemia associated with polycystic ovary syndrome but may also exert other beneficial metabolic and endocrine effects.
  
  
  OBJECTIVE
  To assess the efficacy and safety of statin therapy for women with polycystic ovary syndrome (PCOS) who are not actively trying to conceive.
  
  
  METHODS
  We searched the following databases (from inception to week 1, July 2011): the Cochrane Menstrual Disorders and Subfertility Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE and CINAHL. We handsearched relevant conference proceedings and references of the identified articles for additional studies. We also contacted experts for further studies in progress.
  
  
  METHODS
  Randomised controlled trials (RCTs) comparing a statin versus placebo or statin in combination with another drug versus another drug alone in women with PCOS.
  
  
  METHODS
  Two review authors performed data collection and analysis independently.
  
  
  RESULTS
  Four trials fulfilled the criteria for inclusion. They comprised a total of 244 women with PCOS receiving 12 weeks or 6 weeks of treatment. Two trials (184 women randomised) studied the effects of simvastatin and two trials (60 women randomised) studied the effects of atorvastatin. There was no good evidence that statins improved menstrual regularity, spontaneous ovulation rate, hirsutism or acne, either alone or in combination with the combined oral contraceptive pill (OCP). Nor were there any significant effects on body mass index (BMI). Statins were effective in lowering testosterone levels (nmol/L) (mean difference (MD) -0.90, 95% CI -1.18 to -0.62, P < 0.00001, 3 RCTs, 105 women) when used alone or with the OCP. Statins also improved total cholesterol, low-density lipoprotein (LDL) and triglycerides but had no significant effect on high-density lipoprotein (HDL) levels, high sensitivity (HS) C-reactive protein (HS-CRP), fasting insulin or homeostatic model assessment (HOMA) insulin resistance. No serious adverse events were reported in any of the included studies.
  
  
  CONCLUSIONS
  Although statins improve lipid profiles and reduce testosterone levels in women with PCOS, there is no evidence that statins improve resumption of menstrual regularity or spontaneous ovulation, nor is there any improvement of hirsutism or acne. There is a need for further research to be performed with large sample sizes and well-designed RCTs to assess clinical outcomes.
authors: Shrimati Kaumudiniben Health Outcome Research Group (SKHORG), Near Depala's Chora, Dhrangadhra, Gujrat, India, 363310.
authors: Amit D
authors: AD
authors: Raval
authors: Tamara
authors: T
authors: Hunter
authors: Bronwyn
authors: B
authors: Stuckey
authors: Roger J
authors: RJ
authors: Hart
mesh_terms: D000328:Adult; D000069059:Atorvastatin; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use; D006628:Hirsutism / Q000188:drug therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D017588:Hyperandrogenism / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008599:Menstruation Disturbances / Q000188:drug therapy; D008687:Metformin / Q000627:therapeutic use; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy*; D011758:Pyrroles / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D019821:Simvastatin / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D011758:Pyrroles; D008687:Metformin; D000069059:Atorvastatin; D019821:Simvastatin