Safety of Hormonal Contraceptives Therapies in Polycystic Ovary Syndrome (PCOS) Women

Polycystic ovary syndrome (PCOS) is associated with comorbidities that may contribute to increased risk of cardiovascular disease (CVD). Oral contraceptives (OC) have been the mainstay of PCOS pharmacological therapy for decades. However, in non-hyperandrogenic women, OC use is associated with higher risk of cardiovascular disease, raising concern about a possible worsening of the unfavorable metabolic and cardiovascular profile of PCOS patients. There is lack of evidence about the impact of PCOS pharmacological therapies on cardiovascular risk markers and the long-term safety of these drugs in PCOS has not been established. The aim of this study is to compare the effect of an OC alone or associated with an anti-androgenic drug (spironolactone) on echografic cardiovascular risk markers, metabolic and hemostatic variables.

Inclusion criteria

• age between 18 and 35 years
• diagnosis of PCOS by Rotterdam Consensus

Exclusion criteria

• smoking, alcoholism, drug addiction;
• current pregnancy;
• current or previous use (up to two months before the study) of oral, vaginal, monthly injectable, or transdermal combined hormonal contraceptives;
• current or previous use (up to six months before the study) of a long-lasting hormonal contraceptive method (injectable, implant, or intrauterine device);
• antiandrogenic or hypoglycemic drugs, anti-inflammatory drugs, or statins;
• presence of systemic diseases (DM2, cardiovascular disease, autoimmune diseases, liver disease, thyroid disease, or congenital renal hyperplasia);
• personal history of arterial or venous thrombosis; chronic or acute inflammatory processes;
• puerperium of 12 weeks or less