Different kinds of oral contraceptive pills in polycystic ovary syndrome: a systematic review and meta-analysis
Authors' conclusion
With current evidence, combined regimens containing an antiandrogen (EE/CPA) may be better compared with conventional COCPs in reducing hyperandrogenism, but EE/CPA will not be recommended as a first-line COCP treatment by the pending PCOS guideline update, due to higher venous thrombotic events (VTE) risk in the general population. Later-generation progestins offer theoretical benefits, but better evidence on clinical outcomes is needed in women with PCOS.
Study context
- Population
- Women with polycystic ovary syndrome (PCOS) in randomized controlled trials (RCTs) comparing 2 different combined oral contraceptive pills (COCPs); MEDLINE, EMBASE, All EBM, CINAHL and PsycINFO searched July 8, 202219 RCTs
- Comparison
- Different combined oral contraceptive pills (COCPs) compared head to head in PCOS
- Outcome
- Body mass index (BMI), testosterone and hirsutism
Pooled result
As reported in the abstract
MD, kg/m2 (95% CI)
Third-generation COCPvs Fourth-generation COCPBMI lower with fourth-generation COCP
1.17(0.33–2.02)
Conventional COCPvs EE/CPABMI: EE/CPA better in reducing
0.62(0.05–1.20)
MD, nmol/L (95% CI)
Third-generation COCPvs Fourth-generation COCPTestosterone lower with fourth-generation COCP
0.60(0.13–1.07)
Conventional COCPvs EE/CPATestosterone: EE/CPA better in reducing
0.38(0.33–0.43)
Further pooled results
- No difference in hirsutism between high and low EE doses
- No evidence regarding natural estrogens in COCP was identified
Original publication
Different kinds of oral contraceptive pills in polycystic ovary syndrome: a systematic review and meta-analysis. Eur J Endocrinol. Published 13 July 2023. doi:10.
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