This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Banaszewska, B. Articles by Duleba, A. J. Search for Related Content PubMed PubMed Citation Articles by Banaszewska, B. Articles by Duleba, A. J. Related Collections Lipid Cardiovascular Endocrinology Female Endocrinology

Effects of Simvastatin and Oral Contraceptive Agent on Polycystic Ovary Syndrome: Prospective, Randomized, Crossover Trial

Department of Gynecology/Obstetrics (B.B., L.P., R.Z.S.), Poznan University of Medical Sciences, 60-535 Poznan, Poland; and Departments of Epidemiology and Public Health (J.D.), and Obstetrics and Gynecology (A.J.D.), Yale University School of Medicine, New Haven, Connecticut 06520

Address all correspondence and requests for reprints to: Antoni J. Duleba, Yale University School of Medicine, Department of Obstetrics and Gynecology, 333 Cedar Street, New Haven, Connecticut 06510. E-mail: antoni.duleba{at}yale.edu.

Context: Polycystic ovary syndrome (PCOS) is associated with hyperandrogenism and cardiovascular risks including dyslipidemia and systemic inflammation. In vitro, statins decrease proliferation and steroidogenesis of ovarian theca-interstitial cells.

Objective: The study objective was to compare effects of two treatments of PCOS: simvastatin plus oral contraceptive pill (OCP) vs. OCP alone.

Design: In a prospective, crossover trial, 48 women with PCOS were randomized to either simvastatin plus OCP for 12 wk followed by OCP alone for an additional 12 wk, or to OCP alone for 12 wk and, subsequently, simvastatin plus OCP for an additional 12 wk. Evaluations were performed at baseline, after 12 wk (crossover), and after 24 wk. Data were analyzed using a random effects model.

Setting: The study was conducted in an academic medical center.

Primary Outcome: Serum total testosterone was the primary outcome measure.

Results: Total testosterone decreased by 38% after Statin + OCP, whereas OCP alone led to a 26% decrease; the statin-attributable effect was significant (P < 0.004). Free testosterone declined by 58% after Statin + OCP, significantly more than the 35% decline after OCP alone (P = 0.006). Hirsutism decreased by 8.1% after Statin + OCP, a greater effect than the 4.7% decrease after OCP alone (P = 0.02). Statin decreased LH, but not FSH or prolactin. Statin + OCP decreased total and low-density lipoprotein cholesterol by 7.5% and 20%, respectively. OCP alone led to a 5% increase of total cholesterol without effect on low-density lipoprotein cholesterol. Statin prevented OCP induced increase of triglycerides. C-reactive protein decreased by 45% after Statin + OCP, a significantly different effect (P = 0.006) than a 6% increase after OCP alone. Soluble vascular cell adhesion molecule 1 decreased by 18% after Statin + OCP, a greater decline than the 10% decrease after OCP alone (P = 0.01).

Conclusions: Simvastatin improved endocrine/clinical aspects of PCOS and had beneficial effects on lipid profile and markers of systemic inflammation.

This article has been cited by other articles:

				I. J. Rzepczynska, P. C. Piotrowski, D. H. Wong, A. B. Cress, J. Villanueva, and A. J. Duleba Role of Isoprenylation in Simvastatin-Induced Inhibition of Ovarian Theca-Interstitial Growth in the Rat Biol Reprod, November 1, 2009; 81(5): 850 - 855. [Abstract] [Full Text] [PDF]

				S. Palomba, A. Falbo, F. Zullo, and F. Orio Jr. Evidence-Based and Potential Benefits of Metformin in the Polycystic Ovary Syndrome: A Comprehensive Review Endocr. Rev., February 1, 2009; 30(1): 1 - 50. [Abstract] [Full Text] [PDF]

				K. M. Hoeger Polycystic Ovary Syndrome, Inflammation, and Statins: Do We Have the Right Target? J. Clin. Endocrinol. Metab., January 1, 2009; 94(1): 35 - 37. [Full Text] [PDF]

				T. Sathyapalan, E. S. Kilpatrick, A.-M. Coady, and S. L. Atkin The Effect of Atorvastatin in Patients with Polycystic Ovary Syndrome: A Randomized Double-Blind Placebo-Controlled Study J. Clin. Endocrinol. Metab., January 1, 2009; 94(1): 103 - 108. [Abstract] [Full Text] [PDF]

				S. Palomba, F. Orio Jr., A. Falbo, T. Russo, A. Tolino, and F. Zullo Clomiphene Citrate Versus Metformin as First-Line Approach for the Treatment of Anovulation in Infertile Patients with Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., September 1, 2007; 92(9): 3498 - 3503. [Abstract] [Full Text] [PDF]