Oral contraceptives versus physical exercise on cardiovascular and metabolic risk factors in women with polycystic ovary syndrome: a randomized controlled trial

• Published in: Clinical endocrinology (Oxford) Vol. 85; no. 5; pp. 764 - 771
• Main Authors: Orio, F., Muscogiuri, G., Giallauria, F., Savastano, S., Bottiglieri, P., Tafuri, D., Predotti, P., Colarieti, G., Colao, A., Palomba, S.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-11-2016; Wiley Subscription Services, Inc
• Subjects: Adult; Androstenes - administration & dosage; Androstenes - therapeutic use; Cardiovascular Diseases - pathology; Cardiovascular Diseases - prevention & control; Cardiovascular Diseases - therapy; Carotid Intima-Media Thickness; Contraceptives, Oral - pharmacology; Contraceptives, Oral - therapeutic use; Ethinyl Estradiol - administration & dosage; Ethinyl Estradiol - therapeutic use; Exercise - physiology; Female; Humans; Hyperandrogenism - drug therapy; Metabolic Diseases - prevention & control; Metabolic Diseases - therapy; Polycystic Ovary Syndrome - therapy; Risk Factors; Young Adult
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1111/cen.13112

Summary
Background
Although oral contraceptives (OCs) are one the most widespread therapy in young polycystic ovary syndrome (PCOS) women and physical exercise represents a crucial first step in the treatment of overweight and obese PCOS, no studies were performed to compare the effects on cardiovascular risk (CVR) of OCs and physical exercise in PCOS.
Objective
To compare the effects of OCs administration and physical exercise on the CVR, clinical, hormonal and metabolic parameters in PCOS women.
Methods
One hundred and fifty PCOS women were enrolled and were randomized to OCs (3 mg drospirenone plus 30 μg ethinyloestradiol), structured exercise training programme (SETP) or polyvitamin tablets. The intervention phase study was of 6 months. Primary outcome was intima–media thickness (IMT) and flow‐mediated dilation (FMD). Secondary outcomes were clinical, hormonal and metabolic changes.
Results
A significant reduction of IMT and a significant increase of FMD were observed in the SETP group after treatment. Compared to baseline, in the SETP group, a significant improvement in anthropometric measures, insulin sensitivity indexes, lipid profile, cardiopulmonary function, inflammatory markers and frequency of menses was observed. Oral contraceptives use was associated with a significant decrease of hyperandrogenism and a significant improvement of frequency of menses. Further, OCs use had a neutral effect on CVR risk factors.
Conclusion
OCs effectively treat hyperandrogenism and menstrual disturbances, while SETP is more effective in improving cardiometabolic profile and cardiopulmonary function in PCOS.