Polycystic ovarian syndrome (PCOS) is very common in girls and women of reproductive age and is a major cause of female subfertility. While no treatment is authorized for PCOS, about 98% of the girls who have it, regardless of whether they are sexually active, take a combined oral contraceptive pill that contains an estrogen and a progestin. In adolescent girls with PCOS, bringing the amount of abdominal visceral fat and liver fat to normal ovulation restoration, normalizes the symptoms of excess androgen and can help prevent future subfertility, suggests new research from Spain. In a study conducted at the University of Barcelona, Dr. Ibáñez and her colleagues enrolled 36 young women with PCOS who on average were 16 years of age, were non-obese and not sexually active. They had had their first menstrual cycle at least two years ago; and their excessive hair and irregular menstruation could not be attributed to specific causes.
Participants were randomized to receive one of the two drug combinations per day: some took a combined oral contraceptive pill containing 20 mcg ethinylestradiol + 100 mg levonorgestrel; others took SPIOMET (spironolactone 50 mg + pioglitazone 7.5 mg + and metformin 850 mg). The girls were also encouraged to exercise regularly and follow a Mediterranean diet. They took the drugs for 12 months and were followed without intervention for another 12 months. Referring to menstrual diaries and weekly measurements of salivary progesterone, the researchers counted the number of two-stage ovulations: between 3 and 6 months after treatment and between 9 and 12 months after treatment. The authors also assessed body composition; the amount of abdominal, visceral and hepatic fat; thickness of the carotid artery; blood markers such as cholesterol, androgens, insulin and other cardiovascular health indicators.
- edited by Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.
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