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Pharmacological and surgical treatment of nonreproductive outcomes in polycystic ovary syndrome: An overview of systematic reviews
Author(s) -
Tay Chau T.,
Joham Anju E.,
Hiam Danielle S.,
Gadalla Moustafa A.,
Pundir Jyotsna,
Thangaratinam Shakila,
Teede Helena J.,
Moran Lisa J.
Publication year - 2018
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13753
Subject(s) - polycystic ovary , medicine , hyperandrogenism , systematic review , cinahl , psychological intervention , medline , metformin , meta analysis , gynecology , intensive care medicine , obesity , insulin resistance , insulin , psychiatry , political science , law
Summary Background Polycystic ovary syndrome ( PCOS ) affects up to 13% women and is associated with significant complications. The quality of evidence supporting the recommendations on treatment of nonreproductive outcomes in PCOS is unknown. Objective To summarize and appraise the methodological quality of systematic reviews and meta‐analyses evaluating pharmacological and surgical treatments for nonreproductive outcomes in PCOS . Methods A literature search from MEDLINE , EMBASE , CINAHL PLUS and PROSPERO was performed from inception until 15th of September 2017. Article selection, data extraction and quality appraisal of included reviews were performed in duplicate. A narrative synthesis of the findings was conducted. Results This overview included 31 reviews. The quality was low for 7 (23%), moderate for sixteen (52%) and high for 8 reviews (26%). Two reviews assessed psychological outcomes. Metformin improved anthropometric (7 of 10 reviews), metabolic (4 of 14 reviews) and endocrine outcomes (3 of twelve reviews). Thiazolidinediones improved metabolic (2 of 5 reviews) and endocrine outcomes (one of 5 reviews) but worsened weight gain (5 of 5 reviews). Combined oral contraceptive pill ( COCP ) improved clinical hyperandrogenism (2 of 2 reviews). Statins improved lipid profile (3 of 3 reviews) and testosterone level (2 of 3 reviews). There was no conclusive evidence from included systematic reviews regarding the use of other interventions. Conclusions There is reliable evidence regarding the use of metformin for anthropometric outcomes and COCP s for hyperandrogenism in women with PCOS but not for other interventions. There is significant gap in knowledge regarding the management of psychological outcomes in women with PCOS which needs further evaluation.