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

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 mug ethinylestradiol) structured exercise training program (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. OCs 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. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.