Evidence for statin therapy in polycystic ovary syndrome.  Original paper

What was reviewed?

This paper provides a review of the evidence supporting statin therapy for managing polycystic ovary syndrome (PCOS), focusing on its potential to reduce cardiovascular risks and address some of the metabolic complications associated with PCOS. The review discusses both the lipid-lowering effects of statins and their pleiotropic effects, including improvements in insulin resistance, hyperandrogenemia, and systemic inflammation. These secondary benefits may offer additional therapeutic value for women with PCOS, a condition commonly linked with metabolic and cardiovascular disturbances.

Who was reviewed?

The review examined existing studies and clinical trials investigating the use of statins in PCOS patients. The studies reviewed explored the effectiveness of statins like atorvastatin and simvastatin in reducing various metabolic and biochemical markers in women with PCOS, such as testosterone levels, insulin resistance, and inflammation. The review focused on understanding how statins could be beneficial in managing the hormonal and metabolic dysfunctions seen in PCOS.

What were the most important findings?

The review revealed promising evidence supporting statin therapy for women with PCOS, particularly due to its pleiotropic effects. Statins were shown to improve the lipid profile in women with PCOS, reducing LDL cholesterol levels, which is crucial given the elevated cardiovascular risks associated with the condition. Beyond lipid-lowering, statins also contributed to significant reductions in hyperandrogenemia, insulin resistance, and markers of systemic inflammation such as C-reactive protein (CRP). These findings suggest that statins could offer a dual benefit by improving both metabolic and reproductive parameters in women with PCOS.

Moreover, the review highlighted that statins like atorvastatin and simvastatin have comparable effects on testosterone reduction, an important aspect of managing hyperandrogenism in PCOS. The use of statins led to a decrease in testosterone levels that was similar to the effects of established antiandrogens. This effect was observed independently of the improvement in lipid profiles, which underscores the potential of statins to address some of the hormonal imbalances seen in PCOS.

What are the greatest implications of this review?

The findings from this review suggest that statins may be a valuable addition to the treatment options for PCOS, especially for women who are at high risk of cardiovascular disease due to the metabolic disturbances commonly seen in the condition. The reduction in hyperandrogenemia, improvement in insulin sensitivity, and decrease in inflammation could provide significant therapeutic benefits, particularly for those who have not responded well to other treatments like insulin sensitizers or antiandrogens. However, the review also emphasized the need for further large-scale studies to validate the long-term efficacy of statins in improving fertility outcomes and reducing cardiovascular events in women with PCOS. The potential teratogenic risks of statins, particularly during pregnancy, warrant caution and a careful approach to their use in reproductive-age women.