Diabetes, Obesity, and Human Reproduction Research Group, Instituto Ramón Y Cajal De Investigación Sanitaria, Centro De Investigación Biomédica En Red Diabetes Y Enfermedades Metabólicas Asociadas (CIBERDEM) & University of Alcalá , Madrid, Spain.
Department of Endocrinology and Nutrition, Hospital Universitario Ramón Y Cajal , Madrid, Spain.
Expert Opin Drug Saf. 2020 Dec;19(12):1559-1576. doi: 10.1080/14740338.2020.1839409. Epub 2020 Nov 5.
The polycystic ovary syndrome (PCOS) is a very prevalent disorder in premenopausal women. Cardiovascular risk factors cluster in these patients, raising concern about the safety of the drugs commonly used to ameliorate symptoms of androgen excess in in this population at risk of cardiovascular morbidity.
This review summarizes the clinical efficacy and safety profiles of drugs commonly used for the management of hyperandrogenic symptoms and endometrial protection in adult women with PCOS who do not seek pregnancy.
Antiandrogenic drugs usually used in adult women with PCOS carry a low risk of severe side effects. In spite of the cardiovascular risk profile of women with PCOS, and that individualized risk assessment is of paramount importance, there is no solid evidence supporting that the use of combined oral contraceptives in these women increases the risk of cardiovascular or thromboembolic events compared with the general population. However, virtually all these drugs are used in an off-label fashion. Large, high-quality studies addressing the long-term safety of pharmacological treatments in women with PCOS are definitely needed.
多囊卵巢综合征（PCOS）是绝经前妇女中非常常见的疾病。心血管危险因素在这些患者中聚集，这引起了人们对常用于改善有心血管发病风险的多囊卵巢综合征患者雄激素过多症状的药物安全性的担忧。
本文综述了常用于治疗无生育要求的多囊卵巢综合征成年女性的高雄激素血症和子宫内膜保护的药物的临床疗效和安全性特征。
常用于多囊卵巢综合征成年女性的抗雄激素药物通常具有较低的严重副作用风险。尽管多囊卵巢综合征患者的心血管风险特征，以及个体化风险评估至关重要，但没有确凿的证据表明与一般人群相比，这些妇女使用复方口服避孕药会增加心血管或血栓栓塞事件的风险。然而，几乎所有这些药物都是超适应证使用的。确实需要进行大型、高质量的研究来确定药物治疗多囊卵巢综合征女性的长期安全性。
