Contraception for Women with Polycystic Ovary Syndrome:Dealing with a Complex Condition - Revista Brasileira de Ginecologia e Obstetrícia
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):325-326
Polycystic ovary syndrome (PCOS) is a complex condition, affecting around 9 to 13% of women at reproductive age and characterized by menstrual irregularity, ovulatory dysfunction, hyperandrogenism and polycystic ovarian morphology. Women with PCOS also present higher prevalence of obesity, cardiometabolic disturbances, such as dyslipidemia and hypertension and greater risk of impaired glucose tolerance and diabetes. Current evidence suggests that complex interactions between genetic, epigenetic, environmental, and behavioral factors contribute to the onset and to the heterogeneous clinical presentation of PCOS. In this context, and in the absence of pregnancy plans, it is essential to determine the ideal contraceptive method to offer according to the clinical, hormonal and metabolic profile of each woman.
Menstrual disturbances are a very common clinical feature in women with PCOS. Effective treatment will protect the endometrium from estrogen stimulation and will significantly reduce the risk of endometrial hyperplasia and cancer. Also common are signs of clinical hyperandrogenism, namely hirsutism, acne, and hair loss, which should be considered when choosing a contraceptive method. This choice may, therefore, have advantages that are not related to contraception. As part of a holistic approach to women with PCOS, even if lifestyle changes (and weight loss for overweight and obese patients) can improve or prevent metabolic disorders, their cardiometabolic profile should also be taken into account when choosing a contraceptive method.
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Polycystic ovary syndrome (PCOS) is a complex condition, affecting around 9 to 13% of women at reproductive age and characterized by menstrual irregularity, ovulatory dysfunction, hyperandrogenism and polycystic ovarian morphology. Women with PCOS also present higher prevalence of obesity, cardiometabolic disturbances, such as dyslipidemia and hypertension and greater risk of impaired glucose tolerance and diabetes. Current evidence suggests that complex interactions between genetic, epigenetic, environmental, and behavioral factors contribute to the onset and to the heterogeneous clinical presentation of PCOS. In this context, and in the absence of pregnancy plans, it is essential to determine the ideal contraceptive method to offer according to the clinical, hormonal and metabolic profile of each woman.
Menstrual disturbances are a very common clinical feature in women with PCOS. Effective treatment will protect the endometrium from estrogen stimulation and will significantly reduce the risk of endometrial hyperplasia and cancer. Also common are signs of clinical hyperandrogenism, namely hirsutism, acne, and hair loss, which should be considered when choosing a contraceptive method. This choice may, therefore, have advantages that are not related to contraception. As part of a holistic approach to women with PCOS, even if lifestyle changes (and weight loss for overweight and obese patients) can improve or prevent metabolic disorders, their cardiometabolic profile should also be taken into account when choosing a contraceptive method.
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