Simvastatin improves some aspects of PCOS (Hair & Testosterone)
Simvastatin improves some aspects of PCOS
Bruce K. Dixon
MONTREAL -- The addition of simvastatin to an oral contraceptive regimen significantly reduces hirsutism and elevated levels of total testosterone in women with polycystic ovary syndrome, according to a study conducted by Antoni J. Duleba, M.D., of Yale University, New Haven, Conn., and associates.
"This is the first report that simvastatin improves a clinical end point of treatment of polycystic ovary syndrome/hirsutism," Dr. Duleba, the lead investigator, said in an interview.
The data were presented by another investigator in the study, Beata Banaszewska, M.D., at the conjoint annual meeting of the American Society for Reproductive Medicine and the Canadian Fertility and Andrology Society.
Oral contraceptive pills "do reduce testosterone levels, but in this crossover study, we can appreciate that statins have a greater power to this effect," Dr. Banaszewska, of Poznan University of Medical Sciences in Poland, said at the meeting.
PCOS affects 5%-10% of women of childbearing age, according to Dr. Duleba. Estimates of the cost of evaluation and care in the United States annually are about $4 billion. "We still don't have satisfactory medical treatments for PCOS; symptomatic treatments only partly improve the situation, and long term, these patients are at increased risk of cardiovascular problems," he said.
The study randomized 48 PCOS patients (mean age 24 years) into two treatment groups.
One group received oral contraceptive pills (OCP) alone (20-mcg ethinyl estradiol and 150-mcg desogestrel) for 12 weeks, after which 20-mg simvastatin was added to their regimen daily for 12 more weeks.
The other group first received the combined drug regimen for 12 weeks and then was given OCP alone for 12 weeks. Clinical, endocrine, and metabolic evaluations were performed at baseline, at crossover (12 weeks), and at 24 weeks.
"Simvastatin induced a decrease of total testosterone by 18% below the effect of OCP," Dr. Duleba said. "This effect was paralleled by a 16% decrease of free testosterone below the effect of OCP. We also found that the hirsutism declined, and there was a strong trend toward an improvement in acne, which did not reach statistical significance."
A simvastatin-attributable decline of hirsutism was modestly but significantly greater than with OCP alone; this 4% difference was statistically significant.
"Patients were very happy ... they did not want to stop," Dr. Duleba said.
"Typically, in PCOS, there is an abnormal hypothalamic-pituitary function characterized by elevated LH. It's usually measured by the ratio of LH to FSH, and we observed that statins also improved this ratio," he added. Simvastatin, in comparison with OCP, decreased LH by 24% and the LH-FSH ratio by 22%.
Furthermore, simvastatin (as compared with OCP) decreased total cholesterol by 12%, LDL cholesterol by 21%, and triglycerides by 18%-preventing the OCP-induced rise in triglycerides.
"So the statin not only normalized androgens, it also normalized hypothalamic-pituitary function. And of course, the statin improved lipid profiles," Dr. Duleba said.
BMI was not significantly affected by either treatment.
BY BRUCE K. DIXON
Chicago Bureau
Kate Johnson of the Montreal Bureau contributed to this report.
COPYRIGHT 2005 International Medical News Group
COPYRIGHT 2005 Gale Group
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Hey, SoulCysters! Need to eat more veggies, but can't find recipes??
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I have a doctor's appt. Thursday. He called to let me know that my cholesterol was elevated and that was something he wanted to discuss w/ me on Thursday. Right now I am not on any cholesterol lowering meds and if possible, would like to be on one that also helped lower testosterone. I will ask my doctor about simvastatin but I recall reading somewhere that lovastatin may also lower testosterone. Has anyone else heard this as well? The reason being is my drug coverage insurance is not the greatest (I pay half regardless of generic or brandname) and I noticed simvastatin is a lot more expensive because it's not in generic form. Thanks.
Have searched and found nothing on Lovastatin helping women w/ Pcos but did see articles about Simvastatin helping. I also discovered Simvastatin is going generic later this year, so for me, the cost will definitely come down.
Since it appears I am going to have to go on a cholesterol lowering drug, I'm really glad to have found this info before my appt.
I'm not sure if any of the other statins lower cholesterol. I'm on Pravachol, which is pravastatin. It would be great if some of the other statin drugs were good for PCOS too. If simvastatin is going generic AND helps with PCOS, I'd be willing to try it...but since this is my third cholesterol drug, I don't want to change unless this one doesn't work.
Edit: I found this link that says that statins, specifically pravastatin, *might* have some effect on testosterone function...but they aren't really sure.
"Endocrine Function- HMG-CoA reductase inhibitors interfere with cholesterol synthesis and lower circulating cholesterol levels and, as such, might theoretically blunt adrenal or gonadal steroid hormone production. Results of clinical trials with pravastatin in males and post-menopausal females were inconsistent with regard to possible effects of the drug on basal steroid hormone levels. In a study of 21 males, the mean testosterone response to human chorionic gonadotropin was significantly reduced (p< 0.004) after 16 weeks of treatment with 40 mg of pravastatin. However, the percentage of patients showing a 50% rise in plasma testosterone after human chorionic gonadotropin stimulation did not change significantly after therapy in these patients. The effects of HMG-CoA reductase inhibitors on spermatogenesis and fertility have not been studied in adequate numbers of patients. The effects, if any, of pravastatin on the pituitary-gonadal axis in pre-menopausal females are unknown. Patients treated with pravastatin who display clinical evidence of endocrine dysfunction should be evaluated appropriately. Caution should also be exercised if an HMG-CoA reductase inhibitor or other agent used to lower cholesterol levels is administered to patients also receiving other drugs (e.g., ketoconazole, spironolactone, cimetidine) that may diminish the levels or activity of steroid hormones."
I just got a prescription for Simvastatin (Zocor). Will let you guys know if I notice any difference in the next few weeks/months. I read online that a generic may be available as early as June. I'm hoping cause even w/ my insurance, I paid 70 dollars for a 1 month supply. Ouch. I got a listing of the other cholesterol drugs and any of the others were considerably less for me including lipitor. This one was the priciest. But I am still glad to be starting it and hope that it helps.
Since this lowers testosterone, does anyone know if it helps with acne too?
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Sprintec, HCTZ, Lopressor 200mg, Prozac 20mg, Byetta
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(This is my first post actually, although I've been "lurking" around the boards reading up on things for a few months now!)
Does anyone know if cysters can use Simvastatin on its own, without OCP's?
I get horrible side effects from the pill, so I couldn't do a combination OCP/Simvastatin regimen, but I'd definitely like to look into Simvastatin if it could be used on its own.
Any new treatment to help with the balding / body hair growth would be amazing!
Thanks so much, I look forward to talking more with all of you!
I'm on Simvastatin right now but not on birth control--I was prescribed simva for my cholesterol which was elevated--but I asked specifically to be put on this one because of the recent studies where it's helped lower testosterone.
My doctor asked if I wanted to go back on the pill but right now I don't need birth control so he said that was fine. I think the key is if the doctor asks to let him know you aren't planning on becoming pregnant.
__________________ "On ne voit bien qu'avec le coeur. L'essentiel est invisible pour les yeux." ("It is only with the heart that one can see rightly; what is essential is invisible to the eye.")
I've seen several reports of the effect of simvastatin on testosterone, but none on other statins. The evidence on pravastatin is sketchy...some say it's there, some don't. However, I'd expect that we may eventually find this effect in other statins because hormones (testosterone included) are made from cholesterol. If you get rid of the excess cholesterol in your body, it makes sense that you wouldn't have as many hormones either.
Has anyone had any luck with cholesterol and/or PCOS symptoms on any of the statins? I am on my third lipid-lowering drug (tried Lipitor, Lopid, and now Pravachol) and Pravachol is the only one that seems to be working for me and that I can tolerate. It just isn't bringing my numbers down enough, so I may have to either go on a different drug or a higher dose of this one. But I haven't really noticed much of a difference in PCOS symptoms after about three months on pravastatin.
btw, if anyone else is taking pravastatin (Pravachol)--its patent expires this month, so it should be going generic soon!
Don't know yet if it's helping. Am supposed to go in to have my cholesterol rechecked (haven't done that yet) but also will ask if I can have my testosterone rechecked as well. Am on 20mg like the study but I got the impression in the study the girls weren't necessarily high cholesterol. It's funny, though I'm on it for cholesterol, I am mostly interested in if it will lower my testosterone.
Don't know if other statins will also lower testosterone though it does make sense if they do. I've had no problems w/ simvastatin--unlike met or even spiro it's been an easy drug for me to take.
Simvastatin improves some aspects of PCOS (Hair & Testosterone) 
other statin question 
Zocor is going generic 
