KatCarney

Early results from a trial of statins in women with polycystic ovary syndrome (PCOS) have shown that they can control its symptoms at least as well as the standard treatment, and that they perform better by some measures.

A separate study has also indicated that the hormonal condition may be linked to a shortage of vitamin D, the essential nutrient that is synthesised by the body on exposure to sunlight. This could mean that supplements of the vitamin might help affected women, though it is not yet clear whether the deficiency is a cause of PCOS or an effect.

PCOS occurs when the growth of multiple cysts in the ovaries is associated with other symptoms. These can include irregular menstruation, weight gain, excessive hair growth, acne, raised levels of male hormones and lowered fertility.

About 10 per cent of women have the syndrome, and a further 10 per cent have polycystic ovaries that are not accompanied by any symptoms. Victoria Beckham and Jules Oliver, the wife of the celebrity chef Jamie Oliver, have spoken publicly about having PCOS.

It is often controlled with metformin, a drug that is generally used to treat type 2 diabetes, as well as with topical treatments for acne and unwanted hair.

A research team led by Leszek Pawelczyk, of Poznan University in Poland, decided to investigate statins as an alternative because PCOS is often associated with risk factors for cardiovascular disease, such as obesity. He presented results from the study’s first six months at the American Society for Reproductive Medicine conference in San Francisco.

Dr Pawelcyzk recruited 60 women with PCOS, with an average age of 25, and split them randomly into three groups. One was given metformin, one received simvastatin, a statin marketed under the brand name Zocor, and the other received a combination of both drugs.

Before treatment, the patients on average had just 2.5 periods every six months. While this improved in all the groups, the effects were most marked among those taking statins: period frequency increased by 89 per cent, compared to 36 per cent in the metformin group and 68 per cent in the combination group.

All three treatments led to a reduction in hirsutism, body mass index (BMI, a measure of obesity), acne and testosterone levels. While the benefits of each drug strategy were broadly similar, statins performed a little better for every measure apart from BMI.

Patients in the statin and combination group also showed a reduction in levels of LDL cholesterol, the “bad” form of the fat which is associated with cardiovascular risk. Metformin did not alter cholesterol levels.

Dr Pawelcyzk said the findings suggested that simvastatin was a good option for many women with PCOS, though he cautioned it would not be suitable for those hoping to get pregnant. Statins have been associated with birth defects.

“I think it’s a completely new possibility in the treatment of these patients,” he said. “You can’t treat patients who want to become pregnant with statins, but if you are looking for long-term benefits, simvastatin may be a very good option.

“The conclusion is that statins are superior to metformin in regulation of menses and reduction of cardiovascular risk. They are at least equivalent for improving hyperandrogenism .” In the second study, a team led by Lubna Pal, of Yale University School of Medicine in Connecticut, investigated vitamin D levels among 18 women with abnormal ovulation patterns, 13 of whom had PCOS.

These women had much lower levels of the vitamin than infertile women without ovulation issues or PCOS. With each unit of increase in vitamin D levels, the risk of PCOS was reduced by 99 per cent and the risk of abnormal ovulation by 93 per cent.

Dr Pal said the results suggested that vitamin D deficiency might be involved in the causes of PCOS, though this will need to be studied further in larger samples. It is also possible that lower vitamin D is an effect and not a cause of PCOS: women with the condition may be less likely to spend time in the sun, or more likely to cover their bodies, which would reduce vitamin D levels.

She said: “Given the pandemic of vitamin D insufficiency, if indeed our observations are substantiated, aggressive repletion with vitamin D may emerge as an alternative approach to facilitate ovulation resumption.”

Source: http://www.timesonline.co.uk/tol/new...cle5127920.ece

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