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Hum. Reprod. Advance Access published online on November 10, 2006
Human Reproduction, doi:10.1093/humrep/del407
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Opinion

Polycystic ovary syndrome, oral contraceptives and metabolic issues: new perspectives and a unifying hypothesis

S. Nader 1 * and E. Diamanti-Kandarakis 2

1 Departments of Internal Medicine (Endocrinology) and Obstetrics/Gynecology/Reproductive Sciences, University of Texas Medical School, Houston, TX, USA
2 1st Department of Medicine, Endocrine Section, University of Athens, Athens, Greece

* To whom correspondence should be addressed.
S. Nader, E-mail: shahla.nader-eftekhari{at}uth.tmc.edu


  Abstract

In the chronic treatment of polycystic ovary syndrome (PCOS), oral contraceptive pills (OCPs) are commonly used to induce regular menses, protect the endometrium and ameliorate androgenic symptoms. However, the long-term safety of OCP use in PCOS has not been established, and the literature reveals conflicting data concerning the metabolic effects of OCPs in this patient population, with outcomes ranging from improvement of glucose tolerance to the development of frank diabetes. This article presents new perspectives and a unifying hypothesis concerning the effects of OCPs on carbohydrate metabolism in PCOS and attempts to explain the divergent findings in published reports.

Keywords: carbohydrate metabolism/insulin resistance/polycystic ovary syndrome/oral contraceptive pills.
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