Risk of venous thromboembolism in women with polycystic ovary syndrome: a population-based matched cohort analysis

Steven T. Bird; Abraham G. Hartzema; James M. Brophy; Mahyar Etminan; Joseph A.C. Delaney

doi:10.1503/cmaj.120677

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the indication for the birth control pill (BCP)
Robert W. Shepherd

Posted on: 15 February 2013
PCOS- at higher risk for thromboembolism
dhastagir s Sheriff

Posted on: 12 February 2013

Posted on: (15 February 2013)

the indication for the birth control pill (BCP)
Robert W. Shepherd, physician
Paragraph 2 of the article begins, "Combined oral contraceptives are the mainstay treatment for PCOS." According to the 2009 Compendium of Pharmaceuticals and Specialities, estrogen-progestin birth control pills are indicated for contraception control and for the prevention of pregnancy. PCOS is not an approved indication for the BCP. Bird et al found a 2 fold increased risk of venous thromboembolism among women with...
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Paragraph 2 of the article begins, "Combined oral contraceptives are the mainstay treatment for PCOS." According to the 2009 Compendium of Pharmaceuticals and Specialities, estrogen-progestin birth control pills are indicated for contraception control and for the prevention of pregnancy. PCOS is not an approved indication for the BCP. Bird et al found a 2 fold increased risk of venous thromboembolism among women with PCOS taking combined oral contraceptives. It would seem wise not to prescribe the BCP to a woman with PCOS unless she is seeking contraception.
Conflict of Interest:
None declared
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Competing Interests: None declared.
Posted on: (12 February 2013)

PCOS- at higher risk for thromboembolism
dhastagir s Sheriff, Professor
Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder that is characterized by hyperandrogenism and chronic anovulation, affecting about 5% of premenopausal women (1,2). This syndrome is an important condition associated with risk factors for stroke and coronary artery diseases, including hypertension, insulin resistance, high serum triglyceride levels, and low HDL cholesterol levels (3-6). Althoug...
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Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder that is characterized by hyperandrogenism and chronic anovulation, affecting about 5% of premenopausal women (1,2). This syndrome is an important condition associated with risk factors for stroke and coronary artery diseases, including hypertension, insulin resistance, high serum triglyceride levels, and low HDL cholesterol levels (3-6). Although PCOS is associated with risk factors for cerebrovascular disease, the available evidence does not demonstrate increased stroke mortality, and it has been suggested that some protective mechanisms must be operating for these women (7,8).
There are many studies which showed hemodynamic changes in the pelvic vessels and aorta in patients with PCOS (1,7,9,10). The present study confirms higher risk for venous thromboembolism cautioning the physicans about prescribing oral contraceptives to PCOS patients.
References
1. Kelly CJ, Speirs A, Gould GW, Petrie JR, Lyall H, Connell JM. Altered vascular function in young women with polycystic ovary syndrome. J Clin Endocrinol Metab 2002;87:742-6
2. Franks S. Polycystic ovary syndrome. N Eng J Med 1995;333:853-61
3. Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev 1997;18:774-800
4. Wild RA, Painter RC, Coulson PB, Carruth KB, Ranney GB. Lipoprotein lipid concentrations and cardiovascular risk in women with polycystic ovary syndrome. J Clin Endocrinol Metab 1985; 61:946-51
5. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988;37:1595-607
6. Castelli WP. The triglyceride issue: a view from Framingham. Am Heart J 1986; 112:432-7
7. Lakhani K, Constantinovici N, Purcell WM, Fernando R, Hardiman P. Internal carotid artery haemodynamics in women with polycystic ovaries. Clin Sci 2000; 98:661-5
8. Pierpoint T, McKeigue PM, Isaacs AJ, Wild SH, Jacobs HS. Mortality of women with polycystic ovary syndrome at long-term follow-up. J Clin Epidemiol 1998; 51:581-6
9. Battaglia C, Artini PG, D'Ambrogio G, Allesandro D, Genazzani AD, Genazzani AR. The role of colour Doppler imaging in the diagnosis of polycystic ovary syndrome. Am J Obstet Gynecol 1995; 172:108-13
10. Prelevic GM, Beljic T, Balint-Peric L, Ginsburg J. Cardiac flow velocity in women with the polycystic ovary syndrome. Clin Endocrinol 1995;43:677- 81
Conflict of Interest:
None declared
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Competing Interests: None declared.