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Design: Systematic review and meta-analysis (PROSPERO CRD42022345640). Methods: MEDLINE, EMBASE, All EBM, CINAHL, and PsycINFO searches (July 8, 2022) for PCOS studies in randomized controlled trials comparing two COCPs. Results: 19 RCTs included; fourth-generation COCP lowered BMI and testosterone vs third-generation, EE/CPA improved hirsutism and hyperandrogenism, but no evidence was found for natural estrogens; no hirsutism difference by EE dose. Conclusion: Antiandrogen-containing regimens (EE/CPA) may reduce hyperandrogenism, yet EE/CPA is not recommended as first-line COCP due to higher VTE risk; later-generation progestins need more clinical outcome evidence.",{"@graph":69,"@context":127},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/different-kinds-of-oral-contraceptive-pills-in-polycystic-ovary-syndrome-a-systematic-review-and-meta-analysis/516342/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/different-kinds-of-oral-contraceptive-pills-in-polycystic-ovary-syndrome-a-systematic-review-and-meta-analysis/516342.png","ImageObject",300,407,{"name":92,"@type":93},"Jacob","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-12","2026-10-06",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119,123],{"name":110,"@type":111,"acceptedAnswer":112},"What is the document’s main objective?","Question",{"text":113,"@type":114},"To compare different combined oral contraceptive pills (COCPs) for women with polycystic ovary syndrome as part of an update to international evidence-based PCOS guidelines.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were studies selected for the review?",{"text":118,"@type":114},"The review searched MEDLINE, EMBASE, All EBM, CINAHL, and PsycINFO on July 8, 2022 for randomized controlled trials that included women with PCOS and compared two different COCPs.",{"name":120,"@type":111,"acceptedAnswer":121},"What key outcomes were compared between COCP types?",{"text":122,"@type":114},"The meta-analysis assessed measures such as BMI, testosterone and other biochemical hyperandrogenism, and clinical hirsutism, as well as the evidence about different estrogen/progestin combinations.",{"name":124,"@type":111,"acceptedAnswer":125},"Why might EE/CPA not be recommended as first-line treatment?",{"text":126,"@type":114},"Despite benefits in reducing hyperandrogenism and hirsutism, EE/CPA may be avoided as first-line COCP due to higher venous thrombotic events (VTE) risk in the general population.","https://schema.org",{"og:url":83,"og:type":129,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":131,"canonical":83},"index,follow",{"doc_id":133,"site_id":62},516342,1791403640,{"code":4,"msg":5,"data":136},{"doc_id":133,"user_id":137,"nickname":92,"user_avatar":138,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":139,"file_id":140,"file_url":141,"file_type":142,"file_size":143,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":144,"language":145,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":146,"faqs":147,"seo_title":148,"seo_description":67,"update_tm":149,"read_time":150,"preview_page_count":4},962084931830,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","[https://helda.helsinki.fi](https://helda.helsinki.fi)  \nDifferent kinds of oral contraceptive pills in polycystic ovary syndrome : a systematic review and metaanalysis  \nForslund, Maria; Melin, Johanna; Alesi, Simon; Piltonen, Terhi; Romualdi, Daniela    \n2023-07-20  \nOxford University Press  \n[http://hdl.handle.net/10138/564032](http://hdl.handle.net/10138/564032)  \nForslund, M, Melin, J, Alesi, S, Piltonen, T, Romualdi, D, Tay, C T, Witchel, S, Pena, A, Mousa, A & Teede, H 2023, 'Different kinds of oral contraceptive pills in polycystic ovary syndrome : a systematic review and meta-analysis', European Journal of Endocrinology, vol. 189, no. 1, pp. S1-S16 . [https://doi.org/10.1093/ejendo/lvad082](https://doi.org/10.1093/ejendo/lvad082)  \nDownloaded from Helda, University of Helsinki institutional repository. [https://helda.helsinki.fi](https://helda.helsinki.fi)[ ](https://helda.helsinki.fi)[This is an electronic reprint of the original article.](This is an electronic reprint of the original article.)  \nThis reprint may differ from the original in pagination and typographic detail.  \nPlease cite the original version.  \nEuropean Journal of Endocrinology, 2023, 189, S1–S16 [https://doi.org/10.1093/ejendo/lvad082](https://doi.org/10.1093/ejendo/lvad082)  \nAdvance access publication 13 July 2023  \nSystematic Review and Meta Analysis  \n| Different kinds of oral contraceptive pills in polycystic ovary syndrome: a systematic review and meta-analysis\u003Cbr>Maria Forslund, 1,2, * Johanna Melin,2,3 Simon Alesi,2 Terhi Piltonen,4 Daniela Romualdi,5 Chau Thien Tay,2 Selma Witchel,6 Alexia Pena,7 Aya Mousa,2 and Helena Teede2,8\u003Cbr>1 Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden\u003Cbr>2Monash Centre for Health Research & Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3800, Australia\u003Cbr>3 Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital, 00290 Helsinki, Finland\u003Cbr>4Clinical Research Unit, Department of Obstetrics and Gynecology, Medical Research Centre, Oulu University Hospital, University of Oulu, 90029 Oulu, Finland\u003Cbr>5 Department of Obstetrics and Gynaecology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy\u003Cbr>6 Division of Pediatric Endocrinology, Department of UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, 15224 Pittsburgh, PA, United States\u003Cbr>7 Discipline of Paedriatics, The University of Adelaide and Robinson Research Institute, 5005 Adelaide, Australia 8Endocrine and Diabetes Units, Monash Health, 5246 Clayton, Australia\u003Cbr>*Corresponding author: Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Bla Straket 6, SE-41345 Gothenburg, [Sweden. Email:](Sweden. Email: maria.forslund@gu.se)[ maria.forslund@gu.se](Sweden. Email: maria.forslund@gu.se)\u003Cbr>Abstract\u003Cbr>Objective: To compare between different combined oral contraceptive pills (COCPs) as part of the update of the International Evidence-Based Guidelines on the Assessment and Management of polycystic ovary syndrome (PCOS) .\u003Cbr>Design: A systematic review and meta-analysis was performed, Prospero CRD42022345640 .\u003Cbr>Methods: MEDLINE, EMBASE, All EBM, CINAHL, and PsycINFO was searched on July, 8, 2022, for studies including women with PCOS, comparing 2 different COCPs in randomized controlled trials.\u003Cbr>Results: A total of 1660 studies were identified, and 19 randomized controlled trials (RCTs) were included.\u003Cbr>Fourth-generation COCP resulted in lower body mass index (BMI) (mean difference [MD] 1.17 kg/m2 [95% confidence interval {CI} 0 .33; 2.02]) and testosterone (MD 0.60 nmol/L [95% CI 0. 13; 1.07]) compared with third-generation agents, but no difference was seen in hirsutism.\u003Cbr>Ethinyl estradiol (EE)/cyproterone acetate (CPA) was better in reducing hirsutism as well as ","cbCaiqIZEoXoEp6z","https://ap.wps.com/l/cbCaiqIZEoXoEp6z","pdf",1325832,17,"English","# Abstract\n## Objective\n## Design\n## Methods\n## Results\n## Conclusion\n# Significance\n# Introduction","[{\"question\":\"What is the document’s main objective?\",\"answer\":\"To compare different combined oral contraceptive pills (COCPs) for women with polycystic ovary syndrome as part of an update to international evidence-based PCOS guidelines.\"},{\"question\":\"How were studies selected for the review?\",\"answer\":\"The review searched MEDLINE, EMBASE, All EBM, CINAHL, and PsycINFO on July 8, 2022 for randomized controlled trials that included women with PCOS and compared two different COCPs.\"},{\"question\":\"What key outcomes were compared between COCP types?\",\"answer\":\"The meta-analysis assessed measures such as BMI, testosterone and other biochemical hyperandrogenism, and clinical hirsutism, as well as the evidence about different estrogen/progestin combinations.\"},{\"question\":\"Why might EE/CPA not be recommended as first-line treatment?\",\"answer\":\"Despite benefits in reducing hyperandrogenism and hirsutism, EE/CPA may be avoided as first-line COCP due to higher venous thrombotic events (VTE) risk in the general population.\"}]","Different kinds of oral contraceptive pills in polycystic ovary syndrome - a systematic review and meta-analysis | PDF",1791329689,43]