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Role of Statins in PCOS Management

  • Israel Ortega
  • Antoni J. Duleba
Chapter

Abstract

Polycystic ovary syndrome (PCOS) is characterized by the presence of hyperandrogenism, menstrual cycle irregularities and polycystic-appearing ovaries. Other prominent features associated with PCOS, including hyperinsulinemia, increased oxidative stress, and systemic inflammation may contribute to increased size of the theca-interstitial cell compartment and increased androgen production. Statins are competitive inhibitors of 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMG-CoA reductase), enzyme involved in the rate-limiting step of the mevalonate pathway. In vitro studies have demonstrated that statins reduce proliferation and steroidogenesis of theca-interstitial cells. In clinical trials, statins improve clinical, endocrine, and metabolic profiles of PCOS women. However, despite an overall favorable risk profile, use of statins in reproductive age women should be recommended with caution due to potential teratogenic effects; possible detrimental actions on glucose homeostasis are additionally suggested. Recently, resveratrol (trans-3,5,4′-trihydroxystilbene), a natural polyphenol found in grapes and red wine with anticarcinogenic, antioxidant, and anti-inflammatory properties, has been shown to improve insulin sensitivity and potentiate simvastatin-induced inhibition of theca cell proliferation and steroidogenesis. Thus, combined therapy using statin and resveratrol may potentially offer a novel, promising approach aimed at reduction of ovarian hyperandrogenism and cardiovascular risks in women with PCOS.

Keywords

PCOS Patient Mevalonate Pathway Theca Cell PCOS Woman Androgen Production 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

This study was supported by grant R01-HD050656 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (to AJD).

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Reproductive MedicineIVI-MadridMadridSpain
  2. 2.Department of Reproductive MedicineUniversity of California, San DiegoLa JollaUSA

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