Effect of simvastatin and combined oral contraceptive pills in the treatment of polycystic ovary syndrome

Abstract

Objective: this study compare the effect of combination of simvastatin with combined oral contraceptive (COCP) versus COCP alone on PCOS women with hirsutism
simvastatin plus COCP , then COCP alone .group II use COCP alone then COCP with simvastatin . Each treated for 12 weeks and assessment done before and after each treatment period. All the patients are attending the medical consultation center of niniva 
collage 
medicine.
of 
Results: Patients  in  group  I  have  20.3%  improvement  in  ferriman  and  Gallwey  score (FGS) ,and 49.62 % decrease in testosterone (T) after treatment with simvastatin and COCP for  12 weeks compared with 16.9 % improvement in FGS and 21.84 % decline in T after COCP treatment. Patient in Group II develops  13.4% decrease in FGS and15.97 % reduction in T after treatment with COCP alone compared to 28.92% reduction in FGS and 20% decline in testosterone after treatment with simvastatin and COCP, with significant difference at P value less than 0.05 and 0.01.
In group I : Total cholesterol, LDL decreased by 14.8% ,12.14%  in the combined treatment compared with 7.94 % ,2.76%  in the COCP with significant difference at p value of 0.05 and 0.01.TG decreased by 10 % compared to 11% increase in the COCP alone treatment. HDL increased by 10.5 % in the combined treatment compared to the 5.92 % increase in the COCP group with significant difference at p value of 0.05 and 0.01.
In group II : there is no significant difference in the decrease in cholesterol ,LDL level between COCP and combined treatment, cholesterol tend to decrease by 12.58 % and 12.1%  and LDL by 9.9 % and 8.4 %. Triglyceride tend to be decreased by simvastatin and COCP treatment by 14.3 %, and to increased by 0.02 % by COCP with statistical significant difference  at  P  value  less  than  0.05 and  0.01  .HDL  tend  to  be  increased  by  8.9%  by simvastatin and COCP and 8.7 % increase by COCP with no statistical significant difference. Conclusion: the use of simvastatin combined with COCP can exert a beneficial effects on both endocrine and metabolic aspects of PCOS . simvastatin can improve hyperandrogenisim and hirsutism more than COCP alone and it have beneficial effect on lipid profile unlike COCP.