Endocrine Abstracts

Objective: Combined oral contraceptive pills (COCP), primarily used for contraception; are also indicated in other conditions including polycystic ovary syndrome (PCOS). Evidence on the prevalence and patterns of COCP use in PCOS compared to those without the condition are unknown, and studies in unselected populations, especially longitudinally, are very limited. The aim of this study was to examine prevalence and patterns of COCP use in women with PCOS, compared to the background population and to explore patterns of use in different subgroups by age and BMI.

Study design: Women born 1973-78 were randomly selected and included in the Australian Longitudinal Study of Women´s Health (ALSWH), n= 981 women with and 13 266 women without PCOS. They were followed during a 25-year period.

Results: Altogether, more than 70% of all women had used COCP at some point. More women with than without PCOS reported ever having used COCP (77% vs 71%, P<0.001). However, cross-sectionally at different ages, use was less common in women with PCOS (at mean age 25 years 43% vs 51%; 31 years 31% vs 37%). Usage rates decreased with age in both groups. In the subgroup with BMI ≥30 kg/m², women with PCOS were more likely to use COCP than women without PCOS at different ages (mean age 25 years 16% vs 9%; 31 years 20% vs 8%; 42 years 5% vs 3%, respectively, P<0.001).

Conclusion: COCP usage was common among all women, more common overall in PCOS, but duration of use appeared shorter in PCOS. COCP usage was also more common among women with PCOS in the subgroup with obesity. Considering the increased indications and the increased metabolic risks associated with PCOS, there is a clear need for high-quality studies on COCP use in women with PCOS, to inform a risk-benefit assessment.