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Atorvastatin was beneficial for women with PCOS

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Atorvastatin use reduced inflammation, biochemical hyperandrogenemia and metabolic parameters after 12 weeks in patients with polycystic ovary syndrome.

The researchers randomly assigned 40 medication-naive patients with PCOS and biochemical hyperandrogenemia to either 20 mg per day of atorvastatin (Lipitor, Pfizer) or placebo.

In the atorvastatin group, there was a reduction in total cholesterol (P<.01), LDL (P<.01), triglycerides (P<.01), high-sensitivity C-reactive protein (P=.04), free androgen index (P<.01), testosterone (P<.01) and insulin resistance.

There was an increase in sex hormone–binding globulin (31.1 nmol/L vs. 35.3 nmol/L; P<.01), according to the study. Findings also showed a positive correlation between the reduction in homeostasis model assessment for insulin resistance in the treatment group that experienced the reduction in triglycerides and the reduction of free androgen index. There was a significant deterioration of HOMA-IR in the placebo group (3.0 vs. 3.8).

“Statin treatment may prove to be a useful adjunct for women with PCOS,” the researchers wrote. – by Christen Haigh

J Clin Endocrinol Metab. 2009;94:103-108.

This study adds to the growing literature reporting salutary effects of statins on metabolic and endocrine parameters in women with PCOS. The mechanism is elusive and unlikely to involve inhibition of steroidogenesis. After all, administration of statins to men and women does not result in deficient cortisol or sex steroid production, and so it would be surprising if it were to selectively inhibit ovarian androgen production in PCOS. I suspect that the effects of statins in PCOS relate to changes in lipids that then improve insulin sensitivity. Statins should not be administered to women who might get pregnant, which limits their use in premenopausal women. Nonetheless, when considered in the context of the recent JUPITER trial, statins may play an important role in the long-term management of some women with PCOS. Women with PCOS have an increased risk for cardiovascular disease and often have elevated levels of C-reactive protein, and would be prime candidates for statin therapy if pregnancy is not a consideration.

– John E. Nestler, MD

Endocrine Today Editorial Board member