Simvastatin improved menstrual regularity in women with PCOS

ASRM 64th Annual Meeting

Six-month data demonstrated improved clinical and biochemical measures of hyperandrogenism and reduced cardiovascular risk factors with simvastatin vs. metformin in women with polycystic ovary syndrome.

Researchers at the University of California Davis in Sacramento and Poznan University of Medical Sciences in Poznan, Poland, presented the data from a prospective, randomized trial at the American Society for Reproductive Medicine 64th Annual Meeting in San Francisco. The study included 55 women with PCOS (mean age, 25.8 years) who were each randomly assigned to daily doses of simvastatin 20 mg, metformin 1,700 mg or combination simvastatin and metformin. The researchers reported no differences among the groups at baseline.

Before treatment with simvastatin and/or metformin, women reported an average 2.5 menses per six months. Six months of treatment with simvastatin alone increased the number of menses by 89%, metformin alone by 36% and combination therapy by 68% (P<.001 for all).

Simvastatin alone was also associated with statistically significant decreases in total cholesterol, LDL and C-reactive protein. Women in all three groups experienced significant decreases in BMI, hirsutism, acne and total testosterone. However, there was no additive effect of combination simvastatin and metformin compared with monotherapy alone, according to the study.

“This study demonstrates for the first time that simvastatin improves menstrual regularity in women with PCOS,” the researchers wrote. – by Katie Kalvaitis

These data are fascinating. But there is no apparent mechanism; that doesn't make it wrong but it may mean that maybe there is something that we do not understand. Now it is time to figure that out. I happen to think that metformin is a little bit oversold, in the sense that people put too much faith in it. So what do these data mean: Have we induced insulin sensitivity? Have we lowered triglycerides? I would venture a guess — and only a guess — that something in the brain is happier but I'm not sure what it is. I bet it is not in the peripheral metabolic compartment and query whether or not the hypothalamus and pituitary are involved but someone would have to do that study.

– Sarah L. Berga, MD

Professor and Chairman
Department of Gynecology and Obstetrics
Emory University School of Medicine

For more information:

Pawelczyk L, et al. #O-14. Presented at: the American Society for Reproductive Medicine 64th Annual Meeting; Nov. 8-12, 2008; San Francisco.