Polycystic ovary syndrome (PCOS) affects up to 13% women and is associated with significant complications. The quality of evidence supporting the recommendations on treatment of non-fertility outcomes in PCOS is unknown.
To summarise and appraise the methodological quality of systematic reviews and meta-analyses evaluating pharmacological and surgical treatments for non-fertility outcomes in PCOS.
A literature search from MEDLINE, EMBASE, CINAHL PLUS, and PROSPERO was performed from inception until 15th of September 2017. Article selection, data extraction, and quality appraisal of included reviews were performed in duplicate. A narrative synthesis of the findings was conducted.
This overview included 31 reviews. The quality was low for seven, moderate for sixteen, and high for eight reviews. Two reviews assessed psychological outcomes. Metformin improved anthropometric (seven of ten reviews), metabolic (four of fourteen reviews), and endocrine outcomes (three of twelve reviews). Thiazolidinediones improved metabolic (two of five reviews) and endocrine outcomes (one of five reviews) but worsened weight gain (five of five reviews). Combined oral contraceptive pill (COCP) improved clinical hyperandrogenism (two of four reviews). Statins improved lipid profile (three of three reviews) and testosterone level (two of three reviews). There was no conclusive evidence regarding the use of other interventions.
There is reliable evidence regarding the use of metformin and COCPs in women with PCOS but not for other interventions. There is significant gap in knowledge regarding the management of psychological outcomes in women with PCOS which needs further evaluation.