Evidence mapPaperPMID 24092830Full record

SynthesisThe Journal of clinical endocrinology and metabolism2013

Adverse effects of the common treatments for polycystic ovary syndrome: a systematic review and meta-analysis.

Juan Pablo Domecq, Gabriela Prutsky, Rebecca J Mullan, Vishnu Sundaresh, Amy T Wang, Patricia J Erwin, Corrine Welt, David Ehrmann, Victor M Montori, Mohammad Hassan Murad

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in The Journal of clinical endocrinology and metabolism, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
53citing papers in PubMed, 5 pooled it
13.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

53 citing papers in PubMed, 5 syntheses or guidelines pooled it, 108 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Evaluation of Preeclampsia Results after Use of Metformin in Gestation: Systematic Review and Meta-analysis.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2018
    Pooled it
  5. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline.The Journal of clinical endocrinology and metabolism · 2013 · on this map
    Guideline
  6. Trial
  7. Trial
  8. Feasibility and Acceptability of Metformin to Augment Low Milk Supply: A Pilot Randomized Controlled Trial.Journal of human lactation : official journal of International Lactation Consultant Association · 2019
    Trial
  9. Trial
  10. Trial
  11. Article
  12. Review
  13. Review
  14. Review
  15. Review
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  17. Article
  18. Review
  19. CL22209, a standardizedFood & nutrition research · 2025
    Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Juan Pablo DomecqMD, MPH, Knowledge and Evaluation Research Unit, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. Murad.mohammad@mayo.edu.
Gabriela Prutsky
Rebecca J Mullan
Vishnu Sundaresh
Amy T Wang
Patricia J Erwin
Corrine Welt
David Ehrmann
Victor M Montori
Mohammad Hassan Murad
Mayo Clinic · USDetroit Medical Center · USMassachusetts General Hospital · USUniversity of Chicago · USWinnMed · US

Funding

NICHD NIH HHS R01 HD065029
6 · The paper itself

Abstract

contextPolycystic ovary syndrome (PCOS) is common among women of childbearing age and the available pharmacological therapies have different side-effect profiles.

objectiveWe summarized the evidence about the side effects of oral contraceptive pills, metformin, and anti-androgens in women with PCOS. DATA SOURCE: Sources included Ovid Medline, OVID EMBASE, OVID Cochrane Library, Web of Science, Scopus, PsycInfo, and CINAHL from inception through April 2011. STUDY SELECTION: We included comparative observational studies enrolling women with PCOS who received the agents of choice for at least 6 months and reported adverse effects. DATA EXTRACTION: Using a standardized, piloted, and Web-based data extraction form and working in duplicate, we abstracted data from each study and performed meta-analysis when possible. DATA SYNTHESIS: We found 22 eligible studies of which 20 were randomized. No study reported severe side effects (eg, lactic acidosis, thromboembolic episodes, liver toxicity, cancer incidence, or pregnancy loss). Meta-analysis demonstrated no significant change in weight in oral contraceptive pills or flutamide users. Indirect evidence from populations without PCOS demonstrated no increased risk of lactic acidosis with metformin, only case reports of liver toxicity with flutamide (no comparative evidence), and increased relative risk difference of venous thromboembolism with oral contraceptive pills but very low absolute risk. Evidence on mortality, cardiovascular mortality, and cancer was inconclusive.

conclusionsDrugs commonly used to treat PCOS appear to be associated with very low risk of severe adverse effects although data are extrapolated from other populations.

Indexed as

Evidence-Based MedicineAndrogen AntagonistsContraceptives, OralFemaleFlutamideHumansHypoglycemic AgentsMetforminPolycystic Ovary SyndromeRisk FactorsVenous ThromboembolismAndrogen AntagonistsContraceptives, OralFlutamideHypoglycemic AgentsMetformin

Identifiers

PMID24092830
PMCPMC5399491
OpenAlexW1979724250

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.