The effect of ezetimibe on androgen production in hypercholesterolemic women with polycystic ovary syndrome.

Abstract

Statin therapy was found to reduce circulating androgen levels in patients with polycystic ovary syndrome (PCOS). No similar data are available for ezetimibe. The study included 14 women with PCOS and hypercholesterolemia, intolerant to statins or having contraindications to this treatment, who were treated with ezetimibe (10mg daily). They were compared with 14 matched women with both of these disorders receiving simvastatin (40mg daily). Plasma lipids, glucose homeostasis markers, and serum levels of androgens, sex hormone-binding globulin, and gonadotropins were assessed at baseline and after 3months of treatment. Both simvastatin and ezetimibe decreased plasma levels of total and LDL cholesterol. Ezetimibe, but not simvastatin, slightly reduced insulin resistance. Simvastatin decreased serum levels of total testosterone (-23%, P<0.001), free testosterone (-32%, P<0.001), androstendione (-20%, P<0.01), and dehydroepiandrosterone sulfate (-17%, P<0.05), as well as tended to reduce the luteinizing hormone/follicle-stimulating hormone ratio (-23%, P=0.095). Ezetimibe only insignificantly reduced serum levels of free testosterone (-14%, P=0.098). There were no differences in the effects of simvastatin on circulating hormone levels between insulin-resistant and insulin-sensitive subjects. In turn, the effect of ezetimibe on free testosterone levels was stronger in insulin-resistant patients. Although ezetimibe and simvastatin are equipotent in lowering lipid levels in hypercholesterolemic patients with coexisting PCOS, simvastatin exhibits a more pronounced effect on circulating androgen levels in this group of patients.