{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:07:24Z","timestamp":1793390844410,"version":"4.5.0"},"reference-count":56,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:00:00Z","timestamp":1689206400000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Iris Foundation"},{"DOI":"10.13039\/100010135","name":"Medical Society of Finland","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100010135","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100007083","name":"Orion Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007083","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NHMRC Medical Research Future Fund Practitioner Fellow","id":[{"id":"https:\/\/ror.org\/0513v5k17","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare between different combined oral contraceptive pills (COCPs) as part of the update of the International Evidence-Based Guidelines on the Assessment and Management of polycystic ovary syndrome (PCOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A systematic review and meta-analysis was performed, Prospero CRD42022345640.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MEDLINE, EMBASE, All EBM, CINAHL, and PsycINFO was searched on July, 8, 2022, for studies including women with PCOS, comparing 2 different COCPs in randomized controlled trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1660 studies were identified, and 19 randomized controlled trials (RCTs) were included.<\/jats:p>\n                    <jats:p>Fourth-generation COCP resulted in lower body mass index (BMI) (mean difference [MD] 1.17\u2005kg\/m2 [95% confidence interval {CI} 0.33; 2.02]) and testosterone (MD 0.60\u2005nmol\/L [95% CI 0.13; 1.07]) compared with third-generation agents, but no difference was seen in hirsutism.<\/jats:p>\n                    <jats:p>Ethinyl estradiol (EE)\/cyproterone acetate (CPA) was better in reducing hirsutism as well as biochemical hyperandrogenism (testosterone [MD 0.38\u2005nmol\/L {95% CI 0.33\u20130.43}]) and BMI (MD 0.62\u2005kg\/m2 [95% CI 0.05\u20131.20]) compared with conventional COCPs.<\/jats:p>\n                    <jats:p>There was no difference in hirsutism between high and low EE doses. No evidence regarding natural estrogens in COCP was identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>With current evidence, combined regimens containing an antiandrogen (EE\/CPA) may be better compared with conventional COCPs in reducing hyperandrogenism, but EE\/CPA will not be recommended as a first-line COCP treatment by the pending PCOS guideline update, due to higher venous thrombotic events (VTE) risk in the general population. Later-generation progestins offer theoretical benefits, but better evidence on clinical outcomes is needed in women with PCOS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>The protocol for the systematic review was registered prospectively in Prospero, CRD42022345640.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvad082","type":"journal-article","created":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T16:26:38Z","timestamp":1689179198000},"page":"S1-S16","source":"Crossref","is-referenced-by-count":68,"title":["Different kinds of oral contraceptive pills in polycystic ovary syndrome: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6674-3849","authenticated-orcid":false,"given":"Maria","family":"Forslund","sequence":"first","affiliation":[{"name":"Department of 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