Comparative study of the therapeutic effects of oral contraceptive pills containing desogestrel cyproterone acetate and drospirenone in patients with polycystic ovary syndrome

Therapeutic effects of three different oral contraceptive pills are comparable after 6 months of treatment. After 12 months, the cyproterone containing pill shows greater antiandrogenic effect. Effects on metabolic parameters are identical.

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Authors

Sudhindra Mohan Bhattacharya, M.D. and Ayan Jha, D.P.H.

Vol 98, Issue 4, Pages 1053-1059

Abstract

Objective:

To compare the effects of oral contraceptive pills containing Desogestrel (DSG), Cyproterone acetate (CPA) and Drospirenone (DRSP), in polycystic ovary syndrome (PCOS), after 6 and 12 months of therapy

Design:

Double-blind randomized controlled trial.

Setting:

Gynecologic clinic of the first author.

Patients:

Women (n = 171) with PCOS (Androgen Excess Society criteria, 2006).

Interventions:

The three-arm trial involved 58, 56, 57 cases in DSG, CPA and DRSP groups respectively. Body mass index, abdominal circumference, Hirsutism score (m F: G), acne and acanthosis nigricans scores, blood pressure were noted. Blood levels of total testosterone, sex hormone binding globulin (SHBG), fasting glucose and fasting insulin were measured. Free Androgen Index (FAI), Glucose- Insulin ratio (G: I), Homeostasis model assessment – insulin resistance (HOMA-IR) were calculated. Follow up was after 6 months and 12 months of treatment.

Main outcome measures:

Primarily, absolute change in the FAI score between the three groups and secondarily, changes in the clinical and other hormonal and biochemical parameters were studied.

Results:

Six months of treatment showed similar effects. After 12 months, cyproterone acetate significantly decreased the modified Ferriman Galwey score (change = −5.29) compared with both desogestrel (change = −1.69) and drospirenone (change = −2.12); cyproterone acetate significantly increased sex hormone–binding globulin (change = 142.91) compared with desogestrel (change = 99.53); drospirenone significantly increased sex hormone–binding globulin (change = 131.52) compared with desogestrel; and cyproterone acetate significantly decreased the Free Androgen Index (change = −10.57) compared with desogestrel (change = −5.58).

Conclusion:

No difference in effects after 6 months. At 12 months, CPA showed strongest anti-androgen activities. Effects on metabolic parameters were identical.

Clinical Trial Registration Number:

CTRI/2010/091/000332

Read the full text at: http://www.fertstert.org/article/S0015-0282(12)00688-7/fulltext


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Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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