Combined Oral Contraceptive Treatment of Adolescent Girls with Polycystic Ovary Syndrome: Lipid Profile

Abstract

The clinical signs and neuroendocrine features of adolescents with polycystic ovary syndrome (PCOS) resemble those found in adult women with PCOS. These adolescent patients are candidates for long-term treatment by one of the different therapeutic approaches that have been proposed. It is therefore essential that the treatment does not induce unfavorable metabolic effects. We investigated and compared the effects of cyproterone acetate (CA) and desogestrel (D), as part of combined oral contraceptives (COC), on lipid metabolism and hirsutism in adolescents with PCOS. Twenty-four girls with clinical signs of PCOS were recruited. They were all hyperandrogenemic and euthyroid and had normal prolactin plasma levels. Nonclassic congenital adrenal hyperplasia was ruled out by the ACTH stimulation test. Blood samples were obtained for sex hormone binding globulin (SHBG), total cholesterol (TC), LDL cholesterol, HDL cholesterol, triglycerides (TGs), apolipoproteins A-I, A-II, B, and lipoprotein (a) (Lp(a)) measurements. After the initial examination, therapy was initiated in a randomly selected order (12 and 12 patients were treated daily by 2 mg CA and 0.150 mg D, respectively, plus 0.035 and 0.030 mg ethinylestradiol, respectively). The degree of hirsutism and the lipid profile were reevaluated every 3 months after initiation of therapy for 1 year. Our data show that after 12 months of treatment with the D or CA COC, the Ferriman-Gallway hirsutism score decreased and TC and LDL-C increased. TGs and HDL-C were raised significantly in the CA COC group, whereas apolipoprotein A1 increased during D COC treatment. The atheromatic indices did not change. These data suggest that treatment of adolescent girls with PCOS is comparably effective with the two contraceptive formulations and that the desogestrel COC could be considered in the treatment of adolescent PCOS patients because it does not have side effects on lipid metabolism.

Pcos: Analysis of Symptoms and Management in a Tertiary Hospital

“…Our result is similar to that of previous study conducted by Creatsas G et al 8 Our results suggested that Ethinyl estradiol and Cyproterone acetate combination was effective for PCOS patients when compared to norethisterone.…”

The use of cyproterone acetate/ethinyl estradiol in hyperandrogenic skin symptoms – a review

“…Creatsas et al [46], Luque-Ramierz et al [47], Lemay et al [48], Falsetti et al [49] described consistent reduction in hirsutism scores (F-G and mF-G) in all areas of the body. Kahraman et al [46] describe more prominent changes in specific body areas, for example, the abdomen.…”

“…Creatsas et al [46], Luque-Ramierz et al [47], Lemay et al [48], Falsetti et al [49] described consistent reduction in hirsutism scores (F-G and mF-G) in all areas of the body. Kahraman et al [46] describe more prominent changes in specific body areas, for example, the abdomen. In an openlabel study, Golland and Elstein [50] reported a healing/ improvement rate of 54.6% (reduction in mean F-G score from 14.3 to 5.7) at 12 months with CPA/EE in 22 women with severe facial hirsutism.…”

“…Mastorakos et al [54] and Creatsas et al [46] compared the effects of CPA/EE with desogestrel (DSG)/EE and described similar and significant declines in F-G score for both formulations (compared to baseline) at six months and a continued, but not significant decline until 12 months. Bhattarcharya and Jha [10] compared the effects of CPA/EE on hirsutism score with both DSG/EE and DRSP/EE over 12 months.…”

“…Four of the studies compared the effects of CPA/EE on the hyperandrogenic skin symptoms of PCOS with COCs [10,46,47,53]. Kahraman et al [45] compared CPA/EE with drosperinone (DRSP)/EE and reported a significant difference in reduction in hirsutism score between the two, changes in mF-G score of À35% (À71 to 10) and À18% (À18 to 30) in women treated with CPA/EE and DRSP/EE, respectively.…”