Drospirenone for the Treatment of Hirsute Women with Polycystic Ovary Syndrome: A Clinical, Endocrinological, Metabolic Pilot Study

Guido, Maurizio; Romualdi, Daniela; Giuliani, Maddalena; Suriano, Rosanna; Selvaggi, Luigi; Apa, Rosanna; Lanzone, Antonio

doi:10.1210/jc.2003-031158

Cited by 147 publications

(116 citation statements)

References 36 publications

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“…This indicates that drospirenone-containing oral contraceptives may be more effective in the treatment of hyperandrogenism than oral contraceptives that use 17α-hydroxyprogesterone derivatives as the progestin agents. 69 A similar study conducted over 12 cycles confirmed the same results. 70 In addition, there is also evidence that treatment with EE30 + DRSP decreases the severity of acne in women with polycystic ovarian syndrome.…”

Section: Oral Contraceptives Containing Drospirenonesupporting

confidence: 64%

“…In another study of women with polycystic ovarian syndrome, androstenedione, DHEAS, testosterone, and free testosterone levels were reduced when the women were treated with EE30 + DRSP. 69 The same study showed that the magnitude of the sex hormone-binding globulin increase found with EE30 + DRSP treatment was greater than that found with treatment using 17α-hydroxyprogesterone derivatives. This indicates that drospirenone-containing oral contraceptives may be more effective in the treatment of hyperandrogenism than oral contraceptives that use 17α-hydroxyprogesterone derivatives as the progestin agents.…”

Section: Oral Contraceptives Containing Drospirenonementioning

confidence: 92%

“…Antagonism of the aldosterone and androgen receptor is the mechanism through which the majority of the studies show that drosperidone-containing oral contraceptives are devoid of negative effects, both on insulin-glucose metabolism and lipid metabolism. 69,78 All these effects have to be considered in the choice of an oral contraceptive, particularly in hyperandrogenic women, in whom androgen hyperactivity exposes them to a greater risk of metabolic disorders and their consequences on health.…”

mentioning

confidence: 99%

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Use of oral contraceptives in the management of acne

Melis¹,

Orrù²,

Marotto³

et al. 2011

OAJC

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Abstract:The pathogenesis of acne (the most common disorder involving the sebaceous gland) originates from increased sebum production by the sebaceous gland followed by colonization of the hair follicle with Propionibacterium acnes, hyperkeratinization of the upper follicle, and release of inflammatory mediators into the skin. Androgens are the main stimulators of sebum production. Androgens originate from the gonads and adrenal glands, but can also be locally produced within the sebaceous gland from dehydroepiandrosterone sulfate. In the presence of high androgen levels, which can be either a normal pattern of adolescence or a consequence of gonadal or adrenal disease, overproduction of sebum triggers the pathogenesis of acne which, mainly in adolescent women, has deleterious psychological consequences. Estrogens exert the opposite action on sebum production, probably due to the reduction of androgen availability, a direct consequence of estrogen-related increased production of hepatic sex hormone-binding globulin (SHBG). The inhibition of the hypothalamus-pituitary axis induced by oral contraceptives is followed by reduced androgen production. Oral contraceptives containing ethinyl estradiol, which has strong estrogenic activity, amplify the hypoandrogenic effect via estrogenrelated stimulation of SHBG. The hypoandrogenic effect of oral contraceptives is modulated by the progestin compound. Progestins derived from 19-nortestosterone bind androgenic receptors, whereas others exert antiandrogenic properties by antagonizing the binding of androgens to their receptors, reduce 5α-reductase, and do not bind SHBG. Through this last effect, SHBG is freely available to bind androgens, and the same progestin is totally free to exert its antiandrogenic properties. After correct evaluation of the cause of acne, appropriate management can be undertaken using oral contraceptives containing low daily doses of ethinyl estradiol (20 or 30 µg) associated with a progestin compound, such as cyproterone acetate, drospirenone, or chlormadinone acetate, the antiandrogenic activity of which has been demonstrated by many studies in animals and in humans.

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Section: Oral Contraceptives Containing Drospirenonesupporting

confidence: 64%

Section: Oral Contraceptives Containing Drospirenonementioning

confidence: 92%

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confidence: 99%

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Use of oral contraceptives in the management of acne

Melis¹,

Orrù²,

Marotto³

et al. 2011

OAJC

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“…Oral contraceptives are used for the treatment of PCOS. Combined oral contraceptives containing drospirenone are preferred especially in the PCOS patients with hirsutism [8] . The risk of myocardial infarction and intracerebral events is 2.5% higher in the patients taking combined oral contraceptives containing low dose estrogen [9] .…”

Section: Discussionmentioning

confidence: 99%

Dangerous triplet: Polycystic ovary syndrome, oral contraceptives and Kounis syndrome

Erol¹

2014

WJC

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Polycystic ovary syndrome is characterized by ovulatory dysfunction, androgen excess and polycystic ovaries and is associated with hypertension, diabetes, metabolic syndrome and cardiovascular events. Oral contraceptives constitute first-line treatment, particularly when symptomatic hyperandrogenism is present. However, these drugs are associated with cardiovascular events and hypersensitivity reactions that pose problem in differential diagnosis and therapy. We present a 14 year-old female with polycystic ovary syndrome taking oral contraceptive and suffering from recurrent coronary ischemic attacks with increased eosinophils, and troponin levels suggesting Kounis syndrome. Key words: Contraceptives; Eosinophils; Kounis syndrome; Polycystic ovary syndrome; Troponin Core tip: The young lady in our case has had suffered from hyperandrogenism, oligomenorrhea, polycystic ovaries and while was receiving oral contraceptives she developed intermittent angina attacks not strictly related to her medication. The angina attacks associated with increased cardiac enzymes increased high sensitivity cardiac troponin, skin itching and electrocardiographic changes suggesting of myocardial ischemia. Eosinophils were raised but the coronary arteries were normal. The angina attacks disappeared with discontinuation of contraceptives. Such angina attacks associated with such clinical setting are attributed to disease itself, to oral contraceptives and/or to Kounis hypersensitivity coronary syndrome, namely a dangerous triplet.Erol N, Karaagac AT, Kounis NG. Dangerous triplet: Polycystic ovary syndrome, oral contraceptives and Kounis syndrome.

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“…Drospirenone is normally found in combined oral contraceptives at a dose of 3 mg. In studies that evaluated the effects of ethinyl estradiol/drospirenone in women with PCOS, an improvement in menstrual cycles, hirsutism, and acne has been observed (38,39).…”

Section: Drospirenonementioning

confidence: 99%

Hirsutism, Acne, and Hair Loss: Management of Hyperandrogenic Cutaneous Manifestations of Polycystic Ovary Syndrome

Yaşa

Dural

Baştu

et al. 2017

Gynecol Obstet Reprod Med

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Polycystic ovary syndrome is the most common endocrine abnormality that affects reproductive-aged women. Diagnostic criteria of polycystic ovary syndrome have been established by different societies in recent years, and hyperandrogenism remains as one of the main criteria for diagnosis. Cutaneous manifestations of hyperandrogenism include hirsutism, acne and androgenic alopecia and are commonly observed in women with polycystic ovary syndrome. The major determinants of cutaneous manifestations are increased production of androgen and increased tissue availability. Cutaneous manifestations of hyperandrogenism are cosmetic problems, which produce significant emotional distress and psychological morbidity. Treatment includes a combination of combined oral contraceptives, antiandrogens, insulin sensitizers, gonadotropin releasing hormone agonists, topical medications, and cosmetic procedures. The diagnosis, management, and treatment approaches are described in detail in this review.

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Drospirenone for the Treatment of Hirsute Women with Polycystic Ovary Syndrome: A Clinical, Endocrinological, Metabolic Pilot Study

Cited by 147 publications

References 36 publications

Use of oral contraceptives in the management of acne

Use of oral contraceptives in the management of acne

Dangerous triplet: Polycystic ovary syndrome, oral contraceptives and Kounis syndrome

Hirsutism, Acne, and Hair Loss: Management of Hyperandrogenic Cutaneous Manifestations of Polycystic Ovary Syndrome

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