Ethinylestradio-Chlormadinone Acetate Combination for the Treatment of Hirsutism and Hormonal Alterations of Normal-Weight Women With Polycystic Ovary Syndrome: Evaluation of the Metabolic Impact

Abstract

This is the first study evaluating the clinical, metabolic, and hormonal effects of the ethinylestradiol-chlormadinone acetate (EECMA) combination in hirsute women with polycystic ovary syndrome (PCOS). Ultrasonographic pelvic examination, hirsutism score, and hormone profile evaluation were performed at baseline and after 3 and 6 cycles of treatment. Oral glucose tolerance test, euglycemic-hyperinsulinemic clamp, and assessment of lipid profile were carried out at baseline and after 6 cycles of treatment. A significant improvement in hirsutism was evident at the end of treatment. From the third cycle onward, plasma levels of sex hormone binding globulin significantly increased when compared to baseline. Free androgen index, androstenedione, and 17-hydroxyprogesterone significantly decreased after 6 cycles. The treatment did not affect glucose and insulin homeostasis. Total cholesterol, triglycerides, and high-density lipoprotein (HDL) plasma levels remained unvaried, whereas low-density lipoprotein (LDL) concentrations showed a significant reduction. A significant increase in very-low-density lipoprotein (VLDL) levels was seen at the sixth cycle of therapy. In conclusion, EE-CMA combination ameliorates clinical and hormonal features of PCOS women, with no detrimental effects on glucose, insulin, and lipid metabolism.

Oral Contraceptive Containing Chlormadinone Acetate and Ethinylestradiol Reduces Plasma Concentrations of Matrix Metalloproteinase‐2 in Women with Polycystic Ovary Syndrome

“…OC use reduced serum glucose concentrations in both groups. All the alterations in biochemical metabolism we observed were within normal limits and were in agreement with results of previous studies .…”

“…OC use reduced serum glucose concentrations in both groups. All the alterations in biochemical metabolism we observed were within normal limits and were in agreement with results of previous studies [34,35]. We found that use of an anti-androgenic OC containing ethinylestradiol and chlormadinone acetate reduced plasma MMP-2 concentrations in women with and without PCOS.…”

The role of androgen and androgen receptor in skin-related disorders

“…There are also reports showed its beneficial effect for hirsutism treatment in women, although the detailed mechanism remains elusive [39,44]. …”

Combined Hormonal Contraception and Not Only…

“…Выраженные антиандрогенные свойства ХМА [17,26] позволяют использовать препарат для лечения синдрома поликистозных яичников (СПКЯ) и других проявлений гиперандрогении [41][42][43].…”

“…Антиандрогенные механизмы проявляются за счет конкурентного связывания ХМА с рецепторами к андрогенам, включая волосяные фолликулы и кожные сальные железы, подавления синтеза двух основных яичниковых и надпочечниковых андрогенов (дигидроэпиандростерона сульфата и андростендиона), снижения чувствительности клеток волосяных фолликулов и кожных сальных желез к андрогенам вследствие подавления в них активности 5-aльфа-редуктазы, катализирующей необратимое превращение тестостерона в сверхактивный дигидротестостерон в волосяных и сальных фолликулах, и за счет повышения синтеза глобулина, связывающего половые стероиды, который достоверно снижает уровни активного тестостерона в крови [50][51][52][53][54].…”