“The Effect of Cyproterone Acetate and Ethinylestradiol Combination on Hyperandrogenic and Other Symptoms in Pcos”

Abstract

INTRODUCTION- Polycystic ovarian syndrome (PCOS) is a common, heterogeneous disorder affecting 5-15% of women of reproducing age group and characterized by hyperandrogenic skin symptoms, (acne, Hirsutism and female pattern alopecia,) irregular menstrual bleeding, obesity, dysmenorrhea infertility, and increased risk of metabolic syndrome and endometrial cancer. MATERIAL AND METHOD-The present study was conducted in a private gynecological Clinic Shivpuri, (M.P.). After taking Consent women suffering from PCOS (Fullled the clinical and USG criteria of PCOS(Rotterdam criteria )) along with androgenic symptoms like acne, hirsutism and androgenetic alopecia with or without other symptoms like menstrual irregularities and dysmenorrhea were included in the study.. All patients then received a combination of ethenyl Estradiol (0.035mg) + Cyproterone acetate (2mg). The Patients were followed in the third month, Sixth month, and at about 1 year for improvement in various complaints RESULT- According to presenting symptoms the most common presenting symptom was acne 72.72%, followed by menstrual irregularities 68.18%, hirsutism 50%, alopecia 27.27%, and dysmenorrhea in 27.27%. In acne patients, 37.5% of patients showed improvement after 3 cycles of CPA/EE, 75% showed at 6 months and in 93.75%, improvement was seen at 12 months. In the case of alopecia (83.33%) patient showed improvement after >6 cycles. Patients with hirsutism showed no improvement after 3 months of therapy but 54.54% of the patients showed a change in texture after 6 months of therapy and 72.72% after 9-12 months of therapy. Patients with dysmenorrhea reported a decrease in pain after therapy. The acceptance of the treatment was very good. In 86.36% of patients, good tolerance of drug was seen and in only 3 patients adverse effects (headache and nausea) of the drug were there. All the patients were having good to moderate satisfaction with the therapy. CONCLUSION- Since androgen excess is the prime defect in polycystic ovarian disease, its reduction is the main therapeutic target for most women. Our study found that combined hormonal contraceptives containing ethenyl Estradiol (0.035mg) + Cyproterone acetate (2mg) in a 21/7 regimen had a positive effect in the treatment of acne, hirsutism, menstrual irregularity, and dysmenorrhea in PCOS patients.