Comparison of two oral contraceptives containing either drospirenone or cyproterone acetate in the treatment of hirsutism

Batukan C., Muderris I. I., Ozcelik B., Ozturk A.

GYNECOLOGICAL ENDOCRINOLOGY, cilt.23, sa.1, ss.38-44, 2007 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 23 Sayı: 1
  • Basım Tarihi: 2007
  • Doi Numarası: 10.1080/09637480601137066
  • Dergi Adı: GYNECOLOGICAL ENDOCRINOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.38-44
  • Anahtar Kelimeler: drospirenone, cyproterone acetate, oral contraceptive, hirsutism, hyperandrogenism, ethinyl estradiol, POLYCYSTIC-OVARY-SYNDROME, ETHINYL ESTRADIOL, NONOBESE WOMEN, ANDROGENS, METFORMIN, ETHINYLESTRADIOL, MANAGEMENT, ENDOCRINE, SPIRONOLACTONE, FINASTERIDE
  • Erciyes Üniversitesi Adresli: Evet

Özet

Combined oral contraceptives (COCs) are considered the first-line treatment for women with hirsutism. They diminish androgen release from the ovary and decrease plasma free testosterone levels by increasing sex hormone-binding globulin (SHBG) concentrations. COCs containing cyproterone acetate (CPA) and drospirenone (DRSP) have been proved effective for the treatment of acne and facial hirsutism. This study prospectively compared the clinical and biochemical efficacy of 3 mg DRSP/30 mu g ethinyl estradiol (EE) and 2 mg CPA/35 mu g EE combinations in a total of 91 patients with hirsutism. Individuals randomly received a cyclic combination of either DRSP/EE (n = 48) or CPA/EE (n = 43) for 12 months. Basal serum total testosterone, free testosterone, androstenedione, dehydroepiandrosterone sulfate and SHBG levels, as well as Ferriman-Gallwey scores, were determined before and after treatment. Both COCs achieved a similar effect on clinical hirsutism scores, in addition to serum androgen and SHBG levels, after completion of therapy. The percentage reductions in total hirsutism score (median % (min-max)) during therapy were 0.70 (0-0.58) vs. 0.57 (0.10-1.00) at 6 months (P = 0.028) and 0.80 (0-0.42) vs. 0.81 (0-0.75) at 12 months (p = 0.6) in the DRSP/EE and CPA/EE groups, respectively. In conclusion, the DRSP/EE combination is at least as effective as the CPA/EE combination in improving hirsutism scores.