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Efficacy of second versus third generation oral contraceptives in the treatment of hirsutism.

AbstractOBJECTIVE:
To compare second versus third generation combination oral contraceptives (OCs) in the treatment of hirsutism.
METHODS:
Women with hirsutism, as defined by a minimum Ferriman-Gallwey score of 10, were randomized in a double-blind fashion to receive an OC containing either ethinyl estradiol/desogestrel or ethinyl estradiol/levonorgestrel for 9 months of treatment. Ferriman-Gallwey scores, androgen levels and sex hormone-binding globulin were measured at baseline and every 3 months for the duration of the study. Hormones were measured in duplicate by radioimmunoassay.
RESULTS:
Of the 47 women enrolled, 24 were randomized to ethinyl estradiol/desogestrel and 23 were randomized to ethinyl estradiol/levonorgestrel. Mean sex hormone-binding globulin increased significantly in subjects using the desogestrel-containing contraceptive compared with the levonorgestrel-containing contraceptive. Ten subjects completed the 9 months of treatment in the levonorgestrel group and 11 completed the study in the desogestrel group. Mean free testosterone and 3alpha-androstanediol glucuronide decreased significantly in the group receiving ethinyl estradiol/desogestrel but not in the ethinyl estradiol/levonorgestrel group. Mean Ferriman-Gallwey scores decreased significantly in both treatment groups. Improvement in mean Ferriman-Gallwey score was 35.7 +/- 38.1% (p < 0.001) for the ethinyl estradiol/desogestrel arm and 33.4 +/- 27.3% (p < 0.001) for the ethinyl estradiol/levonorgestrel arm. There were no statistically significant differences found in the improvement of Ferriman-Gallwey scores between the two treatment arms, although the power to detect a difference was limited by the small sample size.
CONCLUSIONS:
Treatment of hirsute women with third generation OCs containing desogestrel results in a significant increase in sex hormone-binding globulin and decrease in free testosterone and 3alpha-androstanediol glucuronide. Both second and third generation OCs were clinically effective in treating hirsutism.
AuthorsDaniel M Breitkopf, Mitchell P Rosen, Steven L Young, Manubai Nagamani
JournalContraception (Contraception) Vol. 67 Issue 5 Pg. 349-53 (May 2003) ISSN: 0010-7824 [Print] United States
PMID12742556 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Androgens
  • Contraceptives, Oral, Combined
  • Sex Hormone-Binding Globulin
  • Ethinyl Estradiol
  • Levonorgestrel
  • Desogestrel
Topics
  • Adolescent
  • Adult
  • Androgens (blood)
  • Contraceptives, Oral, Combined (therapeutic use)
  • Desogestrel (administration & dosage)
  • Double-Blind Method
  • Ethinyl Estradiol (administration & dosage)
  • Female
  • Hirsutism (drug therapy, pathology)
  • Humans
  • Levonorgestrel (administration & dosage)
  • Middle Aged
  • Severity of Illness Index
  • Sex Hormone-Binding Globulin (metabolism)
  • Treatment Outcome

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