Role of the combination spironolactone-norgestimate-estrogen in Hirsute women with polycystic ovary syndrome.

Abstract

OBJECTIVE:

To compare the combination spironolactone-norgestimate-ethinyl estradiol in hirsutism with other protocols including the same dose of estrogen.

STUDY DESIGN:

In this open prospective study, 167 women with hirsutism due to polycystic ovary syndrome (PCOS) were randomly assigned to the following treatment protocols: Group A (n = 72): spironolactone 100 mg-norgestimate 250 mcg-ethinyl estradiol 35 microg; Group B (n = 70): cyproterone acetate 12 mg-ethinyl estradiol 35 microg; Group C (n = 25): norgestimate 250 microg-ethinyl estradiol 35 microg.

RESULTS:

The decrease in the hirsutism score was higher in group A than in the other groups (p < 0.001) and comparable in groups B and C. The decrease in acne score, androgen and estradiol levels, and ovary volume was similar in groups A and B. C-reactive protein increase was similar in all groups, but the augmentation of fibrinogen (p = 0.04), triglycerides (p < 0.01), monocyte count (p = 0.04), platelet number (p < 0.001) and mean volume (p = 0.01) was more pronounced in group B than in group A. Low-density lipoprotein/high-density lipoprotein cholesterol ratio decreased in groups A and C.

CONCLUSION:

Spironolactone-norgestimate-ethinyl estradiol is an effective and well-tolerated combination for the treatment of hirsutism in PCOS, with a favorable influence on lipids and indices of low-grade inflammation.

• Authors: Philippe Hagag, Miriam Steinschneider, Mordechai Weiss
• Journal: The Journal of reproductive medicine (J Reprod Med) 2014 Sep-Oct Vol. 59 Issue 9-10 Pg. 455-63 ISSN: 0024-7758 [Print] United States
• PMID: 25330687 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Estrogens
• Spironolactone
• Norgestrel
• Testosterone
• norgestimate

Topics

• Adult
• Drug Therapy, Combination
• Estrogens (administration & dosage, therapeutic use)
• Female
• Hirsutism (drug therapy, epidemiology)
• Humans
• Norgestrel (administration & dosage, analogs & derivatives, therapeutic use)
• Polycystic Ovary Syndrome (drug therapy, epidemiology)
• Spironolactone (administration & dosage, therapeutic use)
• Testosterone (blood)
• Treatment Outcome
• Young Adult