Comparison of desogestrel/ethinyl estradiol plus spironolactone versus cyproterone acetate/ethinyl estradiol in the treatment of polycystic ovary syndrome: A randomized controlled trial

• Published in: The journal of obstetrics and gynaecology research 2015-03, Vol.41 (3), p.402-410
• Main Authors: Leelaphiwat, Supatra, Jongwutiwes, Theerayut, Lertvikool, Srithean, Tabcharoen, Chotika, Sukprasert, Matchuporn, Rattanasiri, Sasivimol, Weerakiet, Sawaek
• Format: Article
• Language: English
• Subjects: Acne Vulgaris - drug therapy; Acne Vulgaris - etiology; Adult; Androgen Antagonists - therapeutic use; Androgens - blood; Androstenedione - blood; Cholesterol - blood; combined oral contraceptive pills; Contraceptives, Oral, Synthetic - therapeutic use; cyproterone acetate; Cyproterone Acetate - therapeutic use; desogestrel; Desogestrel - therapeutic use; Drug Therapy, Combination; Estrogens - therapeutic use; Ethinyl Estradiol - therapeutic use; Female; Humans; Hyperandrogenism - drug therapy; Hyperandrogenism - etiology; Lipoproteins, HDL - blood; Mineralocorticoid Receptor Antagonists - therapeutic use; polycystic ovary syndrome; Polycystic Ovary Syndrome - blood; Polycystic Ovary Syndrome - complications; Polycystic Ovary Syndrome - drug therapy; Severity of Illness Index; Sex Hormone-Binding Globulin - metabolism; spironolactone; Spironolactone - therapeutic use; Young Adult
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.12543

Aim To compare the effects of ethinyl estradiol (EE) 30 mcg/desogestrel 150 mcg plus spironolactone 25 mg/day (group A) versus EE 35 mcg/cyproterone acetate 2 mg (group B) on hyperandrogenism and metabolism in PCOS. Methods This was a randomized clinical study. Eighteen women in groups A and B received medications for three cycles. Acne score, androgens and metabolic parameters were assessed before and after treatment. Results One and two women in groups A and B, respectively, were excluded from the study. Both groups had significantly decreased acne score and free androgen index, and increased sex hormone‐binding globulin levels. Cholesterol and high‐density lipoprotein were significantly increased in group B, and androstenedione was significantly decreased in group A. The regular withdrawal bleeding was obtained in both groups. Conclusion Both regimens had quite similar efficacy on hyperandrogenism after three cycles of therapy and without any changes in metabolic parameters.