Ethinylestradiol/cyproterone acetate in polycystic ovary syndrome: lipid and carbohydrate changes
Loading...
Date
2004
Journal Title
Journal ISSN
Volume Title
Publisher
PARTHENON PUBLISHING GROUP
Abstract
Objective Ethinylestradiol (EE) combined with the antiandrogenic progestin cyproterone acetate (CPA) is a possible treatment in polycystic ovary syndrome (PCOS). We investigated the impact of EE/CPA on lipid and carbohydrate metabolism in women with PCOS,who were otherwise healthy.
Method The 31 women were separated into two groups paired by body mass index (BMI): Group A (control, n = 15) were cycled with 10 mg medroxyprogesterone acetate (MPA) x 10 days (Provera(R), Pharmacia & Upjohn) every month for 3 months; Group B (n = 16) were treated with 35 mug EE/2 mg CPA (Diane 35(R), Schering) for 3 months. Metabolic and hormonal conditions were similar in both groups.
Results Group A showed no change in any hormone or metabolic parameter. Group B showed a significant decrease in free androgen index (-81%) and increase in sex hormone binding globulin (+639%), a decrease in low density lipoprotein cholesterol (-14%) and total cholesterol/high density lipoprotein (HDL) cholesterol index (-19%), and increases in HDL cholesterol (+23%) and triglycerides (+82%) (p < 0.001). Fasting insulin increased in 18%, the glucose/insulin index worsened in 8%, and the plasma glucose disappearance worsened in 12%, with no statistical significance (p = 0.092, p = 0.308 and p = 0.237, respectively).
Conclusion Treatment of PCOS with EE/CPA induces important favorable changes regarding hormone parameters associated with hyperandrogenism, significant favorable changes in lipid profile except for triglyceride increase, and no significant change in carbohydrate metabolism (measured by fasting insulin, glucose/insulin index and plasma glucose disappearance). MPA cycling does not change any of these parameters.
Method The 31 women were separated into two groups paired by body mass index (BMI): Group A (control, n = 15) were cycled with 10 mg medroxyprogesterone acetate (MPA) x 10 days (Provera(R), Pharmacia & Upjohn) every month for 3 months; Group B (n = 16) were treated with 35 mug EE/2 mg CPA (Diane 35(R), Schering) for 3 months. Metabolic and hormonal conditions were similar in both groups.
Results Group A showed no change in any hormone or metabolic parameter. Group B showed a significant decrease in free androgen index (-81%) and increase in sex hormone binding globulin (+639%), a decrease in low density lipoprotein cholesterol (-14%) and total cholesterol/high density lipoprotein (HDL) cholesterol index (-19%), and increases in HDL cholesterol (+23%) and triglycerides (+82%) (p < 0.001). Fasting insulin increased in 18%, the glucose/insulin index worsened in 8%, and the plasma glucose disappearance worsened in 12%, with no statistical significance (p = 0.092, p = 0.308 and p = 0.237, respectively).
Conclusion Treatment of PCOS with EE/CPA induces important favorable changes regarding hormone parameters associated with hyperandrogenism, significant favorable changes in lipid profile except for triglyceride increase, and no significant change in carbohydrate metabolism (measured by fasting insulin, glucose/insulin index and plasma glucose disappearance). MPA cycling does not change any of these parameters.
Description
Keywords
polycystic ovary syndrome, insulin resistance, lipoproteins, hyperandrogenism, oral contraceptives, cyproterone acetate, medroxyprogesterone acetate, HORMONE-BINDING GLOBULIN, COMBINED ORAL-CONTRACEPTIVES, CYPROTERONE-ACETATE, INSULIN ACTION, ESTROGEN REGIMENS, FREE TESTOSTERONE, GLUCOSE CLAMP, OBESE WOMEN, RESISTANCE, METFORMIN