Hirsutism: metabolic effects of two commonly used oral contraceptives and spironolactone.
Fifty-one hirsute women were randomly treated for nine months with ethinyl estradiol 35 ug plus norethindrone 0.4 mg or 30 ug ethinyl estradiol plus 1.5 mg norethindrone acetate if they needed contraception or spironolactone 200 mg daily if they did not. Metabolic evaluations in response to therapy demonstrated triglyceride elevations with the two oral contraceptives but not with spironolactone. While systolic blood pressure was lower with spironolactone, fasting insulin levels were higher as opposed to either low-dose oral contraceptive preparation. Ethinyl estradiol 30 ug plus 1.5 mg norethindrone acetate lowered 3-alpha-diol glucuronide levels, yet ethinyl estradiol 35 ug plus norethindrone 0.4 mg and spironolactone were more effective in lowering Ferriman-Gallwey Scores. Treatment strategies for hirsute women need to consider metabolic consequences as well as efficacy.
Wild
R A
RA
Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City 73190.
Demers
L M
LM
Applebaum-Bowden
D
D
Lenker
R
R
D000704:Analysis of Variance; D015113:Androstane-3,17-diol / Q000031:analogs & derivatives / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D008076:Cholesterol, HDL / Q000097:blood; D004997:Ethinyl Estradiol / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006628:Hirsutism / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D007328:Insulin / Q000097:blood; D009640:Norethindrone / Q000009:adverse effects / Q000627:therapeutic use*; D013148:Spironolactone / Q000009:adverse effects / Q000627:therapeutic use*; D013739:Testosterone / Q000097:blood
D008076:Cholesterol, HDL; D007328:Insulin; D015113:Androstane-3,17-diol; C028895:androstane-3,17-diol glucuronide; D013148:Spironolactone; D013739:Testosterone; D004997:Ethinyl Estradiol; D009640:Norethindrone