17 beta-Estradiol: oral or parenteral administration in hyperandrogenic women? Metabolic tolerance in association with cyproterone acetate.
OBJECTIVE
To compare the metabolic effects of two different administration routes of estrogen associated with cyproterone acetate (CPA) in young women.


METHODS
Randomized and prospective study.


METHODS
University medical and research center.


METHODS
Sixty-five premenopausal young women with clinical hyperandrogenism.


METHODS
A high dose of CPA was administered, associated with either transdermal (group T) or oral (group O) 17 beta-E2.


METHODS
Glucose tolerance, plasma lipid level, coagulation and fibrinolysis parameters, and angiotensinogen, before and at 6 and 12 months during treatment.


RESULTS
At 12 months, fasting blood glucose and basal insulin levels were significantly lower in group O than in group T. The increase in angiotensinogen was greater in group O, however, without modification in arterial blood pressure. No significant difference between the two groups was observed in lipids, coagulation, and fibrinolysis.


CONCLUSIONS
Natural estrogens associated with CPA have no patent deleterious metabolic effect. However, the choice of oral estrogen administration seems to be better among patients with disorders such as hyperandrogenism or obesity with potential hyperinsulinism.
Endocrinology and Diabetology Department, Hôpital Saint-Louis, Paris, France.
P
P
Vexiau
J
J
Fiet
J
J
Conard
Y
Y
Abramovici
P
P
Boudou
N
N
Hardy
S
S
Consoli
G
G
Cathelineau
D000279:Administration, Cutaneous; D000284:Administration, Oral; D000808:Angiotensinogen / Q000097:blood; D000990:Antithrombin III / Q000032:analysis; D001053:Apolipoproteins / Q000097:blood; D001777:Blood Coagulation / Q000187:drug effects; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D017373:Cyproterone Acetate / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D004970:Estrone / Q000097:blood; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005342:Fibrinolysis / Q000187:drug effects; D005951:Glucose Tolerance Test; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D007328:Insulin / Q000097:blood; D010958:Plasminogen / Q000032:analysis; D017697:Premenopause; D011446:Prospective Studies; D012738:Sex Hormone-Binding Globulin / Q000032:analysis
D001053:Apolipoproteins; D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D012738:Sex Hormone-Binding Globulin; D000808:Angiotensinogen; D004970:Estrone; D017373:Cyproterone Acetate; D004958:Estradiol; D000990:Antithrombin III; D005340:Fibrinogen; D010958:Plasminogen; D002784:Cholesterol