Clinical and hormonal effects of gonadotropin-releasing hormone agonist plus an oral contraceptive in severely hirsute patients with polycystic ovary disease.
OBJECTIVE
To evaluate the therapeutic effects of a GnRH agonist (GnRH-a), leuprolide acetate (LA) plus a pill containing ethinyl E2 plus cyproterone acetate (CPA) in a group of women with severe hirsutism who were unresponsive to oral contraceptive (OC) therapy.


METHODS
Twenty-four patients suffering from severe hirsutism secondary to polycystic ovary disease (PCOD) were treated for 12 months with 3.75 mg IM LA every 28 days in association with 0.035 mg/d ethinyl E2 plus 2 mg/d CPA (Diane; Schering, Berlin, Germany) for 21 d/mo.


METHODS
Patients were recruited in the Institute of Obstetrics and Gynecology, St. Bambino Hospital, University of Catania, Catania, Italy. Hormonal assays were performed in the Hormone Laboratories of St. Bambino Hospital, University of Catania, Catania, Italy.


METHODS
Every 3 months the hirsutism score was evaluated. Mean serum concentrations of LH, FSH, E2, total and free T, androstenedione (A), sex hormone-binding globulin (SHBG), and DHEAS were determined. Every 6 months a vaginal ultrasound examination was performed.


RESULTS
In all patients after 6 and 12 months of treatment with LA plus OC, the hirsutism score improved significantly. Serum levels of LH, FSH, E2, total and free T, A, and DHEAS decreased significantly, whereas SHBG showed a marked increase. A significant reduction in the ovarian size was observed.


CONCLUSIONS
Gonadotropin-releasing hormone agonist, associated with a pill containing CPA, reduced the hirsutism in severely affected women with PCOD who are unresponsive to OC treatment alone.
Ciotta
L
L
Department of Obstetrics and Gynecology, Santo Bambino Hospital, University of Catania, Italy.
Cianci
A
A
Giuffrida
G
G
Marletta
E
E
Aglianò
A
A
Palumbo
G
G
D000328:Adult; D003276:Contraceptives, Oral / Q000008:administration & dosage*; D017373:Cyproterone Acetate / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004997:Ethinyl Estradiol / Q000008:administration & dosage; D005260:Female; D006628:Hirsutism / Q000188:drug therapy*; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*
D003276:Contraceptives, Oral; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; D016729:Leuprolide