title: Oral contraceptive therapy for polycystic ovary disease after chronic gonadotropin-releasing agonist administration. Predictors of continued ovarian suppression.
abstract: OBJECTIVE
  To study the beneficial effects of oral contraceptive (OC) therapy following gonadotropin-releasing hormone agonist (GnRH-a) administration in women with polycystic ovary disease (PCOD).
  
  
  METHODS
  Twenty-three hyperandrogenic women (aged 15-39) were randomized into two groups; GnRH-a (depot every 28 days) for six months or combination therapy (GnRH-a plus OC "addback") for six months. Following six months of treatment with either therapy, all patients received OC therapy for at least six months. The hormonal state was evaluated at three-month intervals.
  
  
  RESULTS
  Hormone levels of luteinizing hormone (LH), testosterone (T) and free T remained suppressed within the normal range in 11 of 17 patients (65%) during the six months of OC only therapy, while the other six patients showed "escape" from suppression, with the LH, T and free T concentrations rising to pre-GnRH-a treatment levels. Use of OC addback therapy did not potentiate the long-acting therapeutic effect of GnRH-a pretreatment; three of six patients in the escape group were pretreated with combination therapy and three with GnRH-a only.
  
  
  CONCLUSIONS
  In the majority of women with PCOD, OC therapy following GnRH-a administration was effective in maintaining ovarian androgen suppression. Failure to maintain ovarian suppression in this patient population was associated with higher elevations of baseline free T concentrations.
authors.affiliation: Department of Obstetrics/Gynecology, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: K E
authors.initials: KE
authors.lastname: Elkind-Hirsch
authors.forename: C
authors.initials: C
authors.lastname: Anania
authors.forename: R
authors.initials: R
authors.lastname: Malinak
mesh_terms: D000293:Adolescent; D000328:Adult; D003276:Contraceptives, Oral / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology; D016729:Leuprolide / Q000627:therapeutic use*; D007986:Luteinizing Hormone / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D013739:Testosterone / Q000097:blood; D013997:Time Factors
chemical_list: D003276:Contraceptives, Oral; D013739:Testosterone; D007986:Luteinizing Hormone; D016729:Leuprolide