Androgen and lipid profiles in adolescents with polycystic ovary syndrome who were treated with two forms of combined oral contraceptives.
OBJECTIVE
To compare the effects of cyproterone acetate and desogestrel, as part of combined oral contraceptives, on lipid metabolism and hirsutism of adolescents with polycystic ovary syndrome (PCOS).


METHODS
Prospective randomized clinical trial.


METHODS
Outpatient gynecology clinic (referral center) of a university.


METHODS
Twenty-eight adolescent girls with clinical and biological hyperandrogenism and six or less menses during the past 12 months.


METHODS
Group A (n = 14) received 0.15 mg of desogestrel plus 0.030 mg of ethinyl estradiol daily. Group B (n = 14) received 2 mg of cyproterone acetate plus 0.035 mg of ethinyl estradiol daily. Treatment was given for 21 days followed by a 7-day rest for a period of 12 months.


METHODS
Hirsutism and lipid profile were evaluated before initiation and at 3, 6, 9, and 12 months of treatment. Androgen profile was evaluated before and at 12 months of treatment.


RESULTS
A significant decline of the Ferriman-Gallway hirsutism score was observed from the sixth month of therapy in both groups. During therapy, the levels of testosterone, free testosterone, Delta(4)-androstenedione, and 17OH-progesterone decreased significantly, whereas sex hormone-binding globulin (SHBG) increased significantly in both groups. The level of total cholesterol and low density lipoprotein (LDL) cholesterol increased significantly, whereas high density lipoprotein (HDL) cholesterol and apolipoprotein A-I increased significantly from the third month of therapy in both groups. Total cholesterol/HDL cholesterol and LDL cholesterol/HDL cholesterol ratios remained unchanged. The levels of triglycerides increased significantly in the cyproterone acetate-treated group after the third month.


CONCLUSIONS
Treatment of adolescent girls with PCOS with the two studied formulations is comparably effective in decreasing hirsutism and androgen levels. Both combined oral contraceptives are associated with an increase of total cholesterol, LDL cholesterol, and HDL cholesterol levels and no change of the total cholesterol/HDL cholesterol and LDL cholesterol/HDL cholesterol ratios. Treatment with the cyproterone acetate combined oral contraceptive is associated with a tendency toward increasing the levels of triglycerides.
Mastorakos
George
G
2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Athens, Greece. mastorak@mail.kapatel.gr
Koliopoulos
Carolina
C
Creatsas
George
G
D000293:Adolescent; D000328:Adult; D000726:Androgen Antagonists / Q000627:therapeutic use; D000728:Androgens / Q000097:blood*; D016632:Apolipoprotein A-I / Q000097:blood; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use*; D003280:Contraceptives, Oral, Synthetic / Q000627:therapeutic use; D017373:Cyproterone Acetate / Q000627:therapeutic use; D017135:Desogestrel / Q000627:therapeutic use; D004967:Estrogens / Q000627:therapeutic use; D004997:Ethinyl Estradiol / Q000627:therapeutic use; D005260:Female; D006628:Hirsutism / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008055:Lipids / Q000097:blood*; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications / Q000188:drug therapy*; D012720:Severity of Illness Index; D014280:Triglycerides / Q000097:blood
D000726:Androgen Antagonists; D000728:Androgens; D016632:Apolipoprotein A-I; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003277:Contraceptives, Oral, Combined; D003280:Contraceptives, Oral, Synthetic; D004967:Estrogens; D008055:Lipids; D014280:Triglycerides; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; D017135:Desogestrel; D002784:Cholesterol