Effect of long-term naltrexone treatment on endocrine profile, clinical features, and insulin sensitivity in obese women with polycystic ovary syndrome.
OBJECTIVE
Evaluation of clinical and endocrine effects of naltrexone administration in obese women with PCOS.


METHODS
Open, controlled, clinical study.


METHODS
Department of Reproductive Medicine and Child Development, Section of Gynecology and Obstetrics, University of Pisa, Pisa, Italy.


METHODS
Ten PCOS women were studied.


METHODS
Women were treated with naltrexone (50 mg/day) for 6 months.


METHODS
Body mass index and the menstrual cyclicity during naltrexone treatment were assessed. Basal levels of LH, FSH, 17beta-estradiol (E(2)), 17-hydroxyprogesterone, total and free T, androstenedione, dehydroepiandrosterone sulfate, cortisol, sex hormone-binding globulin were evaluated before treatment and every 3 months. Progesterone levels were measured in the luteal phase during the sixth month. Gonadotropin response to GnRH administration (10 microg) and a 75-g oral glucose tolerance test were performed before and every 3 months.


RESULTS
Body mass index significantly decreased from 29.94 +/- 1.04 to 26.07 +/- 0.81 during treatment. The menstrual cyclicity improved in 80% of PCOS women: the mean cycle length was 40-360 days before treatment and ranged between 25 and 120 days and 28-120 days after 3 and 6 months of treatment. Plasma levels of free T, androstenedione, dehydroepiandrosterone sulfate, and cortisol significantly decreased. Fasting glucose-to-insulin ratio improved in women with insulin resistance.


CONCLUSIONS
Naltrexone may have a beneficial effect on the clinical and endocrine-metabolic disturbances of obese PCOS women. Whether these effects are the consequences of weight loss or are due to changes in opioidergic tone is debatable.
Fruzzetti
Franca
F
Department of Reproductive Medicine and Child Development, Section of Gynecology and Obstetrics, University of Pisa, Pisa, Italy. ffruzzi@tin.it
Bersi
Chiara
C
Parrini
Donatella
D
Ricci
Cabiria
C
Genazzani
Andrea Riccardo
AR
D000328:Adult; D000728:Androgens / Q000378:metabolism; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D004334:Drug Administration Schedule; D004702:Endocrine Glands; D005215:Fasting / Q000097:blood; D005260:Female; D006062:Gonadotropins / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008597:Menstrual Cycle / Q000187:drug effects; D009271:Naltrexone / Q000008:administration & dosage*; D009292:Narcotic Antagonists / Q000008:administration & dosage*; D009765:Obesity / Q000150:complications*; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D013997:Time Factors
D000728:Androgens; D001786:Blood Glucose; D006062:Gonadotropins; D007328:Insulin; D009292:Narcotic Antagonists; D009271:Naltrexone; D006854:Hydrocortisone