title: Differences in the use of combined oral contraceptives amongst women with and without acne.
abstract: BACKGROUND
  Cyproterone acetate combined with ethinyl estradiol (CPA/EE) provides a treatment option for women with acne, hirsutism or polycystic ovary syndrome (PCOS). CPA/EE may be prescribed as an oral contraceptive (OC), but is not licensed as such in the UK. The use of CPA/EE steadily increased after its introduction to the UK market in 1987, but there was a marked increase in its share of the OC market after 1995.
  
  
  METHODS
  Using the General Practice Research Database, utilization patterns of CPA/EE and conventional oral contraceptives were compared in women aged 15-39 years, with or without acne or PCOS.
  
  
  RESULTS
  Between 1994 and 1998, CPA/EE accounted for an increasing proportion of all OC use. The proportion of CPA/EE prescribed to women with acne declined between 1994 and 1998, whereas that prescribed to women with PCOS remained constant. The age-specific use of CPA/EE by women with acne or PCOS almost doubled. After 1995, there was a marked increase in the use of products containing levonorgestrel by women with acne or PCOS.
  
  
  CONCLUSIONS
  A large proportion of CPA/EE is prescribed to women with acne and/or PCOS, although this proportion decreased between 1992 and 1998. This has important implications in CPA/EE risk assessment studies.
authors.affiliation: Pharmacoepidemiology Unit, Postgraduate Medical School (University of Surrey), Stirling House, Stirling Road, Surrey Research Park, Guildford, Surrey GU2 7DJ, UK. h.seaman@surrey.ac.uk
authors.forename: H E
authors.initials: HE
authors.lastname: Seaman
authors.forename: C S
authors.initials: CS
authors.lastname: de Vries
authors.forename: R D T
authors.initials: RD
authors.lastname: Farmer
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D000726:Androgen Antagonists / Q000627:therapeutic use*; D015331:Cohort Studies; D003271:Contraceptive Agents, Female / Q000627:therapeutic use; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use*; D017373:Cyproterone Acetate / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D045166:Estradiol Congeners / Q000627:therapeutic use*; D004997:Ethinyl Estradiol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016912:Levonorgestrel / Q000627:therapeutic use; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*
chemical_list: D000726:Androgen Antagonists; D003271:Contraceptive Agents, Female; D003277:Contraceptives, Oral, Combined; D045166:Estradiol Congeners; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; D016912:Levonorgestrel