title: Treatment of polycystic ovary syndrome with spironolactone plus licorice.
abstract: OBJECTIVE
  The aim of the study was to compare the effect of spironolactone (antagonist of mineralocorticoid and androgen receptors) versus spironolactone plus licorice (agonist of mineralocorticoid receptors and mild inhibitor of androgen synthesis) on plasma renin activity, aldosterone and androgen levels in women with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  Thirty-two women with PCOS were divided into two groups: 16 received 100 mg spironolactone and 16 spironolactone plus 3.5 g of licorice a day. Blood pressure, body mass index, serum electrolytes, plasma renin activity, plasma aldosterone and cortisol, serum testosterone, and urinary tetrahydrocortisol/tetrahydrocortisone ratio were measured before and during treatment.
  
  
  RESULTS
  Mean blood pressure was significantly reduced during spironolactone treatment, while it was unchanged in women receiving spironolactone plus licorice. Twenty percent of women treated with spironolactone and none treated with the addition of licorice complained of symptoms related to volume depletion. Consistently, the activation of the renin-aldosterone system was significantly lower during spironolactone plus licorice than with spironolactone alone. The prevalence of metrorrhagia was lower in the combined therapy.
  
  
  CONCLUSIONS
  In patients with PCOS the mineralocorticoid properties of licorice can reduce the prevalence of side effects related to the diuretic activity of spironolactone.
authors.affiliation: Department of Medical and Surgical Sciences-Endocrinology, University of Padua, Via Ospedale 105, 35100 Padua, Italy. Electronic address: decio.armanini@unipd.it.
authors.forename: Decio
authors.initials: D
authors.lastname: Armanini
authors.affiliation: Department of Biomedical and Surgical Sciences, Section of Endocrinology and Metabolism, University of Verona, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Castello
authors.affiliation: Department of Medical and Surgical Sciences-Endocrinology, University of Padua, Via Ospedale 105, 35100 Padua, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Scaroni
authors.affiliation: Department of Medical and Surgical Sciences-Endocrinology, University of Padua, Via Ospedale 105, 35100 Padua, Italy.
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Bonanni
authors.affiliation: Department of Morphological and Biomedical Sciences, University of Verona, Italy.
authors.forename: Gianbattista
authors.initials: G
authors.lastname: Faccini
authors.affiliation: Department of Medical and Surgical Sciences-Endocrinology, University of Padua, Via Ospedale 105, 35100 Padua, Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Pellati
authors.affiliation: Department of Medical and Surgical Sciences-Endocrinology, University of Padua, Via Ospedale 105, 35100 Padua, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bertoldo
authors.affiliation: Department of Medical and Surgical Sciences-Endocrinology, University of Padua, Via Ospedale 105, 35100 Padua, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Fiore
authors.affiliation: Department of Biomedical and Surgical Sciences, Section of Endocrinology and Metabolism, University of Verona, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Moghetti
mesh_terms: D000328:Adult; D000450:Aldosterone / Q000378:metabolism; D000728:Androgens / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D004232:Diuretics / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006035:Glycyrrhiza; D006801:Humans; D000451:Mineralocorticoid Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D008901:Mineralocorticoids / Q000037:antagonists & inhibitors; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D018161:Receptors, Mineralocorticoid / Q000819:agonists; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000502:physiology; D013148:Spironolactone / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000728:Androgens; D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists; D008901:Mineralocorticoids; D018161:Receptors, Mineralocorticoid; D013148:Spironolactone; D000450:Aldosterone; D012083:Renin