Treatment of polycystic ovary syndrome with spironolactone plus licorice.
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.
Armanini
Decio
D
Department of Medical and Surgical Sciences-Endocrinology, University of Padua, Via Ospedale 105, 35100 Padua, Italy. Electronic address: decio.armanini@unipd.it.
Castello
Roberto
R
Department of Biomedical and Surgical Sciences, Section of Endocrinology and Metabolism, University of Verona, Italy.
Scaroni
Carla
C
Department of Medical and Surgical Sciences-Endocrinology, University of Padua, Via Ospedale 105, 35100 Padua, Italy.
Bonanni
Guglielmo
G
Department of Medical and Surgical Sciences-Endocrinology, University of Padua, Via Ospedale 105, 35100 Padua, Italy.
Faccini
Gianbattista
G
Department of Morphological and Biomedical Sciences, University of Verona, Italy.
Pellati
Donatella
D
Department of Medical and Surgical Sciences-Endocrinology, University of Padua, Via Ospedale 105, 35100 Padua, Italy.
Bertoldo
Alessandro
A
Department of Medical and Surgical Sciences-Endocrinology, University of Padua, Via Ospedale 105, 35100 Padua, Italy.
Fiore
Cristina
C
Department of Medical and Surgical Sciences-Endocrinology, University of Padua, Via Ospedale 105, 35100 Padua, Italy.
Moghetti
Paolo
P
Department of Biomedical and Surgical Sciences, Section of Endocrinology and Metabolism, University of Verona, Italy.
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*
D000728:Androgens; D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists; D008901:Mineralocorticoids; D018161:Receptors, Mineralocorticoid; D013148:Spironolactone; D000450:Aldosterone; D012083:Renin