Effects of two estroprogestins containing ethynilestradiol 30 microg and drospirenone 3 mg and ethynilestradiol 30 microg and chlormadinone 2 mg on skin and hormonal hyperandrogenic manifestations.
Hyperandrogenic manifestation in women, such as seborrhea, acne and increased hair growth are common reasons of psychological distress. Skin appearance is very important for young women. This study evaluated the hormonal and skin effects of two estroprogestins (EPs) containing ethinyl-estradiol (EE) 30 microg associated with drospirenone (DRSP) 3 mg or chlormadinone acetate (CMA) 2 mg, respectively. Fifty-five women with signs and symptoms of hyperandrogenism (seborrhea, acne and increased hair growth) were enrolled in the study; randomly, 30 women were treated with EE 30 microg + DRSP 3 mg and 25 with EE 30 microg + CMA 2 mg. Follicle-stimulating hormone (FSH), luteinising hormone (LH), 17-hydroxyprogesterone (17OHP), androstenedione (A), testosterone (T), dehydroepiandrosterone sulfate (DHEAS), sex hormone binding globulin (SHBG) and free androgen index (T x 100/SHBG, FAI) were assessed at baseline, and after 3 and 6 months of treatment with EPs. Effects on seborrhea, acne and increased hair growth (as Ferriman-Gallwey score) were also evaluated at the same time points. Finally, skin hydration, transepidermal water loss (TEWL) and skin homogeneity were studied with non-invasive technique during the study. Treatment for 6 months with both EPs decreased significantly the circulating androgen levels (A, T, DHEAS) and FAI, and increased SHBG levels; also skin pattern was improved. EP containing EE and DRSP was better than EP containing EE and CMA as for skin changes, as seborrhea, acne, increased hair, hydration, homogeneity and overall quality of the skin; moreover, hormonal changes (as FAI) under therapy were more pronounced with EE/DRSP than EE/CMA. These effects may be considered in EP choice and could be important in improving patient's compliance and quality of life in hyperandrogenic women.
Lello
Stefano
S
Endocrinological Gynecology and Pathophysiology of Menopause Unit, IRCCS-Istituto Dermopatico dell'Immacolata, Rome, Italy. lellostefano@libero.it
Primavera
Grazia
G
Colonna
Laura
L
Vittori
Giorgio
G
Guardianelli
Francesca
F
Sorge
Roberto
R
Raskovic
Desanka
D
D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000152:Acne Vulgaris / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000726:Androgen Antagonists / Q000008:administration & dosage*; D000735:Androstenedione / Q000097:blood; D000736:Androstenes / Q000008:administration & dosage*; D002715:Chlormadinone Acetate / Q000008:administration & dosage*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D012628:Dermatitis, Seborrheic / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D004997:Ethinyl Estradiol / Q000008:administration & dosage*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006197:Hair / Q000187:drug effects; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D007986:Luteinizing Hormone / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D012871:Skin Diseases / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D013739:Testosterone / Q000097:blood; D055815:Young Adult
D000726:Androgen Antagonists; D000736:Androstenes; D012738:Sex Hormone-Binding Globulin; D002715:Chlormadinone Acetate; D013739:Testosterone; D000735:Androstenedione; D004997:Ethinyl Estradiol; D019314:Dehydroepiandrosterone Sulfate; D019326:17-alpha-Hydroxyprogesterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; C035144:drospirenone