Ethinylestradiol-chlormadinone acetate combination for the treatment of hirsutism and hormonal alterations of normal-weight women with polycystic ovary syndrome: evaluation of the metabolic impact.
This is the first study evaluating the clinical, metabolic, and hormonal effects of the ethinylestradiol-chlormadinone acetate (EECMA) combination in hirsute women with polycystic ovary syndrome (PCOS). Ultrasonographic pelvic examination, hirsutism score, and hormone profile evaluation were performed at baseline and after 3 and 6 cycles of treatment. Oral glucose tolerance test, euglycemic-hyperinsulinemic clamp, and assessment of lipid profile were carried out at baseline and after 6 cycles of treatment. A significant improvement in hirsutism was evident at the end of treatment. From the third cycle onward, plasma levels of sex hormone binding globulin significantly increased when compared to baseline. Free androgen index, androstenedione, and 17-hydroxyprogesterone significantly decreased after 6 cycles. The treatment did not affect glucose and insulin homeostasis. Total cholesterol, triglycerides, and high-density lipoprotein (HDL) plasma levels remained unvaried, whereas low-density lipoprotein (LDL) concentrations showed a significant reduction. A significant increase in very-low-density lipoprotein (VLDL) levels was seen at the sixth cycle of therapy. In conclusion, EE-CMA combination ameliorates clinical and hormonal features of PCOS women, with no detrimental effects on glucose, insulin, and lipid metabolism.
Guido
Maurizio
M
Department of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Rome, Italy. maurizioguido@libero.it
Romualdi
Daniela
D
Campagna
Giuseppe
G
Ricciardi
Luigi
L
Bompiani
Alessandro
A
Lanzone
Antonio
A
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002715:Chlormadinone Acetate / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects / Q000627:therapeutic use*; D004997:Ethinyl Estradiol / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D015309:Glucose Clamp Technique; D005951:Glucose Tolerance Test; D006628:Hirsutism / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D008055:Lipids / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000503:physiopathology*; D055815:Young Adult
D001786:Blood Glucose; D003277:Contraceptives, Oral, Combined; D008055:Lipids; C488302:ethinylestradiol-chlormadinone acetate; D002715:Chlormadinone Acetate; D004997:Ethinyl Estradiol