Effect of oral contraceptive containing ethinyl estradiol combined with drospirenone vs. desogestrel on clinical and biochemical parameters in patients with polycystic ovary syndrome.
BACKGROUND
A prospective randomized trial was conducted to compare efficacy of a drospirenone-containing combined oral contraceptives (COC) with desogestrel-containing COC in women with polycystic ovary-syndrome (PCOS) not desirous of child-bearing.


METHODS
Sixty women were randomized into study group [ethinylestradiol (EE) 30 mcg+drospirenone 3 mg] and control group (EE 30 mcg+desogestrel 150 mcg), treated for 6 months and followed up at 1 month, 3 months, 6 months, during treatment and 3 and 6 months post-treatment. Acne and hirsutism scoring, bodyweight, body mass index (BMI), blood pressure (BP), ultrasound parameters, lipid profile, glycemic profile and hormonal profile were compared.


RESULTS
Cycles were regular in both groups during treatment. Effect of regular cycles persisted in 44.83% (13/30) vs. 17.24% (5/30) in study vs. control group at 6 months post-treatment with 33.3% decreased hirsutism score in the study group (versus no change in control group) even at 6 months after stopping treatment. With treatment, BMI fell by 0.52 kg/m(2) in the study group; systolic and diastolic BP fell in the study group while it rose in the control group. Low-density lipoprotein significantly decreased and high-density lipoprotein was elevated in the study group (p<.05). The study group showed a significant fall in fasting/postprandial blood sugar and insulin and total testosterone against a rise in the control group.


CONCLUSIONS
In women with PCOS, a drospirenone containing COC has better outcome in terms of persistent regular cycles, antiandrogenic effect, fall in BMI and BP, better lipid profile, favorable glycemic and hormonal profile than desogestrel-containing COC.
Kriplani
Alka
A
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi 110029, India. kriplanialka@gmail.com
Periyasamy
Anurekha Janaki
AJ
Agarwal
Nutan
N
Kulshrestha
Vidushi
V
Kumar
Anand
A
Ammini
Ariachery Chinnama
AC
D000152:Acne Vulgaris / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D000736:Androstenes / Q000494:pharmacology* / Q000627:therapeutic use; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000502:physiology; D003277:Contraceptives, Oral, Combined / Q000494:pharmacology* / Q000627:therapeutic use; D017135:Desogestrel / Q000494:pharmacology* / Q000627:therapeutic use; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006628:Hirsutism / Q000378:metabolism; D006801:Humans; D007328:Insulin; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000378:metabolism; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013739:Testosterone; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
D000736:Androstenes; D001786:Blood Glucose; D003277:Contraceptives, Oral, Combined; D004338:Drug Combinations; D007328:Insulin; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D014280:Triglycerides; C534342:drospirenone and ethinyl estradiol combination; D013739:Testosterone; D004997:Ethinyl Estradiol; D017135:Desogestrel