Endocrinological, metabolic and clinical features of treatment with oral contraceptive formulation containing ethinylestradiol plus chlormadinone acetate in nonobese women with polycystic ovary syndrome.
BACKGROUND
Chlormadinone acetate (CMA) is a progestin compound similar to progesterone, with antiandrogenic properties. In healthy eumenorrheic women, it was demonstrated that the monophasic estroprogestin formulation containing CMA (2 mg) plus ethinyl estradiol (EE) (30 mcg) (EE30+CMA) is efficacious both in reducing hyperandrogenic symptoms, fat mass and in improving lipoprotein panel, without changes in insulin-glucose metabolism. These metabolic properties are important for women affected by polycystic ovary syndrome (PCOS) in whom there is a predisposition to insulin resistance.


METHODS
We studied whether in young nonobese women with PCOS (15 subjects, EE30+CMA-PCOS group) a six-cycle treatment with EE30+CMA can reduce androgen levels, androgen bioavailability and the score of hirsutism and acne, and modify glucose-insulin metabolism evaluated by the oral glucose tolerance test and the body composition evaluated by bio-impedenziometry. These parameters were evaluated before (first visit) and during the sixth cycle of EE30+CMA (second visit). All the results were compared with those of a matched-age-group of nonobese PCOS women (15 subjects, no OC-PCOS group) evaluated before (first visit) and after six menstrual cycles in which they did not use any drug or oral contraceptive (second visit).


RESULTS
In the EE30+CMA-PCOS group women, androgen levels and bioavailability, hirsutism and acne score were significantly lower at the second than at the first visit, whereas they did not change in no OC-PCOS group. At the second visit, in both groups, glucose-insulin metabolism and body composition parameters were not affected.


CONCLUSIONS
A six-cycle treatment with EE30+CMA is efficacious in nonobese PCOS women to improve hyperandrogenic symptoms, without negative interferences both on body composition and on insulin-glucose metabolism.
Uras
Roberto
R
Department of Obstetrics and Gynaecology, University of Cagliari, 09124 Cagliari, Italy.
Orrù
Marisa
M
Pani
Fabiana
F
Marotto
Maria Francesca
MF
Pilloni
Monica
M
Guerriero
Stefano
S
Etzi
Rossella
R
Zedda
Pierina
P
Sorge
Roberto
R
Lello
Stefano
S
Melis
Gian Benedetto
GB
Paoletti
Anna Maria
AM
D000152:Acne Vulgaris / Q000503:physiopathology; D000728:Androgens / Q000097:blood; D000886:Anthropometry; D001823:Body Composition / Q000502:physiology; D002715:Chlormadinone Acetate / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D017097:Electric Impedance; D004997:Ethinyl Estradiol / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D005947:Glucose / Q000032:analysis / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006628:Hirsutism / Q000503:physiopathology; D006801:Humans; D007328:Insulin / Q000032:analysis / Q000378:metabolism*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000378:metabolism; D055815:Young Adult
D000728:Androgens; D003277:Contraceptives, Oral, Combined; D007328:Insulin; D002715:Chlormadinone Acetate; D004997:Ethinyl Estradiol; D005947:Glucose