title: Effect of ethinylestradiol/cyproterone acetate on endothelial function in young non-obese women with polycystic ovary syndrome: a pilot study.
abstract: BACKGROUND
  Combined oral contraceptives are used in polycystic ovary syndrome (PCOS) women for the treatment of hyperandrogenism and menstrual cycle disturbances.
  
  
  OBJECTIVE
  To assess the effect of ethinylestradiol and cyproterone acetate (EE/CA) on endothelial function in young, non-obese PCOS women in a pilot study.
  
  
  METHODS
  Thirteen young, non-obese PCOS women (20.9 ± 3.7 years, 23.0 ± 4.0 kg/m(2)) received 35 mcg EE & 2 mg CA for 6 months. Fourteen age- and body mass index (BMI)-matched healthy women served as controls. Endothelial function assessed by brachial artery flow-mediated dilation (FMD), indices of hyperandrogenism, and insulin resistance were studied at baseline and 6-month follow-up.
  
  
  RESULTS
  FMD was impaired in PCOS compared to control women (4.67 ± 2.38% vs. 10.12 ± 3.19%, p < 0.001), but increased significantly following EE/CA (9.99 ± 2.11%, p < 0.001 vs. baseline), reaching normal values (p = NS vs. controls). EE/CA also significantly decreased hyperandrogenism indices and increased total and HDL cholesterol and triglycerides (p < 0.05 vs. baseline). The only independent predictor of treatment-induced FMD improvement in PCOS women was the decrease in free androgen index.
  
  
  CONCLUSIONS
  Treatment with combination of estrogens and antiandrogens reverses endothelial dysfunction in young, non-obese PCOS women mainly via improving hyperandrogenism. Further research is needed to investigate whether this treatment may also reduce cardiovascular risk in these women.
authors.affiliation: Department of Cardiology, University of Ioannina, Ioannina, Greece.
authors.forename: Katerina K
authors.initials: KK
authors.lastname: Naka
authors.forename: Sophia N
authors.initials: SN
authors.lastname: Kalantaridou
authors.forename: Aris
authors.initials: A
authors.lastname: Bechlioulis
authors.forename: Maria
authors.initials: M
authors.lastname: Kravariti
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kazakos
authors.forename: Christos S
authors.initials: CS
authors.lastname: Katsouras
authors.forename: Agathocles
authors.initials: A
authors.lastname: Tsatsoulis
authors.forename: Lampros K
authors.initials: LK
authors.lastname: Michalis
mesh_terms: D000293:Adolescent; D000328:Adult; D000726:Androgen Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D017373:Cyproterone Acetate / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004967:Estrogens / Q000494:pharmacology / Q000627:therapeutic use*; D004997:Ethinyl Estradiol / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D010865:Pilot Projects; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D011446:Prospective Studies; D012044:Regression Analysis; D014664:Vasodilation / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000726:Androgen Antagonists; D004967:Estrogens; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate