title: A comparative study to illustrate the benefits of using ethinyl estradiol-cyproterone acetate over metformin in patients with polycystic ovarian syndrome.
abstract: OBJECTIVE
  This study was done to illustrate the clinical and biochemical effects of ethinyl estradiol-cyproterone acetate (EE-AC) and metformin in this disease.
  
  
  METHODS
  This was a randomized control trial study, done on twenty-six female patients already diagnosed as cases of PCOS. Participants were divided into two study groups: group one (Group 1), received metformin of 500mg twice daily and the second group (Group 2), was given ethinyl estradiol-cyproterone acetate for 21 consecutive days followed by 7 days drug-free. The course of the treatment for both groups was continued for three consecutive months.
  
  
  RESULTS
  Group 1 showed a statistical significant increase in serum high density lipoprotein cholesterol (HDL-C) levels (P=0.006) and a decrease in the level of triglyceride (TG) (P=0.006). In addition, Group 1 had a significant reduction in the levels of very density lipoprotein cholesterol (VLDL-C) (P=0.006). Group 2 had a significant increase in serum TG levels (P=0.01), associated with a significant decrease in serum LDL-C (P=0.04). Serum testosterone was significantly reduced in group 1 (P=0.038). This was associated with an improvement in glucose tolerance test (GTT) and BMI in the same group (group 1). Group 2, had an improvement in the menstrual cycle control; hirsutism and acne.
  
  
  CONCLUSIONS
  This study showed that metformin treatment is beneficial in improving serum lipids; glucose homeostasis and BMI, however, the ethinyl estradiol-cyproterone acetate is superior in improving the clinical manifestation of patients with PCOS, including menstrual cycle regulation, hyperandrogenic state.
authors.affiliation: Department of Medicine, College of Medicine, Kufa University, Najaf, Iraq.
authors.forename: Noorhan S
authors.initials: NS
authors.lastname: Mhao
authors.affiliation: Department of Medicine, College of Medicine, Kufa University, Najaf, Iraq.
authors.forename: Ahmed S A
authors.initials: AS
authors.lastname: Al-Hilli
authors.affiliation: Department of Pharmacology, College of Medicine, Kufa University, Najaf, Iraq.
authors.forename: Najah R
authors.initials: NR
authors.lastname: Hadi
authors.affiliation: School of Medicine, University of Tasmania, TAS, 7001, Australia.
authors.forename: Dina A
authors.initials: DA
authors.lastname: Jamil
authors.affiliation: School of Medicine, University of Tasmania, TAS, 7001, Australia. Electronic address: h.alaubaidy@utas.edu.au.
authors.forename: Hayder A
authors.initials: HA
authors.lastname: Al-Aubaidy
mesh_terms: D000293:Adolescent; D000328:Adult; D000726:Androgen Antagonists / Q000627:therapeutic use*; D002784:Cholesterol / Q000097:blood; D017373:Cyproterone Acetate / Q000627:therapeutic use*; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008074:Lipoproteins / Q000097:blood; D008687:Metformin / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy*; D018570:Risk Assessment; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D000726:Androgen Antagonists; D004338:Drug Combinations; D007004:Hypoglycemic Agents; D008074:Lipoproteins; D014280:Triglycerides; C030104:lipoprotein cholesterol; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; C032640:Cyproterone acetate, ethinyl estradiol drug combination; D008687:Metformin; D002784:Cholesterol
keywords: Ethinyl estradiol-cyproterone acetate; Metabolic regulation; Metformin; Polycystic ovarian syndrome