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Androgen and lipid profiles in adolescents with polycystic ovary syndrome who were treated with two forms of combined oral contraceptives

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Mastorakos, George, Koliopoulos, Carolina, Creatsas, George·2002·Fertility and Sterility
DOI 10.1016/s0015-0282(02)02993-x
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Abstract

Objective To compare the effects of cyproterone acetate and desogestrel, as part of combined oral contraceptives, on lipid metabolism and hirsutism of adolescents with polycystic ovary syndrome (PCOS).Design Prospective randomized clinical trial.Setting Outpatient gynecology clinic (referral center) of a university.Patient(s) Twenty-eight adolescent girls with clinical and biological hyperandrogenism and six or less menses during the past 12 months.Intervention(s) Group A (n = 14) received 0.15 mg of desogestrel plus 0.030 mg of ethinyl estradiol daily. Group B (n = 14) received 2 mg of cyproterone acetate plus 0.035 mg of ethinyl estradiol daily. Treatment was given for 21 days followed by a 7-day rest for a period of 12 months.Main outcome measure(s) Hirsutism and lipid profile were evaluated before initiation and at 3, 6, 9, and 12 months of treatment. Androgen profile was evaluated before and at 12 months of treatment.Result(s) A significant decline of the Ferriman-Gallway hirsutism score was observed from the sixth month of therapy in both groups. During therapy, the levels of testosterone, free testosterone, Delta(4)-androstenedione, and 17OH-progesterone decreased significantly, whereas sex hormone-binding globulin (SHBG) increased significantly in both groups. The level of total cholesterol and low density lipoprotein (LDL) cholesterol increased significantly, whereas high density lipoprotein (HDL) cholesterol and apolipoprotein A-I increased significantly from the third month of therapy in both groups. Total cholesterol/HDL cholesterol and LDL cholesterol/HDL cholesterol ratios remained unchanged. The levels of triglycerides increased significantly in the cyproterone acetate-treated group after the third month.Conclusion(s) Treatment of adolescent girls with PCOS with the two studied formulations is comparably effective in decreasing hirsutism and androgen levels. Both combined oral contraceptives are associated with an increase of total cholesterol, LDL cholesterol, and HDL cholesterol levels and no change of the total cholesterol/HDL cholesterol and LDL cholesterol/HDL cholesterol ratios. Treatment with the cyproterone acetate combined oral contraceptive is associated with a tendency toward increasing the levels of triglycerides.

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  • Intervention trials in adolescents with polycystic ovary syndrome have also shown improvements related to hirsutism, ovulation, quality of life, sleep, lipid profile, adipocytokine levels, and insulin resistance.

    “These trials have also shown improvements related to hirsutism, ovulation, quality of life, sleep, lipid profile, adipocytokine levels, and insulin resistance [148-160]”

    From The Diagnosis of Polycystic Ovary Syndrome during Adolescence (2015) · cites this paper as [152]

  • A small RCT involving adolescents with PCOS showed no difference in hirsutism improvement when two COCPs were compared during 12 months (30 μg of ethinyl estradiol and 0.15 mg of desogestrel vs 35 μg of ethinyl estradiol and 2 mg of cyproterone acetate).

    “A small RCT involving adolescents with PCOS showed no difference in hirsutism improvement when two COCPs were compared during 12 months (30 µg of ethinyl estradiol and 0.15 mg of desogestrel vs 35 µg of ethinyl estradiol and 2 mg of cyproterone acetate) [204].”

    From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [204]

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Authors
Mastorakos, G., Koliopoulos, C., & Creatsas, G.
Affiliations
National and Kapodistrian University of Athens (GR)
Corresponding author
Mastorakos, George
ORCID
Mastorakos, George
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
2002-05
Volume
77
Issue
5
Pages
919-927
ISSN
0015-0282 (ISSN-L)
DOI
10.1016/s0015-0282(02)02993-x
OpenAlex
W1963628647
Cited by
137
References
47
Citations by year
2025: 4 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 8 · 2018: 6 · 2017: 7 · 2016: 8 · 2015: 9 · 2014: 11 · 2013: 6 · 2012: 4
FWCI
3.70
Type
journal article
Language
en
Open access
Licence
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Dermatology › Acne and Rosacea Treatments and Effects
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
polycystic ovary syndrome, adolescents, combined oral contraceptives, cyproterone acetate, desogestrel, ethinyl estradiol, hirsutism, hyperandrogenism, lipid profile, cholesterol, triglycerides, sex hormone-binding globulin, testosterone, apolipoprotein A-I, androgen deprivation therapy, treatment comparison
MeSH terms
Adolescent, Adult, Androgen Antagonists, Androgens, Cholesterol, Contraceptives, Oral, Combined, Contraceptives, Oral, Synthetic, Estrogens, Ethinyl Estradiol, Female, Hirsutism, Humans, Lipids, Cholesterol, HDL, Cholesterol, LDL, Polycystic Ovary Syndrome, Severity of Illness Index, Triglycerides, Apolipoprotein A-I, Desogestrel, Cyproterone Acetate

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