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Comparison of two oral contraceptives containing either drospirenone or cyproterone acetate in the treatment of hirsutism.

Abstract
Combined oral contraceptives (COCs) are considered the first-line treatment for women with hirsutism. They diminish androgen release from the ovary and decrease plasma free testosterone levels by increasing sex hormone-binding globulin (SHBG) concentrations. COCs containing cyproterone acetate (CPA) and drospirenone (DRSP) have been proved effective for the treatment of acne and facial hirsutism. This study prospectively compared the clinical and biochemical efficacy of 3 mg DRSP/30 microg ethinyl estradiol (EE) and 2 mg CPA/35 microg EE combinations in a total of 91 patients with hirsutism. Individuals randomly received a cyclic combination of either DRSP/EE (n=48) or CPA/EE (n=43) for 12 months. Basal serum total testosterone, free testosterone, androstenedione, dehydroepiandrosterone sulfate and SHBG levels, as well as Ferriman-Gallwey scores, were determined before and after treatment. Both COCs achieved a similar effect on clinical hirsutism scores, in addition to serum androgen and SHBG levels, after completion of therapy. The percentage reductions in total hirsutism score (median % (min-max)) during therapy were 0.70 (0-0.58) vs. 0.57 (0.10-1.00) at 6 months (p = 0.028) and 0.80 (0-0.42) vs. 0.81 (0-0.75) at 12 months (p = 0.6) in the DRSP/EE and CPA/EE groups, respectively. In conclusion, the DRSP/EE combination is at least as effective as the CPA/EE combination in improving hirsutism scores.
AuthorsCem Batukan, Iptisam Ipek Muderris, Bulent Ozcelik, Ahmet Ozturk
JournalGynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology (Gynecol Endocrinol) Vol. 23 Issue 1 Pg. 38-44 (Jan 2007) ISSN: 0951-3590 [Print] England
PMID17484511 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References
  • Androstenes
  • Contraceptives, Oral, Combined
  • Ethinyl Estradiol
  • drospirenone
Topics
  • Adolescent
  • Adult
  • Androstenes (administration & dosage, therapeutic use)
  • Contraceptives, Oral, Combined (administration & dosage, therapeutic use)
  • Ethinyl Estradiol (administration & dosage, therapeutic use)
  • Female
  • Hirsutism (drug therapy, pathology)
  • Humans
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome

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