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Comparative study of the therapeutic effects of oral contraceptive pills containing desogestrel, cyproterone acetate, and drospirenone in patients with polycystic ovary syndrome
Fertility and Sterility, 07/17/2012  Clinical Article

Bhattacharya SM et al. – No difference in effects after 6 months. At 12 months, cyproterone acetate showed the strongest antiandrogen activities. Effects on metabolic parameters were identical.

Methods
  • Women (n = 171) with PCOS (Androgen Excess Society criteria, 2006).
  • The three–arm trial involved 58, 56, and 57 cases in desogestrel, cyproterone acetate, and drospirenone groups, respectively.
  • Body mass index, abdominal circumference, hirsutism score (modified Ferriman Galwey), acne and acanthosis nigricans scores, and blood pressure were noted.
  • Blood levels of total T, sex hormone–binding globulin, fasting glucose, and fasting insulin were measured.
  • Free androgen index, glucose–insulin ratio, and homeostasis model assessment–insulin resistance were calculated.
  • Follow–up was after 6 and 12 months of treatment.

Results
  • Six months of treatment showed similar effects.
  • After 12 months, cyproterone acetate significantly decreased the modified Ferriman Galwey score (change = –5.29) compared with both desogestrel (change = –1.69) and drospirenone (change = –2.12); cyproterone acetate significantly increased sex hormone–binding globulin (change = 142.91) compared with desogestrel (change = 99.53); drospirenone significantly increased sex hormone–binding globulin (change = 131.52) compared with desogestrel; and cyproterone acetate significantly decreased the Free Androgen Index (change = –10.57) compared with desogestrel (change = –5.58).

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