Effect of oral contraceptive containing ethinyl estradiol combined with drospirenone vs. desogestrel on clinical and biochemical parameters in patients with polycystic ovary syndrome

Contraception. 2010 Aug;82(2):139-46. doi: 10.1016/j.contraception.2010.02.009. Epub 2010 May 23.

Abstract

Background: A prospective randomized trial was conducted to compare efficacy of a drospirenone-containing combined oral contraceptives (COC) with desogestrel-containing COC in women with polycystic ovary-syndrome (PCOS) not desirous of child-bearing.

Study design: Sixty women were randomized into study group [ethinylestradiol (EE) 30 mcg+drospirenone 3 mg] and control group (EE 30 mcg+desogestrel 150 mcg), treated for 6 months and followed up at 1 month, 3 months, 6 months, during treatment and 3 and 6 months post-treatment. Acne and hirsutism scoring, bodyweight, body mass index (BMI), blood pressure (BP), ultrasound parameters, lipid profile, glycemic profile and hormonal profile were compared.

Results: Cycles were regular in both groups during treatment. Effect of regular cycles persisted in 44.83% (13/30) vs. 17.24% (5/30) in study vs. control group at 6 months post-treatment with 33.3% decreased hirsutism score in the study group (versus no change in control group) even at 6 months after stopping treatment. With treatment, BMI fell by 0.52 kg/m(2) in the study group; systolic and diastolic BP fell in the study group while it rose in the control group. Low-density lipoprotein significantly decreased and high-density lipoprotein was elevated in the study group (p<.05). The study group showed a significant fall in fasting/postprandial blood sugar and insulin and total testosterone against a rise in the control group.

Conclusion: In women with PCOS, a drospirenone containing COC has better outcome in terms of persistent regular cycles, antiandrogenic effect, fall in BMI and BP, better lipid profile, favorable glycemic and hormonal profile than desogestrel-containing COC.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acne Vulgaris / metabolism
  • Adolescent
  • Adult
  • Androstenes / pharmacology*
  • Androstenes / therapeutic use
  • Anthropometry
  • Blood Glucose / analysis
  • Blood Pressure / physiology
  • Contraceptives, Oral, Combined / pharmacology*
  • Contraceptives, Oral, Combined / therapeutic use
  • Desogestrel / pharmacology*
  • Desogestrel / therapeutic use
  • Drug Combinations
  • Ethinyl Estradiol / pharmacology*
  • Ethinyl Estradiol / therapeutic use
  • Female
  • Hirsutism / metabolism
  • Humans
  • Insulin
  • Lipoproteins, HDL / blood
  • Lipoproteins, LDL / blood
  • Polycystic Ovary Syndrome / drug therapy*
  • Polycystic Ovary Syndrome / metabolism
  • Prospective Studies
  • Statistics, Nonparametric
  • Testosterone
  • Triglycerides / blood
  • Young Adult

Substances

  • Androstenes
  • Blood Glucose
  • Contraceptives, Oral, Combined
  • Drug Combinations
  • Insulin
  • Lipoproteins, HDL
  • Lipoproteins, LDL
  • Triglycerides
  • drospirenone and ethinyl estradiol combination
  • Testosterone
  • Ethinyl Estradiol
  • Desogestrel