Role of the combination spironolactone-norgestimate-estrogen in Hirsute women with polycystic ovary syndrome

• Published in: Journal of reproductive medicine Vol. 59; no. 9-10; p. 455
• Main Authors: Hagag, Philippe, Steinschneider, Miriam, Weiss, Mordechai
• Format: Journal Article
• Language: English
• Published: United States 01.09.2014
• Subjects: Adult; Drug Therapy, Combination; Estrogens - administration & dosage; Estrogens - therapeutic use; Female; Hirsutism - drug therapy; Hirsutism - epidemiology; Humans; Norgestrel - administration & dosage; Norgestrel - analogs & derivatives; Norgestrel - therapeutic use; Polycystic Ovary Syndrome - drug therapy; Polycystic Ovary Syndrome - epidemiology; Spironolactone - administration & dosage; Spironolactone - therapeutic use; Testosterone - blood; Treatment Outcome; Young Adult
• ISSN: 0024-7758

To compare the combination spironolactone-norgestimate-ethinyl estradiol in hirsutism with other protocols including the same dose of estrogen. In this open prospective study, 167 women with hirsutism due to polycystic ovary syndrome (PCOS) were randomly assigned to the following treatment protocols: Group A (n = 72): spironolactone 100 mg-norgestimate 250 mcg-ethinyl estradiol 35 microg; Group B (n = 70): cyproterone acetate 12 mg-ethinyl estradiol 35 microg; Group C (n = 25): norgestimate 250 microg-ethinyl estradiol 35 microg. The decrease in the hirsutism score was higher in group A than in the other groups (p < 0.001) and comparable in groups B and C. The decrease in acne score, androgen and estradiol levels, and ovary volume was similar in groups A and B. C-reactive protein increase was similar in all groups, but the augmentation of fibrinogen (p = 0.04), triglycerides (p < 0.01), monocyte count (p = 0.04), platelet number (p < 0.001) and mean volume (p = 0.01) was more pronounced in group B than in group A. Low-density lipoprotein/high-density lipoprotein cholesterol ratio decreased in groups A and C. Spironolactone-norgestimate-ethinyl estradiol is an effective and well-tolerated combination for the treatment of hirsutism in PCOS, with a favorable influence on lipids and indices of low-grade inflammation.