Long-term treatment of hirsutism: desogestrel compared with cyproterone acetate in oral contraceptives
Porcile, A.; Gallardo, E.
Fertility and Sterility 55(5): 877-881
1991
ISSN/ISBN: 0015-0282 PMID: 1827074 DOI: 10.1016/s0015-0282(16)54291-5Document Number: 556561
This study examined the effectiveness of a 2-year treatment for hirsutism with low estrogen oral contraceptives (OCs) containing nonandrogenic or antiandrogenic progestogen and evaluated the changes in plasma lipids. 10 patients were treated with desogestrel 150 mcg + 30 mcg ethinyl estradiol, 6 with desogestrel 150 mcg + ethinyl estradiol, 10 with cyproterone acetate 2 mg + 35 mcg ethinyl estradiol in a random allocation with paired comparisons. 24 of 26 women with hirsutism (idiopathic and/or polycystic ovary) completed the treatment; the control group consisted of 19 normal, untreated women. Initial hirsutism scores (11.8 +or- 0.6 SE) declined with treatment (-7.2 +or- 0.4, p0.01) to 4.7 +or- 0.6, almost reaching control (3.6 +or- 0.3). The initial plasma cholesterol (4.33 mmol/L +or- 0.30 SE) were similar to controls (4.78 +or- 0.24) and increased slowly over the 2 years (=2.04 +or- 0.34, p0.01). High density lipoprotein cholesterol (1.05 mmol/L +or- 0.04 SE) was similar to the controls (1.12 +or- 0.07), did not change the 1st year, and increased at 2 years (+0.57 +or- 0,11, p0.01). No differences appeared among treatment groups. The authors conclude that treatment is very effective and is best when spread over the 2-year period. The OCs tested are equally efficacious. Changes in plasma lipids are of some concern but proved to be difficult to interpret.