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

Kriplani, Alka; Periyasamy, Anurekha Janaki; Agarwal, Nutan; Kulshrestha, Vidushi; Kumar, Anand; Ammini, Ariachery Chinnama

doi:10.1016/j.contraception.2010.02.009

« Previous Next »Contraception
Volume 82, Issue 2 , Pages 139-146, August 2010

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

Alka Kriplani
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi 110029, India
- Corresponding author. Tel.: +91 11 26594933, +91 26589883, +91 9810828717; fax: +91 11 26588641, +91 26588663.
Anurekha Janaki Periyasamy
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi 110029, India
Nutan Agarwal
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi 110029, India
Vidushi Kulshrestha
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi 110029, India
Anand Kumar
- Department of Reproductive Endocrinology, All India Institute of Medical Sciences, New Delhi 110029, India
Ariachery Chinnama Ammini
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi 110029, India

Received 25 September 2009; received in revised form 28 January 2010; accepted 4 February 2010. published online 26 May 2010.

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/m² 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.

Keywords: COCs, PCOS, Drospirenone, Desogestrel