Publication:

Hormonal effects of drosperinone and ethinyl estradiol based combined oral contraceptives on polycystic ovarian syndrome

Background Polycystic ovarian syndrome (PCOS) is a common endocrine disorder treated with combined oral contraceptives (COCs). The androgenic potential of any type of COC is in part determined by the progestin present. A newer form of progestin, drospirenone, has been recently introduced, and is available in combination with ethinyl estradiol.

Methods The study was conducted on 60 patients fulfilling inclusion criteria, in the department of obstetrics and gynecology, Terna Medical College and Hospital. Patients were diagnosed as PCOS according to Rotterdam criteria. After initial evaluation, blood samples were sent for levels of serum luteinizing hormone (LH), follicle stimulating hormone (FSH), dehydroepiandrosterone-sulphate (DHEA-S), free testosterone, sex hormone binding globulin (SHBG). Each patient was advised to take a combination of EE (30 mcg) + drosperinone (3 mg), 1 tablet daily from the second day of her menstruation for 21 days then a 7 days gap and again for 21 days and so on cyclically for 3 cycles, then to repeat the tests as done at the beginning.  Hirsutism was assessed clinically using the Ferriman-Gallwey scale at initial visit and three months later.

Results We found a significant improvement in the Serum LH, FSH levels and a significant fall in free testosterone levels accompanied by a rise in SHBG levels. There is also overall improvement in the hirsutism scores.

Conclusions Drosperinone based COCs are a good and effective means of treatment of PCOS. Treatment duration of three months was found to be effective in our study.