Effects of an Oral Contraceptive Containing Cyproterone Acetate (Diane-35) on the Symptoms, Hormone Profile, and Ovarian Volume of Hirsute Women with Polycystic Ovarian Syndrome

ABSTRACT Background Patients with polycystic ovarian syndrome (PCOS) are believed to have large ovaries due to increased stroma. They also have derangement in luteinizing hormone (LH) and testosterone levels and high insulin resistance. As insulin resistance is thought to be associated with androgen and stromal excess, correlation was expected between insulin resistance and stromal excess. Aim To assess if ovarian and stromal volumes in PCOS patients have any correlation with fasting and postprandial insulin levels. Materials and methods A prospective study of 153 subfertile patients was done over a period 18 months. After detailed history, clinical examination and informed consent of all patients were scanned by two-dimensional (2D) on day 3 of the cycle. Patients were divided into PCOS and non-PCOS groups according to Rotterdam criteria. Patients with hormonal derangements other than PCOS were excluded from the study. Patients were assessed by three-dimensional (3D) ultrasound (US) for ovarian and stromal volumes and fasting and postprandial insulin levels were checked on the same day. Results With Pearson correlation significance level of 0.354 (2 tailed) correlation for ovarian volume to fasting insulin was 0.588, for ovarian volume to postprandial insulin was 0.523, for stromal volume to fasting insulin was 0.601, and for stromal volume to postprandial insulin was 0.523. No correlation could be established in non-PCOS group. Conclusion In PCOS patients, a strong correlation was found between ovarian and stromal volume and fasting and post prandial insulin levels. How to cite this article Panchal S, Nagori CB. Correlation of Ovarian and Stromal Volumes to Fasting and Postprandial Insulin Levels in Polycystic Ovarian Syndrome Patients. Int J Infertil Fetal Med 2014;5(1):12-14.

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A randomized placebo controlled trial of metformin alone and metformin plus fixed dose combination of cyproterone acetate and ethinyl estradiol in hirsute women with polycystic ovarian syndrome

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20181652 ◽

2018 ◽

Vol 7 (5) ◽

pp. 1011

Author(s):

Shivani Jalota ◽

Jatinder Singh ◽

Ravi Saini

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Cyproterone Acetate ◽

Polycystic Ovarian Syndrome ◽

Ethinyl Estradiol ◽

Chief Complaint ◽

Fixed Dose ◽

Beneficial Effects ◽

Dose Combination ◽

Ovarian Syndrome

Background: Polycystic ovarian syndrome is a common endocrine disorder seen in reproductive age group. Hirsutism, oligomennorhea and infertility being the most common chief complaint. Oral contraceptives have shown their efficacy in hirsute females. Metformin, an insulin sensitizer, have also shown some beneficial effects in improving metabolic abnormalities. Aim of this study is to compare the efficacy of metformin alone and metformin with fixed dose combination of cyproterone acetate and ethinyl estradiol in hirsute women with PCOS.Methods: 60 females of PCOS with chief complaint of hirsutism were enrolled. Patients were randomized to either metformin and Diane -35 (35 microgram ethinyl estradiol plus 2mg cyproterone acetate) or metformin and placebo for 9 months. Ferriman Gallwey score and body mass index was calculated at baseline, 3months, 6months and 9 months. FSH/LH/Prolactin/Testosterone/Fasting glucose and Fasting insulin levels were measured at the baseline and at the end of treatment.Results: Majority of females enrolled in the study were in third decade of life. Metformin and Diane- 35 showed higher reduction in Ferriman Gallwey score but Body mass index was reduced in both the groups. There was no significant difference seen between the groups with respect to biochemical profile.Conclusions: This data show that a combination of metformin and contraceptive pill may be more effective in treating hirsutism than metformin alone. Beneficial effects of therapy were seen in relation to BMI as well. Hence, combination therapy is better therapeutic option for treating hirsutism in PCOS.

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