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Key message pointsG Yasmin provides control of the menstrual cycle in women with polycystic ovary syndrome (PCOS).G Acne improves, and hirsutism and BMI do not change, in women prescribed Yasmin for PCOS. IntroductionPolycystic ovary syndrome (PCOS) is the most common endocrine disturbance affecting women of reproductive age. 1 Estimates of the presence of PCOS in the general population range from 15% to 25% 2,3 in Caucasians and are as high as 52% in Asians in the UK. 4 The features of PCOS include menstrual irregularities, infertility, hyperandrogenism (acne, hirsutism), obesity and the metabolic features of insulin resistance. 1 All symptoms are aggravated by an increase in body weight. 5 Management of the symptoms of PCOS is orientated to the individual's symptoms, which may change over time. Young women with menstrual irregularity and hyperandrogenism have traditionally been treated with the combined oral contraceptive pill (COCP). 6 A frequently prescribed preparation is Dianette ® (Schering Healthcare Ltd, Burgess Hill, UK), which contains ethinyl oestradiol 35 µg and the anti-androgen, cyproterone acetate 2 mg. Other medical treatments of the cutaneous aspects of PCOS include cyproterone acetate alone, spironolactone, flutamide and finasteride, but all take at least 3-6 months before an improvement is seen and may be associated with potentially toxic and adverse metabolic effects. A new combined oral contraceptive, Yasmin ® (Schering Healthcare Ltd), has recently been developed, containing ethinyl oestradiol 30 mg and a new progestogen drospirenone (3 mg). Drospirenone is derived from 17-α-spironolactone, unlike most other current progestogens that are derived from 19-nortestosterone and therefore may have androgenic effects. Several studies have shown that drospirenone has a similar pharmacological profile to that of natural progesterone with clinically relevant antimineralocorticoid and anti-androgenic effects. [7][8][9][10] We performed a pilot observational study to determine whether the clinical and biochemical features of PCOS are ameliorated by Yasmin. MethodsPatients with PCOS were recruited from the gynaecology clinic in a university teaching hospital setting. PCOS was defined as the presence of polycystic ovaries on ultrasound combined with at least one of the following symptoms: irregular menstrual cycles, hirsutism, acne, elevated serum concentrations of luteinising hormone and testosterone. 1 Patients were selected on the basis of their willingness and suitability to be treated with a COCP. Exclusion criteria were obesity [body mass index (BMI) >35 kg/m 2 ], heavy smokers (>10 cigarettes/day) and other contraindications to oral contraceptive use.Local research ethics committee approval was obtained prior to commencing the study and all patients gave written consent. Treatment continued for 6 months and patients were assessed at baseline and after 1, 3 and 6 months.BMI was calculated as kilograms per square metre (kg/m 2 ). Waist:hip ratio was calculated from waist circumference at t...

BackgroundPolycystic ovary syndrome (PCOS) is the most common chronic endocrine disorder affecting women of reproductive age. This study aimed to compare the HRQoL of South Asian and white Caucasian women with PCOS, given that it is particularly common among women of South Asian origin and they have been shown to have more severe symptoms.MethodsThe Polycystic Ovary Syndrome Questionnaire (PCOSQ) and the Short Form-36 (SF-36) were administered in a cross-sectional survey to 42 South Asian and 129 Caucasian women diagnosed with PCOS recruited from the gynaecology outpatient clinics of two university teaching hospitals in Sheffield and Leeds. Additional clinical data was abstracted from medical notes. Normative data, collected as part of the Oxford Health and Lifestyles II survey, was obtained to compare SF-36 results with ethnically matched women from the general UK population. Using the SF-36, normative HRQoL scores for women of South Asian origin were lower than for Caucasian women. Given this lower baseline we tested whether the same relationship holds true among those with PCOS.ResultsAlthough HRQoL scores for women with PCOS were lower than normative data for both groups, South Asian women with PCOS did not have poorer HRQoL than their Caucasian counterparts. For both the SF-36 and PCOSQ, mean scores were broadly the same for both Asian and Caucasian women. For both groups, the worst two HRQoL domains as measured on the PCOSQ were 'infertility' and 'weight', with respective scores of 35.3 and 42.3 for Asian women with PCOS compared to 38.6 and 35.4 for Caucasian women with PCOS. The highest scoring domain for South Asian women with PCOS was 'menstrual problems' (55.3), indicating best health, and was the only statistically significant difference from Caucasian women (p = 0.01). On the SF-36, the lowest scoring domain was 'Energy & Vitality' for Caucasian women with PCOS, but this was significantly higher for Asian women with PCOS (p = 0.01). The best health status for both groups was 'physical functioning', although this was significantly lower for South Asian women with PCOS (p = 0.005). Interestingly, only two domains differed significantly from the normative data for the Asian women with PCOS, while seven domains were significantly different for the Caucasian women with PCOS compared to their normative counterparts.ConclusionsThe HRQoL differences that exist between South Asian and Caucasian women in the general population do not appear to be replicated amongst women with PCOS. PCOS reduces HRQoL to broadly similar levels, regardless of ethnicity and differences in the normative baseline HRQoL of these groups.

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Current data suggests that the mechanisms of atherothrombosis have separate pathways in the two ethnic groups. Larger studies exploring the current theme need to be carried out in the PCOS groups to obtain adequate insight.