Comparison of effects of 3 mg drospirenone plus 20 μg ethinyl estradiol alone or combined with metformin or cyproterone acetate on classic metabolic cardiovascular risk factors in nonobese women with polycystic ovary syndrome

Fruzzetti, Franca; Perini, Daria; Lazzarini, Veronica; Parrini, D; Gambacciani, Marco; Genazzani, Andrea Riccardo

doi:10.1016/j.fertnstert.2009.10.016

Cited by 33 publications

(29 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a second study, ethinyl E 2 /DRSP was associated with an increase in systolic, diastolic and 24-h blood pressure of about 5 mmHg and an increase in triglyceride levels (72). A third study using a lower dose of 20 mg ethinyl E 2 showed improved insulin sensitivity and did not adversely affect blood pressure or serum lipid values, effects that were not enhanced with the addition of metformin (73). The optimal estrogen containing oral contraceptive for PCOS needs clarification, but these studies suggest that the combination of 20 mg ethinyl E 2 with 3 mg DRSP may at least be neutral on CVR.…”

Section: Medical Intervention In Pcosmentioning

confidence: 92%

“…Drospirenone (DRSP) is a 17a-spironolactone derivative progestin that combines progestogenic activity with anti-androgenic and anti-mineralocorticoid activity that may therefore have a beneficial CVR profile (71,72,73). In one study on 16 lean and 12 overweight PCOS subjects, after giving 30 mg ethinyl estradiol (E 2 ) and 3 mg DRSP for 6 months, no effects were found on endothelial function or CVR indices (71).…”

Section: Medical Intervention In Pcosmentioning

confidence: 99%

See 1 more Smart Citation

MECHANISMS IN ENDOCRINOLOGY: Recent advances in cardiovascular aspects of polycystic ovary syndrome

Sathyapalan

Atkin²

2012

European Journal of Endocrinology

View full text Add to dashboard Cite

Polycystic ovary syndrome (PCOS) has been associated with increased cardiovascular risk (CVR) markers, but population studies have not clarified whether there is an increase in cardiovascular morbidity and mortality. Four different PCOS phenotypes resulted from the Rotterdam criteria that may differ in their CVR potential, thus introducing further complexity. This has led to studies using surrogate CVR markers including biomarkers in blood and imaging such as flow-mediated vasodilatation. In PCOS, both peripheral and central insulin resistance (IR) have been shown. Weight loss has been shown to improve IR and visceral fat, while insulin sensitizer therapies with metformin or thiazolidinediones improve IR and endothelial dysfunction. IR is also found in non-alcoholic fatty liver disease that in turn is very common in PCOS; studies have suggested that IR may be improved by treatment with metformin and omega-3 fish oils. PCOS patients have a more dyslipidemic phenotype that is worse in 'classical PCOS' associated with a higher CVR. Studies with atorvastatin and simvastatin have reported a decrease in the lipid parameters and an improvement in CVR indices including IR, but it is unclear whether this is due to their lipid-lowering action or a pleiotropic effect of the statin. In this expert opinion review, the relevant literature published during the last 2 years was considered. It focuses on some recent important data that has emerged while also exposing the gaps that remain in our knowledge that need to be addressed.

show abstract

Section: Medical Intervention In Pcosmentioning

confidence: 92%

Section: Medical Intervention In Pcosmentioning

confidence: 99%

MECHANISMS IN ENDOCRINOLOGY: Recent advances in cardiovascular aspects of polycystic ovary syndrome

Sathyapalan

Atkin²

2012

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…One study (73) found no significant difference after 1 year of treatment with ethinylestradiolC dospirenone alone or combined with cyproterone acetate (100 mg/day) or spironolactone (100 mg/day). Intriguingly, another study (74) investigating the efficacy of ethinylestradiolCdospirenone added to cyproterone acetate (12.5 mg/day) or metformin (1500 mg/day) found that metformin favoured some significant benefit of selected cardiovascular risk factors; by contrast, cyproterone acetate abolished this positive effect, at least in normal weight women with PCOS. Another study (75) reported that a 9-month treatment with ethinylestradiolC cyproterone acetate (2 mg/day) was significantly more effective than finasteride alone in decreasing the mFG score.…”

Section: Combined Treatment With Eps and Antiandrogensmentioning

confidence: 99%

THERAPY OF ENDOCRINE DISEASE: Treatment of hirsutism in the polycystic ovary syndrome

Pasquali

Gambineri

2014

European Journal of Endocrinology

View full text Add to dashboard Cite

Hirsutism is a common medical complaint among women of reproductive age, and it affects the majority of women with the polycystic ovary syndrome (PCOS). Increased rate of androgen production and its availability in tissue represent the main pathophysiological mechanisms responsible for hirsutism. In addition, androgens may be generated de novo in the hair follicle; therefore, circulating androgen levels do not quantify the real exposure of the hair follicle to androgens, as a quota is locally generated. Hirsutism is a clinical sign and not a disease in itself; its presence does not therefore necessarily require treatment, particularly in mild-to-moderate forms, and when an affected woman does not worry about it. Physicians should decide whether hirsutism is to be treated or not by evaluating not only the severity of the phenomenon but also the subjective perception of the patient, which does not necessarily correspond to the true extent of hair growth. In any case, a physician should manage a woman with hirsutism only on the basis of a diagnosis of the underlying cause, and after a clear explanation of the efficacy of each therapeutic choice. Cosmetic procedures and pharmacological intervention are commonly used in the treatment of hirsutism and are discussed in this paper. Importantly, there are different phenotypes of women with hirsutism and PCOS that may require specific attention in the choice of treatment. In particular, when obesity is present, lifestyle intervention should be always considered, and if necessary combined with pharmacotherapy.

show abstract

“…22,23 Indeed, metformin reduces hyperinsulinemia and improves insulin sensitivity, dyslipidemia, and also ovulation rate. [24][25][26] Oral contraceptives (OCs) represent the traditional medical therapy for women with PCOS, in order to obtain regular menstrual cycles and to improve the clinical signs of hyperandrogenism. [27][28][29] Regarding the metabolic profile, the effects of the OCs are variable, depending on the used dose of ethinylestradiol (EE) and on the type of the associated progestin.…”

Section: Introductionmentioning

confidence: 99%

“…31 Moreover, some authors demonstrated that the treatment with EE þ DRSP may improve insulin sensitivity in patients with PCOS. 26 Based on the above-mentioned evidences, the aim of the present study was to evaluate the effects of DRSP/EE alone versus metformin alone versus DRSP/EE in combination with metformin on the CD4 þ CD28 null T-cell frequencies, in patients with hyperinsulinemic PCOS. Moreover, we analyzed some endocrinometabolic parameters at baseline and after 6 months of treatment.…”

Section: Introductionmentioning

confidence: 99%

Effects of Drospirenone–Ethinylestradiol and/or Metformin on CD4+CD28null T Lymphocytes Frequency in Women With Hyperinsulinemia Having Polycystic Ovary Syndrome: A Randomized Clinical Trial

et al. 2013

View full text Add to dashboard Cite

show abstract

Comparison of effects of 3 mg drospirenone plus 20 μg ethinyl estradiol alone or combined with metformin or cyproterone acetate on classic metabolic cardiovascular risk factors in nonobese women with polycystic ovary syndrome

Cited by 33 publications

References 41 publications

MECHANISMS IN ENDOCRINOLOGY: Recent advances in cardiovascular aspects of polycystic ovary syndrome

MECHANISMS IN ENDOCRINOLOGY: Recent advances in cardiovascular aspects of polycystic ovary syndrome

THERAPY OF ENDOCRINE DISEASE: Treatment of hirsutism in the polycystic ovary syndrome

Effects of Drospirenone–Ethinylestradiol and/or Metformin on CD4+CD28null T Lymphocytes Frequency in Women With Hyperinsulinemia Having Polycystic Ovary Syndrome: A Randomized Clinical Trial

Contact Info

Product

Resources

About