Clinical and metabolic effects of medroxyprogesterone acetate and ethinyl estradiol plus drospirenone in women with polycystic ovary syndrome

Objectives: To investigate the effects of treatment with medroxyprogesterone acetate (MPA), 10 days per month for 6 months, on lipid and carbohydrate metabolism in women with polycystic ovary syndrome (PCOS). Methods: Sixty-three women with PCOS were randomized to receive MPA or ethinyl estradiol plus drospirenone. Results: There were no changes in lipid or carbohydrate metabolism in the MPA group, but serum levels of luteinizing hormone (P < 0.001) and total testosterone (P < 0.003) significantly decreased, as did the free androgen index (P < 0.02) and acne (P < 0.03) and seborrhea (P < 0.04) scores. In the ethinyl estradiol plus drospirenone group lipid and hormone values significantly increased whereas acne, seborrhea, hair Loss, and Ferriman-Gallwey scores decreased. There was no statistically significant change in the total cholesterol to high-density cholesterol ratio in either group. Conclusion: Treatment of PCOS patients with MPA provided good menstrual cycle control, beneficial changes in hormonal values associated with hyperandrogenism, and no significant changes in lipid or carbohydrate metabolism. (c) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All, rights reserved.