Thirty-two women with polycystic ovary syndrome (PCOS) were allocated to two antiandrogen treatment regimens; 28 women completed the trial. Twenty women were treated with ethinyloestradiol and cyproterone acetate (EO-CA) cyclically for 6 months and eight women were treated with the gonadotrophin releasing hormone (GnRH) analogue, goserelin for 6 months. Effects on hirsutism, insulin sensitivity (estimated by glucose clamp technique), blood lipids and hormones were measured. Women treated with EO-CA showed a reduction in hirsutism ( P <0.05), and decreased serum androgen concentrations ( P <0.001) as well as reduced insulin sensitivity ( P <0.05). In women treated with goserelin, serum androgen concentrations also decreased ( P <0.001), but there was no significant reduction of hirsutism. This group, however, showed an improved insulin sensitivity ( P <0.05) despite an unchanged body mass index. Bone mineral density was unaltered in both treatment groups. The reduction in androgen concentrations caused by EO-CA was not paralleled by increased insulin sensitivity, most probably due to the effect of ethinyloestradiol per se . In contrast, the reduction in androgen concentrations by goserelin was accompanied by an improved insulin sensitivity.
Copyright (C) 1998, European Society of Human Reproduction and Embryology
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