Effects of two antiandrogen treatments on hirsutism and insulin sensitivity in women with polycystic ovary syndrome

Thirty-two women with polycystic ovary syndrome (PCOS) were allocated to tw o antiandrogen treatment regimens; 28 women completed the trial. Twenty wom en were treated with ethinyloestradiol and cyproterone acetate (EO-CA) cycl ically for 6 months and eight women were treated with the gonadotrophin rel easing hormone (GnRH) analogue, goserelin for 6; months. Effects on hirsuti sm, insulin sensitivity (estimated by glucose clamp technique), blood lipid s and hormones were measured. Women treated with EO-CA showed a reduction i n hirsutism (P <0.05), and decreased serum androgen concentrations (P <0.00 1) as well as reduced insulin sensitivity (P <0.05). In women treated with goserelin, serum androgen concentrations also decreased (P <0.001), but the re was no significant reduction of hirsutism, This group, however, showed a n improved insulin sensitivity (P <0.05) despite an unchanged body mass ind ex. Bone mineral density wets unaltered in both treatment groups. The reduc tion in androgen concentrations caused by EO-CA was not paralleled by incre ased insulin sensitivity, most probably due to the effect of ethinyloestrad iol pw se, In contrast, the reduction in androgen concentrations by goserel in was accompanied by an improved insulin sensitivity.