The effect of combined oral contraception with or without spironolactone on bone mineral density of hyperandrogenic women

We studied the effect of treatment with combined oral contraception (COC) w ith or without spironolactone on the bone mineral density (BMD) of hyperand rogenic women. A group of 22 women (group 1) was treated with ethinylestrad iol plus desogestrel for 21 days each month for 12 months, while another gr oup of 21 patients (group 2) was treated with ethinylestradiol and desogest rel for 21 days each month plus spironolactone daily for 12 months. There w as no statistically significant difference with respect to mean age, body m ass index (BMI) and BMD between the two groups of patients before the treat ment. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH ), androstenedione, total testosterone, dehydroepiandrosterone sulfate (DHE AS), sex hormone binding globulin (SHBG), prolactin and estradiol were asse ssed in both groups and Mo statistically significant difference was found b efore treatment. Nor war there any statistically significant difference in bone turnover between the two groups. Statistical analysis was performed us ing the Student's t test for unpaired data to compare age, BMD and biochemi cal data, and statistical significance war defined ar p < 0.05. The BMD bef ore and after 12 months of treatment showed no statistically significant di fference between the patients of group 1 and those of group 2, suggesting t hat both ethinylestradiol plus desogestrel, and ethinylestradiol and desoge strel plus spironolactone daily for 12 months at the given doses do not aff ect the BMD of the treated women, while the addition of spironolactone impr oves the efficacy of hirsutism treatment.