Efficacy of the combination ethinyl oestradiol and cyproterone acetate on endocrine, clinical and ultrasonographic profile in polycystic ovarian syndrome

This study shows the effect of a long-term treatment (60 cycles) with the e thinyl oestradiol/cyproterone acetate pill, and the follow-up after 6 month s from cessation, in polycystic ovarian syndrome. The 140 studied women had polycystic ovaries and moderate or severe acne, 108 also presented hirsuti sm. The endocrine profile significantly modified after six cycles (P < 0.00 1), with a further significant decrease of gonadotrophins, oestrogens and a ndrogens after 12 cycles, and a greater increase of sex hormone-binding glo bulins and insulin-like growth factor-binding globulins. Between the 12th a nd 60th cycle there was only a significant reduction of dehydroepiandroster one sulphate (P < 0.05), Acne disappeared in all patients within 12-24 cycl es, but hirsutism was still present in 30.6% after 60 cycles. Mild-moderate hirsutism disappeared in 36-60 cycles, whereas severe hirsutism substantia lly decreased, but persisted. Ovarian volume, microcyst numbers and stroma percentage significantly decreased (P < 0.01), After 6 months from the end of the therapy, endocrine parameters were identical to the starting ones, a cne and hirsutism reappeared, whereas ovarian morphology was between the in itial and final condition. Ovaries were polycystic in 42 (30%) patients and multifolliculars in 98 (70%), Our results show the effectiveness of this c ombination on androgenic symptoms, especially on acne, and suggest that acn e and hirsutism are induced by different peripheral mechanisms.