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  • Title: Long-term treatment of hirsutism: desogestrel compared with cyproterone acetate in oral contraceptives.
    Author: Porcile A, Gallardo E.
    Journal: Fertil Steril; 1991 May; 55(5):877-81. PubMed ID: 1827074.
    Abstract:
    OBJECTIVE: Effectiveness of 2-year treatment of hirsutism with low estrogen oral contraceptives (OCs) containing nonandrogenic or antiandrogenic progestogen. Evaluation of changes in plasma lipids. DESIGN: Ten patients treated with desogestrel 150 micrograms + 30 micrograms ethinyl estradiol, 6 with desogestrel 150 micrograms + 50 micrograms ethinyl estradiol, 10 with cyproterone acetate 2 mg + 35 micrograms ethinyl estradiol. Random allocation. Paired comparisons. CONTROL GROUP: 19 normal women, not treated. SETTING: Academic tertiary care. PATIENTS: Women with hirsutism (idiopathic and/or polycystic ovary), 24 of 26 completed treatment. INTERVENTION: Two-year treatment. MAIN OUTCOME MEASURES: Hirsutism score, plasma testosterone, and lipids. RESULTS: Initial hirsutism scores (11.8 +/- 0.6 SE) declined with treatment (-7.2 +/- 0.4, P less than 0.01) to 4.7 +/- 0.6, almost reaching control (3.6 +/- 0.3). Initial plasma cholesterol (4.33 mmol/L +/- 0.30 SE), similar to control (4.78 +/- 0.24), increased slowly over 2 years (+2.04 +/- 0.34, P less than 0.01). High-density lipoproteins cholesterol (1.05 mmol/L +/- 0.04 SE), similar to control (1.12 +/- 0.07), did not change the 1st year and increased at 2 years (+0.57 +/- 0.11, P less than 0.01). No differences appeared among treatment groups. CONCLUSIONS: Treatment is very effective, 2 years for best results. The OCs tested are equally efficacious. Changes in plasma lipids are of some concern but of difficult interpretation. This study examined the effectiveness of a 2-year treatment for hirsutism with low estrogen oral contraceptives (OCs) containing nonandrogenic or antiandrogenic progestogen and evaluated the changes in plasma lipids. 10 patients were treated with desogestrel 150 mcg + 30 mcg ethinyl estradiol, 6 with desogestrel 150 mcg + ethinyl estradiol, 10 with cyproterone acetate 2 mg + 35 mcg ethinyl estradiol in a random allocation with paired comparisons. 24 of 26 women with hirsutism (idiopathic and/or polycystic ovary) completed the treatment; the control group consisted of 19 normal, untreated women. Initial hirsutism scores (11.8 +or- 0.6 SE) declined with treatment (-7.2 +or- 0.4, p0.01) to 4.7 +or- 0.6, almost reaching control (3.6 +or- 0.3). The initial plasma cholesterol (4.33 mmol/L +or- 0.30 SE) were similar to controls (4.78 +or- 0.24) and increased slowly over the 2 years (=2.04 +or- 0.34, p0.01). High density lipoprotein cholesterol (1.05 mmol/L +or- 0.04 SE) was similar to the controls (1.12 +or- 0.07), did not change the 1st year, and increased at 2 years (+0.57 +or- 0,11, p0.01). No differences appeared among treatment groups. The authors conclude that treatment is very effective and is best when spread over the 2-year period. The OCs tested are equally efficacious. Changes in plasma lipids are of some concern but proved to be difficult to interpret.
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