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  • Title: Effect of a combination of ethinylestradiol and desogestrel in adolescents with oligomenorrhea and ovarian hyperandrogenism.
    Author: Nappi C, Farace MJ, Leone F, Minutolo M, Tommaselli AP, Montemagno U.
    Journal: Eur J Obstet Gynecol Reprod Biol; 1987 Jul; 25(3):209-19. PubMed ID: 2956138.
    Abstract:
    Nine oligomenorrheic adolescent girls with a clinical and hormonal picture of ovarian hyperandrogenism were treated with a monophasic oral contraceptive (OC) containing 0.03 mg ethinylestradiol (EE) plus 0.150 mg desogestrel (DOG) for six months. The same treatment was administered in eight eumenorrheic adolescents. In both groups the treatment induced a decrease in LH, FSH, androstenedione (delta 4-A), testosterone (T) and dehydroepiandrosterone sulphate (DHEA-S) levels associated with a significant sex-hormone-binding globulin (SHBG) increase. In oligomenorrheic adolescents a marked decrease in both the total ovarian volume and the number of cystic follicles was observed. All parameters, except SHBG and ovarian volume in hyperandrogenic girls, returned to pre-treatment values 3 months after treatment. Subjective improvement of skin problems occurred in six of the nine oligomenorrheic girls. Although temporary, the EE + DOG formulation pill is effective in the treatment of ovarian hyperandrogenism in adolescents. It may also be useful for the prevention of the progressive transformation in the 'classical' and 'irreversible' micropolycystic ovary of adult age. The hormonal effects of a combined, monophasic oral contraceptive (OC) containing 0.03 mg of ethinyl estradiol and 0.150 mg of desogestrel were compared in 9 adolescents with oligomenorrhea and ovarian hyperandrogenism and 8 controls with regular menstrual periods. All adolescents were treated for 6 consecutive months. Before treatment, the females with irregular periods had significantly higher basal luteinizing hormone (LH), delta 4-androstenedione (A), testosterone (T), and dehydroepiandrosterone sulfate (DHEA-S) levels than controls. In addition, the oligomenorrheic females had significantly lower sex hormone binding globulin (SHBG) levels and greater mean ovarian volume. OC treatment produced a decrease in all hormones (LH, follicle-stimulating hormone, delta-4 A, T, and DHEA-S) in girls in both groups and a significant increase in SHBG levels. Oligomenorrheic subjects further manifested a significant decrease in total ovarian volume, with reduced number or disappearance of all echo-free cystic follicles in both ovaries. With the exception of SHBG and ovarian volume in hyperandrogenic subjects, all parameters returned to pretreatment values 3 months after discontinuation of the OC. 6 of the 9 oligomenorrheic subjects showed subjective improvement of skin problems; in addition, 6 reported a longterm decrease in hair growth. Post-treatment, oligomenorrhea and anovulation persisted in 7 of the 9 subjects. Although the effect of this treatment is temporary, the ethinyl estradiol-desogestrel OC appears to be effective in hyperandrogenic adolescents and may delay the progression of hirsutism and prevent adult micropolycystic ovarian disease.
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