KatCarney

Polycystic Ovary Syndrome Therapy Unaffected By Low-Dose Contraceptive
A DGReview of :"Low-dose combination of flutamide, metformin and an oral contraceptive for non-obese, young women with polycystic ovary syndrome."
Human Reproduction

01/23/2003
By Anne MacLennan


Use of a low-dose oral contraceptive (OC) does not curb the chief benefits of combined flutamide-metformin treatment in young women with polycystic ovary syndrome (PCOS).

This is the finding of a follow-up study by Dr L Ibanez and Dr F De Zegher from the Hospital Sant Joan de Deu, University of Barcelona, Barcelona, Spain, and the University of Leuven, Leuven, Belgium, respectively.

Flutamide and metformin in combination are known to normalise the endocrine-metabolic status of young, non-obese PCOS patients more effectively than does either of these drugs used alone.

Objective of these investigators was to assess whether the advantages of this two-drug PCOS treatment are maintained in the presence of a low-dose OC.

Study participants were 24 young, non-obese PCOS patients already receiving flutamide-metformin (125 mg/day and 1,275 mg/day). Their mean age was ± SEM 18.7 ± 0.3 years (body mass index, 21.8 ± 0.5 kg/m(2)).

Twelve of the women elected to receive a low-dose OC (ethinyl estradiol 20 micro g + gestodene 75 micro g) to reduce the risk of pregnancy. This sub-group (OC+) was matched to a subgroup continuing on flutamide-metformin alone (OC-).

Investigators assessed the women's endocrine-metabolic indices before any treatment (zero months), on flutamide-metformin (12 months) and again after a further six months with or without additional OC (18 months).

The beneficial effects of the combination therapy on hyperandrogenaemia, hyperinsulinaemia and dyslipidaemia were maintained in both the OC+ and OC- subgroups.

In the OC+ women, there was an additional increase in sex hormone-binding globulin (SHBG), and thus a further drop in the free androgen index.

When a low-dose OC is administered with a low-dose flutamide-metformin combination in women with PCOS, the beneficial effects are maintained on hyperinsulinaemia-dyslipidaemia, which are key determinants of long-term complications.

Thus, in daily practice, this low-dose OC may become a therapeutic option of first choice for young women with PCOS, these authors conclude.
Hum Reprod 2003 Jan;18(1):57-60. "Low-dose combination of flutamide, metformin and an oral contraceptive for non-obese, young women with polycystic ovary syndrome."

http://www.docguide.com/news/content.nsf/news/8525697700573E1885256CB0000F7DCD

__________________