Weight change and androgen levels during contraceptive treatment of women affected by polycystic ovary.
Vrbikova J, Dvorakova K, Hill M, Starka L.
Institute of Endocrinology, Prague, 116 94 Czech Republic. JVRBIKOVA@ENDO.CZ
OBJECTIVE: The aim of this study was to investigate the effect of oral contraceptive Diane 35 (ethinylestradiol + cyproteroneacetate EE/CPA) which is widely used in the treatment of PCOS in Europe, on body weight, lipid levels and endocrine parameters in non-obese women with PCOS.
CONCLUSIONS:Increase of body weight in a significant number of PCOS-affected women was seen after treatment with Diane 35 and it is assumed to blunt ameliorating effects of this treatment on androgen levels. Considering our findings, we conclude that the treatment with CPA/EE can result in significant weight gain ameliorating positive effects of the treatment on androgen levels.
These findings could underline the necessity of the finding new therapeutical options for PCOS, besides contraception. Studies concerning body composition during contraceptive treatment in PCOS would be also useful in the future.
SUBJECTS AND METHODS: Nineteen PCOS women were examined in the early follicular phase of menstrual cycle, blood samples for the estimation of cholesterol (C), HDL cholesterol (HDL-C), triglycerides (TG), testosterone (T), androstenedione (A), dehydroepiandrosterone sulfate (DHEAS) and sex hormone binding globulin (SHBG) were taken before the start of treatment with Diane 35 and again after 7 +/- 3.8 months of treatment with Diane 35. Body weight (W) was recorded at the time of both examinations.
RESULTS: After the treatment with Diane 35 the levels of W (p<0.05), total C (p<0.05), TG (p<0.004) and SHBG (p<0.0001) increased significantly. In addition, significant negative correlation between SHBG levels before treatment and increase of W after Diane 35 was found (r= -0.56; p<0.02). Increase of W correlated negatively with T before treatment (r= 0.58; p< .02) and positively with the change in T level after treatment (r=0.50; p<0.05).
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Hey, SoulCysters! Need to eat more veggies, but can't find recipes??
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I've been on Diane-35 three different times in the last decade. I found it very effective (as pcos treatment) the first time I took it. However, it's effectiveness had decreased significanlty the second and now third time I'm on it.
My fertility specialist warned me after I was about to stop it the first time, that I would expect weight gain, and boy was she right. Today I weigh about 40 lbs more then the first time I started Diane-35. However, most of this weight gain occurred right after stopping the pill, and/or was gradual while on the pill.
I feel like I need to stop taking it as I have had an increase in symptoms recently (excess hair growth) and I've never had this happen before while being "medicated." My TSH has also increased, but Canada still uses the old reference ranges, and I'm considered "perfectly normal" despite feeling perfectly abnormal. I'm hesitent to stop the pill outright without having an action plan. I hate to even imagine what would happen to my body after stopping it now.
I'm going to see my Endocrinologist later in October. What can you suggest I talk to her about? I've brought up Flutimide before (rather briefly) and she seemed hesitent to say the least. I'd like to ask about it again. I have no objections to starting Metformin again, but I don't think it's enough. Also, I'm quite regular with af while on Metformin, and would definitely require bcp, for actual birth control, if nothing else.
I would like to take in some research, but I don't want to bombard her. Are there some articles you can recommend that are concise enough, without seeming like information overload?
I'd appreciate anything you could offer.
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"We can't solve problems by using the same kind of thinking we used when we created them."
-Albert Einstein
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I would like to take in some research, but I don't want to bombard her. Are there some articles you can recommend that are concise enough, without seeming like information overload?
I'd appreciate anything you could offer.
Are you interested in research on flutamide? (what is the approval and off-label usage for it in Canada? I only ask because here in the states usage in women is considered off-label. Also, I don't think we ahve Diane 35 here...)
Have you checked out the Medifocus Guide (look in the RESEARCH ARTICLES FORUM above the stickies). It's a very comprehensive collection of pcos reasearch...great for patients and doctors since it's nicely organized with study abstracts, and it's updated quarterly.
(BTW, are you still working out? I don't think I saw your name over at Bootcamp?? http://www.FitCysters.com )
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Hey, SoulCysters! Need to eat more veggies, but can't find recipes??
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Kat, I don't know anything about the approval here in Canada. I have hope, if it is legal here, that my Endo will prescribe it with a little proding. She did allow me to try Spiro, but I started to have an allergic reaction a few weeks into it, and stopped.
The book is downloading as we speak. If I had more time before my appointment, I'd probably have ordered the printed version, but I don't think it would get here in time for me to really go through it.
I haven't been working out like I was before I got sick with my gallbladder. This summer has been one curve ball after the other. In short, I suspect that I could have Endometriosis, and I see my GYN on Oct. 9. Mentally, I'm still "there" though, so I just know it's a matter of time (and pain relief!) before I get the ball rolling again. As far as nutrition goes, I'm still pretty much on target. I struggled for a little while with late-night snacking, but I've nipped that and feeling much better for it.
Thanks for linking to FitCysters, this is the first I have heard/read of it! I've joined, and ready to start the walking challenge tomorrow.
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"We can't solve problems by using the same kind of thinking we used when we created them."
-Albert Einstein
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Kat, now that I've downloaded the Guide - do you know which research articles are about Flutamide? I've skimmed through the titles, and didn't notice, however I imagine it is in there somewhere.
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"We can't solve problems by using the same kind of thinking we used when we created them."
-Albert Einstein
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it's been awhile since I've seen the guide, so I don't know about a section on flutamide. (from your earlier post, I wasn't sure if that was the 'only' research you were interested in.)
Fortunately, you can supplement the guide with flutamide abstracts from pubmed. Again, not knowing what, specifically, you're looking for with respect to the research, I simply put in the terms: flutamide pcos (only 43 studies, so fairly easy to manage)
You might also want to search: flutamide cholesterol women
STUDY: Diane 35 and Weight Gain in PCOS 
