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Effects of two antiandrogen treatments on hirsutism and insulin sensitivity in women with polycystic ovary syndrome
Authors:Dahlgren, E.   Landin, K.   Krotkiewski, M.   Holm, G.   Janson, P.O.
Affiliation:1 Department of Obstetrics and Gynecology Sahlgrenska University Hospital, Göteborg University, Sweden 2 Division of Endocrinology, Department of Medicine, Sahlgrenska University Hospital, Göteborg University, Sweden 3 Division of Rehabilitation Medicine and Department of Medicine, Sahlgrenska University Hospital, Göteborg University, Sweden 4 Division of Heart and Lung Diseases, Department of Medicine, Sahlgrenska University Hospital, Göteborg University, Sweden
Abstract:
Thirty-two women with polycystic ovary syndrome (PCOS) wereallocated to two antiandrogen treatment regimens; 28 women completedthe trial. Twenty women were treated with ethinyloestradioland cyproterone acetate (EO-CA) cyclically for 6 months andeight women were treated with the gonadotrophin releasing hormone(GnRH) analogue, goserelin for 6 months. Effects on hirsutism,insulin sensitivity (estimated by glucose clamp technique),blood lipids and hormones were measured. Women treated withEO-CA showed a reduction in hirsutism (P <0.05), and decreasedserum androgen concentrations (P <0.001) as well as reducedinsulin sensitivity (P <0.05). In women treated with goserelin,serum androgen concentrations also decreased (P <0.001),but there was no significant reduction of hirsutism. This group,however, showed an improved insulin sensitivity (P <0.05)despite an unchanged body mass index. Bone mineral density wasunaltered in both treatment groups. The reduction in androgenconcentrations caused by EO-CA was not paralleled by increasedinsulin sensitivity, most probably due to the effect of ethinyloestradiolper se. In contrast, the reduction in androgen concentrationsby goserelin was accompanied by an improved insulin sensitivity.
Keywords:antiandrogen/bone mineral density/hirsutism/insulin resistance/polycystic ovary syndrome
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