Abstract:
BACKGROUND:The effectiveness of different
combined oral contraceptive pills and metformin
in reducing hirsutism in patients with polycystic
ovary syndrome (PCOS) remains unclear.
OBJECTIVE: We sought to determine the effects of
ethinylestradiol (35μg)/cyproterone acetate (2mg)
(EE/CPA) and ethinylestradiol (20μg)/desogestrel
(0.15mg) (EE/DES), alone or with metformin, on
hirsutism in PCOS. METHODS: A randomized,
double-blind, triple-dummy study was conducted
on women with PCOS and hirsutism (N=107) who
received one of four drug combinations (Arm A: EE/
CPA; Arm B: EE/DES; Arm C: EE/CPA plus metformin;
or Arm D: EE/DES plus metformin). Hirsutism was
assessed at baseline, six months, and 12 months
by using five outcomes variables. RESULTS: No
outcomes variable showed a significant difference
between the four arms at 12 months. There was
a significant reduction in both hair density and
modified Ferriman-Gallwey score (mFGS) in Arm A,
mFGS in Arm B, hair density in Arm C, and diameter
of sideburn hair in Arm D, respectively. Separately,
there was a significant increase noted in the
hair growth rate of chin and an improvement in
patients’ perceptions of hirsutism in all four study
arms. CONCLUSION: EE/CPA and EE/DES were
equally effective in improving hirsutism in PCOS,
with no added benefit from low-dose metformin.
Sri Lanka Clinical Trials Registry (http://www.slctr.
lk) registration no. SLCTR/2015/007
