Polikistik over sendromunda hirsutizm tedavisi için dienogest veya drospirenon içeren iki farklı oral kontraseptifin karşılaştırıldığı prospektif randomize bir çalışma

Amaç:Polikistik over sendromlu kadınlarda hirsutizm tedavisinde drospirenon ve dienogest içeren iki oral kontraseptifin klinik etkinliğini karşılaştırmak için prospektif randomize bir çalışma yapıldı. Hastalar ve Yöntem:Bu çalışmaya orta-şiddetli hirsutizm tanısı olan 50 kadın alındı. Yirmi beş hastaya 6 ay boyunca oral 0,03 mg etinil estradiol ve 3 mg drospirenon 21/7 (Grup 1) verildi. 25 hastalık bir başka gruba 6 ay boyunca oral 0,03 mg etinil estradiol ve 2 mg dienogest 21/7 (Grup 2) verildi. Hirsutizm, 6 ay sonra Ferriman-Gallwey (FG) puanlama sistemi kullanılarak değerlendirildi. Her iki tedavinin de 6 ayının sonrasında görülen hormonal seviyeler bazal değerlerle ve birbirleriyle karşılaştırıldı. Bulgular:Hirsutizm için F-G skorlarında (ortalama ± SD) Grup 1\'de (19,3±6,2\'den 9,7±3,5’ye, p<0,001) ve Grup 2\'de (19,5±5,8\'den 8,9±3,8’e, p<0,001) bir iyileşme gözlenmiştir. Tedavi öncesi ve sonrası hirsutizm skorları gruplar arasında karşılaştırılabilir olmuştur. Her iki grupta da tedaviden sonra toplam ve serbest testosteron düzeyleri anlamlı olarak azalmıştır. Cinsiyet hormonu bağlayıcı globulin düzeyleri, 6 aylık dönemde her iki grupta da anlamlı olarak artmıştır. Sonuç:Hirsutizmin, hem drospirenon hem de dienogest içeren kombine oral kontraseptiflerle (KOK) tedavisi, herhangi bir yan etkisi olmadan kıyaslanabilir etkilere sahiptir.

A prospective randomized trial comparing two different oral contraceptive containing dienogest or drospirenone for the treatment of hirsutism in policystic ovarian syndrome

Purpose:A prospective randomized trial was conducted to compare the clinical efficacy of two oral contraceptives containing drospirenone and dienogest in the treatment of hirsutism in women with policystic ovarian syndrome. Patients and Methods:Fifty women with moderate to severe hirsutism were recruited in this study. Twenty-five patients received oral 0.03 mg ethinyl estradiol and 3 mg drospirenone 21/7 regimen (Group 1) for 6 months. Another group of 25 patients received oral 0.03 mg ethinyl estradiol and 2 mg dienogest 21/7 regimen (Group 2) for 6 months. Hirsutism was assessed after 6 months using the Ferriman–Gallwey (F-G) scoring system. Hormonal levels after 6 months of both therapies were compared with baseline values and each other. Results:An improvement in the F-G scores for hirsutism (mean±SD) was observed in Group 1 (19.3 ± 6.2 to 9.7 ± 3.5, p<.001) and in Group 2 (19.5 ± 5.8 to 8.9 ± 3.8, p<.001). Pre- and post-treatment hirsutism scores were comparable between the groups. Total and free testosterone levels decreased significantly after the therapy in both groups. The sex hormone-binding globulin levels increased significantly in both groups during the 6-month period. Conclusion:The treatment of hirsutism with both combined oral contraceptives (COCs) containing drospirenone and dienogest have comparable effects without any side effect.

Keywords:

Drospirenone, Dienogest, Hirsutizm Combined oral contraceptives,

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