From the Guidelines
For patients with Polycystic Ovary Syndrome (PCOS), the most recommended oral contraceptive brand is one containing 35 mcg ethinylestradiol and 2 mg cyproterone acetate, as seen in a pharmacotherapy regimen compared to bariatric surgery in a recent study 1. When considering oral contraceptive pills (OCPs) for PCOS management, it's crucial to select those with low androgenic activity to help mitigate the hormonal imbalances characteristic of the syndrome.
- Key benefits of using OCPs in PCOS patients include the suppression of androgen secretion by the ovaries and an increase in the level of circulating sex hormone-binding globulin, as noted in guidelines on PCOS management 1.
- The use of combination OCPs can also reduce the risk of endometrial cancer, although the extent of this effect in women with PCOS is not fully understood 1.
- In practice, first-line options may include formulations like those containing drospirenone, norgestimate, or desogestrel, due to their lower androgenic effects or anti-androgenic properties.
- However, the specific formulation of 35 mcg ethinylestradiol and 2 mg cyproterone acetate is highlighted in recent research 1, suggesting its potential as a preferred option due to its direct mention in the context of PCOS management.
- It's essential to monitor patients for improvement in symptoms such as irregular periods, acne, and hirsutism, and to be prepared to adjust the formulation if necessary to achieve the best outcomes in terms of morbidity, mortality, and quality of life.
From the Research
Oral Contraceptive Brands for PCOS
Some recommended oral contraceptive brands for patients with Polycystic Ovary Syndrome (PCOS) include:
- Diane35, which contains 35 microg ethinyl estradiol plus 2 mg cyproterone acetate 2
- Drospirenone/ethinyl estradiol combination, which has shown benefit in the PCOS population 3
- Chlormadinone acetate containing oral contraceptives, which have similar positive therapeutic effects to drospirenone-containing OCs 4
- Yasmin, which contains a new progestogen, drospirenone, and has been shown to provide good cycle control and improve acne in women with PCOS 5
Key Findings
Key findings from the studies include:
- Diane35 resulted in a higher reduction of Ferriman-Gallwey score in both obese and non-obese PCOS patients compared with metformin 2
- Metformin significantly decreased body mass index (BMI) and waist-to-hip ratio (WHR) in obese patients, and improved insulin sensitivity 2
- Drospirenone/ethinyl estradiol combination has been shown to improve clinical, hormonal, and metabolic parameters in women with PCOS 3, 4
- Yasmin provides good cycle control and improves acne in women with PCOS, but may not improve other symptoms of the syndrome 5
- The combination of metformin and oral contraceptive pill may be more effective in suppressing hyperandrogenemia and improving elastic properties of the aorta in women with PCOS 2, 6