Polycystic ovary syndrome and cardiovascular risk in young patients treated with drospirenone-ethinylestradiol or contraceptive vaginal ring : a prospective, randomized, pilot study
Articolo
Data di Pubblicazione:
2010
Citazione:
Polycystic ovary syndrome and cardiovascular risk in young patients treated with drospirenone-ethinylestradiol or contraceptive vaginal ring : a prospective, randomized, pilot study / C. Battaglia, F. Mancini, R. Fabbri, N. Persico, P. Busacchi, F. Facchinetti, S. Venturoli. - In: FERTILITY AND STERILITY. - ISSN 0015-0282. - 94:4(2010 Sep), pp. 1417-1425.
Abstract:
OBJECTIVE:
To compare the effects of a pill containing drospirenone with those of a combined contraceptive vaginal ring on the lipid and carbohydrate metabolism and on the surrogate markers of arterial function.
SETTING:
Bologna University School of Medicine.
PATIENT(S):
Thirty-seven women with polycystic ovary syndrome (PCOS) were randomly submitted to drospirenone+ethinylestradiol (group I; n=19) or combined contraceptive vaginal ring (group II; n=18) therapy. The duration of the study was 6 months.
INTERVENTION(S):
The effect of treatments was assessed after 6 months of therapy.
MAIN OUTCOME MEASURE(S):
Utero-ovarian ultrasound analysis and color Doppler evaluation of uterine and stromal ovarian arteries. In addition, analysis of brachial artery flow-mediated vasodilatation and 24-hour ambulatory blood pressure monitoring were performed. Fasting blood samples were drawn for testing biochemical and hormonal parameters and nitrites/nitrates.
RESULT(S):
Both treatments improved hirsutism, hyperandrogenemia, and ultrasound and color Doppler ovarian parameters. Both drospirenone+ethinylestradiol or contraceptive vaginal ring induced a slight but significant increase of diurnal and 24-hour blood pressure. Although both therapies worsened the lipid profile, the oral pill administration was associated with a more evident increase of circulating triglycerides. The 6-month treatment with the vaginal ring significantly improved the area under the curve for glucose, insulin, and C-peptide, whereas the drospirenone+ethinylestradiol pill induced an increase in the insulinogenic index and homeostatic model assessment estimate for insulin resistance values.
CONCLUSION(S):
Vaginal hormonal contraception appears to be preferable to oral ethinylestradiol + drospirenone administration in hyperinsulinemic patients with PCOS.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Adult; Androstenes; Blood Pressure; Brachial Artery; Cardiovascular Diseases; Cardiovascular Physiological Phenomena; Contraception; Ethinyl Estradiol; Female; Humans; Insulin; Ovary; Pilot Projects; Polycystic Ovary Syndrome; Regional Blood Flow; Risk Factors; Ultrasonography; Young Adult; Contraceptive Devices, Female
Elenco autori:
C. Battaglia, F. Mancini, R. Fabbri, N. Persico, P. Busacchi, F. Facchinetti, S. Venturoli
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