41082
document
Polycystic ovary syndrome and cardiovascular risk in young patients treated with drospirenone-ethinylestradiol or contraceptive vaginal ring . A prospective , randomized , pilot study . 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 .
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Intervention_Pharmacological
drospirenone-ethinylestradiol
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Intervention_Pharmacological
contraceptive vaginal ring
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Intervention_Pharmacological
pill containing drospirenone
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Intervention_Pharmacological
combined contraceptive vaginal ring
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Intervention_Pharmacological
drospirenone+ethinylestradiol
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Intervention_Pharmacological
combined contraceptive vaginal ring
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Intervention_Pharmacological
therapy
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Intervention_Pharmacological
therapy
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Outcome_Physical
hirsutism
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Outcome_Physical
hyperandrogenemia
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Outcome_Physical
ultrasound and color Doppler ovarian parameters
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Outcome_Physical
diurnal and 24-hour blood pressure
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Outcome_Physical
lipid profile
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Outcome_Physical
circulating triglycerides
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Outcome_Physical
area under the curve for glucose , insulin , and C-peptide
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Outcome_Physical
insulinogenic index
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Outcome_Physical
homeostatic model assessment estimate for insulin resistance