Ethinyl estradiol-drospirenone versus ethinyl estradiol-drospirenone plus metformin in the treatment of lean women with polycystic ovary syndrome; Cinar N, Harmanci A, Bayraktar M, Yildiz BO; Clinical Endocrinology (Apr 2012)

Oral contraceptive use might be associated with cardiometabolic risk in PCOS. ;Cinar N, Harmanci A, Bayraktar M, Yildiz BO,studied to compare the effects of ethinyl estradiol-drospirenone (EE/DRSP) alone versus EE/DRSP plus metformin on clinical and cardiometabolic parameters in PCOS. DESIGN: Prospective observational study PATIENTS: Forty-five lean PCOS patients who received EE/DRSP (30μg/3mg) (n=25) or EE/DRSP plus metformin (1700mg/d) (n=20) and 45 BMI-matched healthy controls. MEASUREMENT: BMI, waist-to-hip ratio (WHR), hirsutism scores, androgens, lipids, glucose and insulin levels during an OGTT were measured before and after 6 months of treatment in patients and compared to controls. RESULTS: At baseline, PCOS patients showed similar glucose, insulin and lipids but increased 2h glucose values compared to controls. Hirsutism scores and free androgen index decreased in both treatment groups. BMI and WHR did not show any change in the EE/DRSP group while metformin addition resulted in a decrease in BMI. Lipid levels increased in both groups. Glucose and insulin parameters did not change in any group, but metformin addition compared to EE/DRSP alone significantly decreased waist circumference, fasting insulin and HOMA-IR. After-treatment values for both EE/DRSP alone and in combination with metformin compared to the control group showed increased 2h glucose and increased lipids in PCOS patients. CONCLUSION: EE/DRSP alone or in combination with metformin improves clinical and biochemical hyperandrogenism in lean PCOS. Both treatments similarly alter lipid profile. EE/DRSP alone does not affect insulin sensitivity whereas combining EE/DRSP with metformin might improve it.