Department of Obstetrics and Gynaecology, University of Cagliari, 09124 Cagliari, Italy.
Contraception. 2010 Aug;82(2):131-8. doi: 10.1016/j.contraception.2010.01.022. Epub 2010 Mar 1.
Chlormadinone acetate (CMA) is a progestin compound similar to progesterone, with antiandrogenic properties. In healthy eumenorrheic women, it was demonstrated that the monophasic estroprogestin formulation containing CMA (2 mg) plus ethinyl estradiol (EE) (30 mcg) (EE30+CMA) is efficacious both in reducing hyperandrogenic symptoms, fat mass and in improving lipoprotein panel, without changes in insulin-glucose metabolism. These metabolic properties are important for women affected by polycystic ovary syndrome (PCOS) in whom there is a predisposition to insulin resistance.
We studied whether in young nonobese women with PCOS (15 subjects, EE30+CMA-PCOS group) a six-cycle treatment with EE30+CMA can reduce androgen levels, androgen bioavailability and the score of hirsutism and acne, and modify glucose-insulin metabolism evaluated by the oral glucose tolerance test and the body composition evaluated by bio-impedenziometry. These parameters were evaluated before (first visit) and during the sixth cycle of EE30+CMA (second visit). All the results were compared with those of a matched-age-group of nonobese PCOS women (15 subjects, no OC-PCOS group) evaluated before (first visit) and after six menstrual cycles in which they did not use any drug or oral contraceptive (second visit).
In the EE30+CMA-PCOS group women, androgen levels and bioavailability, hirsutism and acne score were significantly lower at the second than at the first visit, whereas they did not change in no OC-PCOS group. At the second visit, in both groups, glucose-insulin metabolism and body composition parameters were not affected.
A six-cycle treatment with EE30+CMA is efficacious in nonobese PCOS women to improve hyperandrogenic symptoms, without negative interferences both on body composition and on insulin-glucose metabolism.
醋酸氯地孕酮（CMA）是一种类似于孕激素的孕激素化合物，具有抗雄激素作用。在健康的月经正常女性中，已证明含有 CMA（2 毫克）加炔雌醇（EE）（30 微克）（EE30+CMA）的单相雌孕激素制剂在减少高雄激素症状、脂肪量和改善脂蛋白谱方面均有效，同时不改变胰岛素-葡萄糖代谢。这些代谢特性对于患有多囊卵巢综合征（PCOS）的女性很重要，因为她们有胰岛素抵抗的倾向。
我们研究了在患有 PCOS 的年轻非肥胖女性（15 例，EE30+CMA-PCOS 组）中，六周期 EE30+CMA 治疗是否可以降低雄激素水平、雄激素生物利用度以及多毛症和痤疮评分，并通过口服葡萄糖耐量试验评估葡萄糖-胰岛素代谢，通过生物电阻抗法评估身体成分。这些参数在治疗前（第一次就诊）和第六个 EE30+CMA 周期（第二次就诊）期间进行评估。所有结果均与年龄匹配的非肥胖 PCOS 女性（15 例，无 OC-PCOS 组）进行比较，该组在未使用任何药物或口服避孕药的情况下进行了六个月经周期的评估（第二次就诊）。
在 EE30+CMA-PCOS 组女性中，第二次就诊时的雄激素水平和生物利用度、多毛症和痤疮评分均明显低于第一次就诊时，而无 OC-PCOS 组则无变化。在第二次就诊时，两组的葡萄糖-胰岛素代谢和身体成分参数均未受影响。
六周期 EE30+CMA 治疗可有效改善非肥胖 PCOS 女性的高雄激素症状，对身体成分和胰岛素-葡萄糖代谢无负面影响。
