Klebe U, Moltz L, Pickartz H
Arch Gynecol. 1983;234(2):113-20. doi: 10.1007/BF00207683.
The influence of cyproterone acetate (CPA) containing drugs on the endometrium has not yet been investigated. Therefore, endometrial biopsies were obtained in 22 hirsute patients between day 14 and 28 of the cycle after 7-18 months of oral antiandrogen therapy. The effects of various regimens consisting of different doses of CPA in combination with ethinylestradiol (EE) were evaluated. The low-dose standard regimen (50 micrograms of EE plus 2 mg of CPA daily from day 5 to 25) caused regressive changes in the endometrium, i.e., sparse atrophic glands, relatively compact stroma, islands of stromal edema. These alterations correspond to those induced by conventional balanced low-dose combined oral contraceptives. High-dose reversed sequential regimen (40 micrograms of EE daily from day 5 to 25 plus 100 mg of CPA daily from day 5 to 14) resulted in pseudodeciduation and massive stromal edema. Pseudodeciduation during the early secretory phase is taken as a sign of the progestational depot effect of CPA, while the stromal edema is regarded as a result of the relatively unopposed estrogen intake during the second half of the treatment cycle. Thus, the effects of CPA containing drug on the endometrium depend essentially on their type, dosage and mode of administration.
含醋酸环丙孕酮（CPA）药物对子宫内膜的影响尚未得到研究。因此，在22名多毛症患者口服抗雄激素治疗7 - 18个月后的月经周期第14天至28天期间进行了子宫内膜活检。评估了由不同剂量的CPA与炔雌醇（EE）组成的各种治疗方案的效果。低剂量标准方案（从第5天至25天每天服用50微克EE加2毫克CPA）导致子宫内膜出现退行性变化，即腺体稀疏萎缩、间质相对致密、间质水肿岛状。这些改变与传统的低剂量复方口服避孕药引起的改变一致。高剂量反向序贯方案（从第5天至25天每天服用40微克EE加从第5天至14天每天服用100毫克CPA）导致假蜕膜形成和大量间质水肿。分泌期早期的假蜕膜形成被视为CPA孕激素储存效应的标志，而间质水肿被认为是治疗周期后半期相对无对抗的雌激素摄入的结果。因此，含CPA药物对子宫内膜的影响主要取决于其类型、剂量和给药方式。
