In case of LH/FSH >2 or T >2.0 nmol/L, oral contraceptive pills (ethinylestradiol and desogestrel
, Marvelon, Organon, Netherlands) were administered once daily for 21 days, and pills were used as necessary until the levels of LH and T returned to normal.
(15) The 1980s brought the third generation progestins, gestodene and desogestrel
. They are less androgenic and thus, result in decreased impact on metabolism, weight gain, acne, and mood changes.
In the present study, the contraceptive agent subtypes used by pregnant women included medroxyprogesterone acetate 5 mg (n=9), estradiol valerate 2 mg+norgestrel 0.5 mg (n=4), ethinyl estradiol 0.03 mg+levonorgestrel 0.15 mg (n=4), ulipristal 30 mg (n=2), medroxyprogesterone acetate 150 mg/ml (n=2), ethinyl estradiol 0.02 mg+gestodene 0.075 mg (n=2), norethisterone enanthate 50 mg+estradiol valerate 5 mg (n=1), desogestrel
75 [micro]g (n=1), progesterone 50 mg/ml (n=1), dydrogesterone 10 mg (n=1), and norethindrone 5 mg (n=1), provided that one woman had used one or more types of agents.
Treatment with a monophasic COC containing 0.15 mg desogestrel
and 30 mcg ethinyl E2 was initiated in all patients with moderate and severe anemia, in accordance with the guidelines given above, except for two patients who were treated with oral tranexamic acid initially and then switched to COCs because of recurrent bleeding.
Combination oral contraceptives, especially those with progestins like norgestimate, desogestrel
, or drospirenone (because of their low androgenic effects), are among the most commonly used medications for hirsutism in women with PCOS11.
Duijkers et al., "A prospective, randomized, pharmacodynamic study of quick-starting a desogestrel
progestin-only pill following ulipristal acetate for emergency contraception," Human Reproduction, vol.
The impact of 150 [micro]g of the progestin desogestrel
(DSG) combined with 30 [micro]g EE on CRP levels was verified in two studies published in 2008 and 2011, which included only 60 PCOS patients [30, 31].
Some studies also suggest that the progestin hormones drospirenone and desogestrel
may also increase the blood's ability to clot.
Drospirenone was rated as most beneficial for acne, followed by norgestimate and desogestrel
, then levonorgestrel and norethindrone.
She is currently using an oral contraceptive containing desogestrel
and ethinyl estradiol for contraception and is inquiring about a refill for the coming year.
The OEPs with drospirenone, norgestimate, desogestrel
, or norethindrone acetate may be optimal choices for the treatment of acne caused by PCOS.