Effects of Etisterone and Contrasmine pills on clinical and biochemical findings of hyperandrogenism and metabolic parameters of patients with polycystic ovary syndrome: A randomized clinical trial

Nowadays, selection of a contraceptive with most anti-androgenic effects is an important challenge in treatment of patients with polycystic ovary syndrome (PCOS). This study was performed with aim to compare the effects of Etisterone and Contrasmine pills on PCOS outcomes.

This randomized clinical trial was conducted between 2016 and 2018, and enrolled 108 patients with PCOS referred to Research institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. The patients were randomly assigned to one of the intervention groups with Etisterone or Contrasmine pills. The studied outcomes included androgenic, clinical and metabolic parameters at baseline, third and sixth months of treatment. Data collection tools included standard questionnaires, bio-physiologic instruments, and laboratory diagnostic kits. To investigate the differences between the two treatment groups, the statistical model of generalized estimating equations was used. P-value less than 0.05 was considered significant.

After 3 months of treatment, the androgens levels was not significantly different between the two treatment groups (p>0.05), while after 6 months of treatment, the patients treated with Etisterone had lower testosterone levels, compared to those treated with Contrasmine (p=0.029). After 3 months of treatment, the metabolic parameters was not significantly different between the two groups (p>0.05), whereas in 6th month of treatment, patients treated with Etisterone had higher triglyceride levels than those taking Contrasmine (p=0.049). At the end of 3rd and 6th months of treatment, diastolic blood pressure was significantly higher in patients treated with Etisterone, compared to those treated with Contrasmine (p < 0.05).

Use of contraceptives containing cyproterone acetate (CPA) is associated with greater improvement in biochemical hyperandrogenism compared to drospirenone containing products (DRSP), while these compounds can induce hypertriglyceridemia and hypertension in patients with PCOS.