The possibilities of using combined oral contraceptives and antiandrogens in the treatment of polycystic ovary syndrome in women of late reproductive age

Polycystic ovary syndrome is one of the most common endocrine disorders in women of reproductive age and is accompanied by menstrual irregularities, hyperandrogenism, and insulin resistance. Combined oral contraceptives or antiandrogenic drugs are usually used to correct androgenia.
The aim of the study was to compare the efficacy and safety of antiandrogens and combined oral contraceptives in the treatment of androgen syndrome in polycystic ovary syndrome in the late reproductive period.
Object and methods. 44 women with polycystic ovary syndrome aged 35–45 years were examined. The first group consisted of 25 patients who received ethinyl estradiol therapy in combination with drospirenone. The second group consisted of 19 patients receiving ciproterone therapy. All patients underwent general clinical studies (general blood analysis, general urinalysis, biochemical blood test, assessment of psychological state on the Beck depression scale, echocardiography, daily monitoring of blood pressure, determination of the level of androgens, dihydrotestosterone, testosterone, D–dimer, homocysteine, markers of bone resorption and resynthesis in the blood.
Results. The results of the study showed that androgen levels in patients treated with combined oral contraceptives and antiandrogens were comparable in both groups. Patients taking combined oral contraceptives had higher levels of depression on the Beck scale, hypertension was more common, and higher levels of D–dimer were noted, while lower levels of atherogenic lipidogram fractions and homocysteine were noted. Patients taking antiandrogens had higher levels of hepatic transaminases.
Conclusions. Combined oral contraceptives and antiandrogens have demonstrated comparable efficacy in correcting laboratory manifestations of androgenism. Combined oral contraceptives contribute to reducing cardiovascular risk by reducing the level of atherogenic lipidogram fractions and homocysteine, but they can provoke the development of hypertension. Combined oral contraceptive therapy is associated with a higher risk of developing depressive states, therefore, it is advisable to test patients on the Beck depression scale before initiating therapy. Antiandrogen therapy leads to a higher risk of hepatotoxicity, which is accompanied by an increase in the level of hepatic transaminases and requires regular laboratory monitoring of these parameters.

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