Treatment of hirsutism with ethinyl estradiol–desogestrel contraceptive pills has beneficial effects on the lipid profile and improves insulin sensitivity

Abstract

Objective: To evaluate the effects on the lipid pattern and insulin sensitivity of hirsute women of an oral contraceptive pill containing 30 μg of ethinyl estradiol and 150 μg of desogestrel. Design: Prospective clinical study. Setting: Tertiary care institutional hospital. Patient(s): 16 hirsute women. Intervention(s): Women were evaluated at baseline and after receiving six cycles of oral contraceptive therapy. Main Outcome Measure(s): Body mass index (BMI); hirsutism score (nine body areas); serum levels of total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, apolipoprotein B, lipoprotein(a), and serum adrenal and ovarian androgens; and fasting glucose and insulin concentrations. Result(s): The mean serum total, HDL, and LDL cholesterol levels increased after six cycles of oral contraceptive therapy. Levels of HDL cholesterol were < 50 mg/dL in 7 of the 16 patients at baseline; these levels normalized in 4 patients after treatment. Serum total and LDL cholesterol remained within the normal range in all patients before and after therapy. No significant changes were observed in serum triglyceride, apolipoprotein B and lipoprotein(a) concentrations. Fasting insulin levels and insulin resistance as analyzed by homeostasis model assessment were reduced significantly after therapy. No changes in BMI were observed. Administration of oral contraceptive pills significantly reduced the hirsutism score and hyperandrogenemia. Conclusion(s): Oral contraceptive pills containing low-dose ethinyl estradiol and desogestrel are effective in controlling hyperandrogenism and hirsutism and ameliorate the abnormal metabolic profile of women with hirsutism.