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Human Reproduction, Vol. 18, No. 3, 515-521, March 2003
© 2003 European Society of Human Reproduction and Embryology

Differences in the use of combined oral contraceptives amongst women with and without acne

H.E. Seaman1, C.S.de Vries and R.D.T. Farmer

Pharmacoepidemiology Unit, Postgraduate Medical School (University of Surrey), Guildford, Surrey, UK

1 To whom correspondence should be addressed at: Pharmacoepidemiology Unit, Postgraduate Medical School (University of Surrey), Stirling House, Stirling Road, Surrey Research Park, Guildford, Surrey GU2 7DJ, UK. e-mail: h.seaman{at}surrey.ac.uk

BACKGROUND: Cyproterone acetate combined with ethinyl estradiol (CPA/EE) provides a treatment option for women with acne, hirsutism or polycystic ovary syndrome (PCOS). CPA/EE may be prescribed as an oral contraceptive (OC), but is not licensed as such in the UK. The use of CPA/EE steadily increased after its introduction to the UK market in 1987, but there was a marked increase in its share of the OC market after 1995. METHODS: Using the General Practice Research Database, utilization patterns of CPA/EE and conventional oral contraceptives were compared in women aged 15–39 years, with or without acne or PCOS. RESULTS: Between 1994 and 1998, CPA/EE accounted for an increasing proportion of all OC use. The proportion of CPA/EE prescribed to women with acne declined between 1994 and 1998, whereas that prescribed to women with PCOS remained constant. The age-specific use of CPA/EE by women with acne or PCOS almost doubled. After 1995, there was a marked increase in the use of products containing levonorgestrel by women with acne or PCOS. CONCLUSIONS: A large proportion of CPA/EE is prescribed to women with acne and/or PCOS, although this proportion decreased between 1992 and 1998. This has important implications in CPA/EE risk assessment studies.

Key words: cyproterone acetate/ethinyl estradiol/oral contraception/utilization


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H.E. Seaman, C.S.d. Vries, and R.D.T. Farmer
The risk of venous thromboembolism in women prescribed cyproterone acetate in combination with ethinyl estradiol: a nested cohort analysis and case-control study
Hum. Reprod., March 1, 2003; 18(3): 522 - 526.
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