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Hum. Reprod. Advance Access originally published online on September 30, 2005
Human Reproduction 2006 21(1):121-128; doi:10.1093/humrep/dei312
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Rosiglitazone and ethinyl estradiol/cyproterone acetate as single and combined treatment of overweight women with polycystic ovary syndrome and insulin resistance

A. Lemay1, S. Dodin, L. Turcot, F. Déchêne and J-C. Forest

Départements d’Obstétrique–Gynécologie et de Biologie Médicale, Centre de Recherche, Hôpital St-François d’Assise, CHUQ, Université Laval, Québec, Canada

1 To whom correspondence should be addressed at: Hôpital St-François d’Assise (CHUQ), 10 rue de l’Espinay, Québec P.Q., Canada G1L 3L5. E-mail: andre.lemay{at}ogy.ulaval.ca

BACKGROUND: Few studies have evaluated insulin sensitizers in comparison/association with oral contraceptives (OC) in women with polycystic ovary syndrome (PCOS) with insulin resistance (IR). This study assessed the effects of a thiazolidinedione versus an anti-androgenic estrogen–progestin followed by their sequential combinations in overweight PCOS women. METHODS AND RESULTS: Twenty-eight candidates in whom elevated insulin was not normalized after 4 months of diet were randomly assigned to 6 months of rosiglitazone 4 mg/day or to ethinyl estradiol 35 mg/cyproterone acetate 2 mg (EE/CPA: 21/28 days cycle). Each group then received both medications for another 6 months. Rosiglitazone reduced insulin, IR indices [homeostasis model assessment (HOMA) and quantitative sensitivity check index (QUICKI)] and the insulin area under the curve in response to an oral glucose tolerance test (OGTT), but had limited effect on lipids, androgens and hirsutism. EE/CPA did not modify insulin and OGTT response but increased high-density lipoprotein cholesterol and triglycerides and decreased androgens and hirsutism. Similar changes occurred during combined treatments. End results were highly significant in combined groups without noticeable side-effects or changes in safety parameters. CONCLUSIONS: In obese PCOS women with high insulin not corrected by diet, the combination of rosiglitazone and EE/CPA may be used to achieve complementary beneficial effects on endocrine–metabolic anomalies and clinical symptoms.

Key words: insulin resistance/insulin sensitizer/oral contraceptives/polycystic ovarian disease


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[Abstract] [Full Text] [PDF]


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