Official publication of Rawalpindi Medical University
Efficacy Of Cyproterone Acetate And Drosperinone Containing Cocps In Treatment Of Hirsutism In Patients With PCOS

Supplementary Files



Combined Oral Contraceptive Pill
Cyproterone Acetate

How to Cite

Sarfraz N, Akram H, Abbas A, Shaheen S, Zafar R, Eesha Yaqoob. Efficacy Of Cyproterone Acetate And Drosperinone Containing Cocps In Treatment Of Hirsutism In Patients With PCOS. JRMC [Internet]. 2023 Sep. 26 [cited 2024 Jul. 17];27(3). Available from:


Introduction: Hirsutism is a condition characterized by excess hair growth on the face, chest, and/or back in women and it is often caused by an imbalance of hormones, such as androgens. OCPs prove to be effective in reducing hirsutism in patients with PCOS by inhibiting the production of androgens and decreasing the activity of androgen receptors. OCPs may have additional benefits for patients with PCOS, such as regulating menstrual cycles, improving fertility, and reducing the risk of endometrial cancer. However, OCPs may not be suitable for all women with PCOS.

Methods: The study was conducted to investigate the effectiveness of these OCPs in reducing hirsutism in PCOS patients. In the study, 80 participants were included, 40 in the intervention group and 40 in the control group. The intervention group received a combination oral contraceptive pill containing cyproterone acetate and drosperinone (COCP) for a period of 6 months, while the control group received a placebo. Hirsutism was assessed at baseline and at the end of the 6-month treatment period using the Ferriman-Gallwey score. The primary outcome measure was the change in Ferriman-Gallwey score from baseline to the end of the treatment period.

Results: The study found that OCPs containing cyproterone acetate and drosperinone were more effective in reducing hirsutism in patients with PCOS compared to OCPs containing levonorgestrel.

Conclusion: It is important to note that OCPs may not be appropriate for all women with PCOS, therefore it's crucial to explore the risks and advantages with a healthcare professional before beginning therapy.


Somani, N., Turvy, D. Hirsutism: An Evidence-Based Treatment Update. Am J Clin Dermatol 15, 247–266 (2014).

Sahu A, Tripathy P, Mohanty J, Nagy A. Doppler analysis of ovarian stromal blood flow changes after treatment with metformin versus ethinyl estradiol-cyproterone acetate in women with polycystic ovarian syndrome: A randomized controlled trial. J Gynecol Obstet Hum Reprod. 2019 May;48(5):335-339. doi: 10.1016/j.jogoh.2018.10.006. Epub 2018 Oct 11. PMID: 30316907.

Okyay E, Gode F, Acet F, Bodur T, Cagliyan E, Sahan C, Posaci C, Gulekli B. The effect of drospirenone (3 mg) with ethinyl estradiol (30 mcg) containing pills on ovarian blood flows in women with polycystic ovary syndrome: a case controlled study. Eur J Obstet Gynecol Reprod Biol. 2014 Sep;180:93-9. doi: 10.1016/j.ejogrb.2014.06.027. Epub 2014 Jul 6. PMID: 25063905.

Archer JS, Chang RJ. Hirsutism and acne in polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol. 2004 Oct;18(5):737-54. doi: 10.1016/j.bpobgyn.2004.05.007. PMID: 15380144.

Barrionuevo P, Nabhan M, Altayar O, Wang Z, Erwin PJ, Asi N, Martin KA, Murad MH. Treatment Options for Hirsutism: A Systematic Review and Network Meta-Analysis. J Clin Endocrinol Metab. 2018 Apr 1;103(4):1258-1264. doi: 10.1210/jc.2017-02052. PMID: 29522176.

Blume-Peytavi U, Hahn S. Medical treatment of hirsutism. Dermatol Ther. 2008 Sep-Oct;21(5):329-39. doi: 10.1111/j.1529-8019.2008.00215.x. PMID: 18844711.

Batukan C, Muderris II, Ozcelik B, Ozturk A. Comparison of two oral contraceptives containing either drospirenone or cyproterone acetate in the treatment of hirsutism. Gynecol Endocrinol. 2007 Jan;23(1):38-44. doi: 10.1080/09637480601137066. PMID: 17484511.

Yildiz BO. Diagnosis of hyperandrogenism: clinical criteria. Best Pract Res Clin Endocrinol Metab. 2006 Jun;20(2):167-76. doi: 10.1016/j.beem.2006.02.004. PMID: 16772149.

Goodman NF, Cobin RH, Futterweit W, Glueck JS, Legro RS, Carmina E; American Association of Clinical Endocrinologists (AACE); American College of Endocrinology (ACE); Androgen Excess and PCOS Society (AES). AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ANDROGEN EXCESS AND PCOS SOCIETY DISEASE STATE CLINICAL REVIEW: GUIDE TO THE BEST PRACTICES IN THE EVALUATION AND TREATMENT OF POLYCYSTIC OVARY SYNDROME--PART 1. Endocr Pract. 2015 Nov;21(11):1291-300. doi: 10.4158/EP15748.DSC. PMID: 26509855.

Kahraman K, Sükür YE, Atabekoğlu CS, Ateş C, Taşkın S, Cetinkaya SE, Tolunay HE, Ozmen B, Sönmezer M, Berker B. Comparison of two oral contraceptive forms containing cyproterone acetate and drospirenone in the treatment of patients with polycystic ovary syndrome: a randomized clinical trial. Arch Gynecol Obstet. 2014 Aug;290(2):321-8. doi: 10.1007/s00404-014-3217-5. Epub 2014 Mar 28. PMID: 24676694.

Salva-Pastor N, Chávez-Tapia NC, Uribe M, Nuño-Lámbarri N. Understanding the association of polycystic ovary syndrome and non-alcoholic fatty liver disease. J Steroid Biochem Mol Biol. 2019 Nov;194:105445. doi: 10.1016/j.jsbmb.2019.105445. Epub 2019 Aug 2. PMID: 31381969.

Krattenmacher R. Drospirenone: pharmacology and pharmacokinetics of a unique progestogen. Contraception. 2000 Jul;62(1):29-38. doi: 10.1016/s0010-7824(00)00133-5. PMID: 11024226.

Rittmaster RS. Clinical review 73: Medical treatment of androgen-dependent hirsutism. J Clin Endocrinol Metab. 1995 Sep;80(9):2559-63. doi: 10.1210/jcem.80.9.7673394. PMID: 7673394.

Pehlivanov B, Mitkov M. Efficacy of an oral contraceptive containing drospirenone in the treatment of women with polycystic ovary syndrome. Eur J Contracept Reprod Health Care. 2007 Mar;12(1):30-5. doi: 10.1080/13625180600983082. PMID: 17455042.

Guido M, Romualdi D, Giuliani M, Suriano R, Selvaggi L, Apa R, Lanzone A. Drospirenone for the treatment of hirsute women with polycystic ovary syndrome: a clinical, endocrinological, metabolic pilot study. J Clin Endocrinol Metab. 2004 Jun;89(6):2817-23. doi: 10.1210/jc.2003-031158. PMID: 15181063.

Mathur R, Levin O, Azziz R. Use of ethinylestradiol/drospirenone combination in patients with the polycystic ovary syndrome. Ther Clin Risk Manag. 2008 Apr;4(2):487-92. doi: 10.2147/tcrm.s6864. PMID: 18728832; PMCID: PMC2504056.

Bhattacharya SM, Jha A. Comparative study of the therapeutic effects of oral contraceptive pills containing desogestrel, cyproterone acetate, and drospirenone in patients with polycystic ovary syndrome. Fertil Steril. 2012 Oct;98(4):1053-9. doi: 10.1016/j.fertnstert.2012.06.035. Epub 2012 Jul 13. PMID: 22795636.

Kriplani A, Periyasamy AJ, Agarwal N, Kulshrestha V, Kumar A, Ammini AC. Effect of oral contraceptive containing ethinyl estradiol combined with drospirenone vs. desogestrel on clinical and biochemical parameters in patients with polycystic ovary syndrome. Contraception. 2010 Aug;82(2):139-46. doi: 10.1016/j.contraception.2010.02.009. Epub 2010 May 23. PMID: 20654754.

Donald RA, Espiner EA, Cowles RJ, Fazackerley JE. The effect of cyproterone acetate on the plasma gonadotrophin response to gonadotrophin releasing hormone. Acta Endocrinol (Copenh). 1976 Apr;81(4):680-4. doi: 10.1530/acta.0.0810680. PMID: 769466.

Jeffcoate WJ, Matthews RW, Edwards CR, Field LH, Besser GM. The effect of cyproterone acetate on serum testosterone, LH, FSH, and prolactin in male sexual offenders. Clin Endocrinol (Oxf). 1980 Aug;13(2):189-95. doi: 10.1111/j.1365-2265.1980.tb01041.x. PMID: 6777092.

Podfigurna A, Meczekalski B, Petraglia F, Luisi S. Clinical, hormonal and metabolic parameters in women with PCOS with different combined oral contraceptives (containing chlormadinone acetate versus drospirenone). J Endocrinol Invest. 2020 Apr;43(4):483-492. doi: 10.1007/s40618-019-01133-3. Epub 2019 Oct 25. PMID: 31654312; PMCID: PMC7067819.

van Zuuren EJ, Fedorowicz Z, Carter B, Pandis N. Interventions for hirsutism (excluding laser and photoepilation therapy alone). Cochrane Database Syst Rev. 2015 Apr 28;2015(4):CD010334. doi: 10.1002/14651858.CD010334.pub2. PMID: 25918921; PMCID: PMC6481758.

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Copyright (c) 2023 Nazish Sarfraz, Humera Akram, Afroza Abbas, Sadaf Shaheen, Rida Zafar, Eesha Yaqoob