A Randomized Crossover Study of Medroxyprogesterone Acetate and Diane-35 in Adolescent Girls with Polycystic Ovarian Syndrome

Abstract Objective To investigate the effects of 4-month treatment of medroxyprogesterone acetate (MPA) and Diane-35 on the clinical and biochemical features of hyperandrogenism and quality of life of adolescent girls with polycystic ovarian syndrome (PCOS). Design A prospective, randomized, cross-over study. Setting An accredited pediatric and adolescent gynecology clinic of a university-affiliated tertiary hospital. Participants 76 adolescents girls aged 14 to 19 years old with PCOS were recruited from July 2007 to July 2010. Interventions Girls were randomized into 2 groups. Group 1 received oral MPA for 4 months, followed by a washout period of 4 months, and then Diane-35 for another 4 months. Group 2 received the same combination but in the reverse order. Main Outcome Measures Clinical and biochemical features of hyperandrogenism and quality of life were assessed. Results There was no significant difference between the 2 groups at baseline. No significant difference was found in the clinical and biochemical parameters of hyperandrogenism before and after treatment with MPA. Significant reduction of the acne score, LH/FSH ratio, and testosterone level was seen after taking Diane-35. Hirsutism was also improved but it did not reach statistical significant. When comparing post-MPA and post-Diane-35, the post-Diane-35 group had significantly improved acne score and LH/FSH ratio. No significant difference was found on quality of life between both groups after treatment. Conclusion Diane-35 may be a more suitable treatment option in adolescent girls diagnosed with PCOS when compared to MPA.