Keslie S Woods1, Rosario Reyna, Ricardo Azziz. 1. Department of Obstetrics and Gynecology The University of Alabama at Birmingham, Birmingham, Alabama 35233-7333, USA.
Abstract
OBJECTIVE: To determine whether the use of oral micronized progesterone (OMP) to induce withdrawal bleeding in women suspected of having polycystic ovary syndrome (PCOS) alters circulating androgen levels. DESIGN: Prospective clinical trial. SETTING: Academic medical center. PATIENT(S): Eight reproductive-aged women with PCOS. INTERVENTION(S): Blood was sampled before (week 0) and weekly after (weeks 1 to 4) the administration of OMP (Prometrium, Solvay Pharmaceuticals, Marietta, GA), 100 mg in the morning and 200 mg before bedtime for 7 days. MAIN OUTCOME MEASURE(S): The levels of total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), and androstenedione (A4) were determined in the blood samples. RESULT(S): In seven of the eight women studied, menstrual cycle intervals were >3 months, while one was eumenorrheic; six of the eight women had hirsutism (modified Ferriman-Gallwey score >7). Mean age was 28.9 +/- 10.4 years and mean body mass index was 33.9 +/- 4.7 kg/m2. The mean values of TT, FT, SHBG, DHEAS, A4, and 17-OHP did not change with OMP administration. However, a higher 17-OHP level was observable at the completion of OMP administration (week 2). CONCLUSION(S): We conclude that the administration of OMP (100 mg in the morning and 200 mg before bedtime for 7 days) to induce withdrawal bleeding in women with PCOS does not significantly alter circulating androgen or 17-OHP levels, and can be used to time blood sampling in these patients.
OBJECTIVE: To determine whether the use of oral micronized progesterone (OMP) to induce withdrawal bleeding in women suspected of having polycystic ovary syndrome (PCOS) alters circulating androgen levels. DESIGN: Prospective clinical trial. SETTING: Academic medical center. PATIENT(S): Eight reproductive-aged women with PCOS. INTERVENTION(S): Blood was sampled before (week 0) and weekly after (weeks 1 to 4) the administration of OMP (Prometrium, Solvay Pharmaceuticals, Marietta, GA), 100 mg in the morning and 200 mg before bedtime for 7 days. MAIN OUTCOME MEASURE(S): The levels of total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), and androstenedione (A4) were determined in the blood samples. RESULT(S): In seven of the eight women studied, menstrual cycle intervals were >3 months, while one was eumenorrheic; six of the eight women had hirsutism (modified Ferriman-Gallwey score >7). Mean age was 28.9 +/- 10.4 years and mean body mass index was 33.9 +/- 4.7 kg/m2. The mean values of TT, FT, SHBG, DHEAS, A4, and 17-OHP did not change with OMP administration. However, a higher 17-OHP level was observable at the completion of OMP administration (week 2). CONCLUSION(S): We conclude that the administration of OMP (100 mg in the morning and 200 mg before bedtime for 7 days) to induce withdrawal bleeding in women with PCOS does not significantly alter circulating androgen or 17-OHP levels, and can be used to time blood sampling in these patients.
Authors: Eric Nilsson; Ginger Larsen; Mohan Manikkam; Carlos Guerrero-Bosagna; Marina I Savenkova; Michael K Skinner Journal: PLoS One Date: 2012-05-03 Impact factor: 3.240