ANTI-ANDROGENIC THERAPY USING HORMONAL CONTRACEPTIVES


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Abstract

The lecture for practicing gynecologists gives an update on the physiological and pathological effects of androgens in the female body. It discusses the clinical situations within the wide range of indications for anti-androgenic therapy. The goals of treatment and the choice of drugs for goal achievement are covered. The main focus is on the anti-androgenic effects of chlormadinone acetate. Clinical trials demonstrating the high therapeutic activity of this agent in combination with ethinyl estradiol as ingredients of the monophasic hormonal contraceptive Belara are reviewed in detail.

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About the authors

D. E SHILIN

A.I. Evdokimov Moscow State University of Medicine and Dentistry

Email: d.e.shilin@tochka.ru

References

  1. Hodgson T.K., Braunstein G.D. Physiological effects of androgens in women. In: Azziz R., Nestler J.E., D. Dewailly D., eds. Androgen excess disorders in women : polycystic ovary syndrome and other disorders. 2nd ed. Totowa, New Jersey: Humana Press; 2006: 49 - 62.
  2. Шилин Д.Е. Синдром гиперандрогении: современные подходы к диагностике и новые технологии терапии. Лечащий врач. 2003; 10: 36-9.
  3. Шилин Д.Е. Синдром поликистозных яичников: международный диагностический консенсус (2003 г.) и современная идеология терапии. Consilium medicum. 2004; 6(9): 683-9.
  4. Arowojolu A.O., Gallo M.F., Lopez L.M., Grimes D.A., Garner S.E. Combined oral contraceptive pills for treatment of acne. Cochrane Database Syst. Rev. 2009; (3): CD004425.
  5. Johnson K.H. Are oral contraceptives (OCPs) with anti-androgenic progestins preferred over other OCPs in patients with acne? J. Fam. Pract. 2002; 51(1): 86.
  6. Серов В.Н. Белара - новый низкодозированный оральный контрацептив с антиандрогенным эффектом. Гинекология. 2003; 5(5): 217-21.
  7. Прилепская В.Н., Шулятьева Н.Н. Клинические аспекты применения оральных контрацептивов с антиандрогенным действием. Гинекология. 2005; 7(2): 49-53.
  8. Curran M.P., Wagstaff A.J. Ethinylestradiol/chlormadinone acetate. Drugs. 2004; 64(7): 751-60; discussion 761-2.
  9. Bitzer J. Belara - proven benefits in daily practice. Eur. J. Contracept. Reprod. Health Care. 2005; 10(Suppl.1): 19-25.
  10. Druckmann R. Profile of the progesterone derivative chlormadinone acetate - pharmacodynamic properties and therapeutic applications. Contraception. 2009; 79(4): 272-81.
  11. Caruso S., Rugolo S., Agnello C, Romano M., Cianci A. Quality of sexual life in hyperandrogenic women treated with an oral contraceptive containing chlormadinone acetate. J. Sex. Med. 2009; 6(12): 3376-84.
  12. Heskamp M.L., Schramm G.A. Efficacy of the low-dose combined oral contraceptive chlormadinone acetate/ethinylestradiol: physical and emotional benefits. Contraception. 2010; 81(1): 49-56.
  13. Kerscher M, Reuther T., Bayrhammer J., Schramm G. Effects of an oral contraceptive containing chlormadinone and ethinylestradiol on acne-prone skin of women of different age groups: an open-label, single-centre, Phase IV study. Clin. Drug Invest. 2008; 28(11): 703-11.
  14. Lello S., Primavera G, Colonna L, Vittori G, Guardianelli F., Sorge R., Raskovic D. Effects of two estroprogestins containing ethynilestradiol 30 microg and drospirenone 3 mg and ethynilestradiol 30 microg and chlormadinone 2 mg on skin and hormonal hyperandrogenic manifestations. Gynecol. Endocrinol. 2008; 24(12): 718-23.
  15. Plewig G., Cunliffe W.J., Binder N., Hoschen K. Efficacy of an oral contraceptive containing EE 0.03 mg and CMA 2 mg (Belara) in moderate acne resolution: a randomized, doubleblind, placebo-controlled phase III trial. Contraception. 2009; 80(1): 25-33.
  16. Raudrant D., Rabe T. Progestogens with antiandrogenic properties. Drugs. 2003; 63(5): 463-92.
  17. Sabatini R., Orsini G., Cagiano R., Loverro G. Noncontraceptive benefits of two combined oral contraceptives with antiandrogenic properties among adolescents. Contraception. 2007; 76(5): 342-7.
  18. Schneider J., Kneip C., Jahnel U. Comparative effects of chlormadinone acetate and its 3alpha- and 3beta-hydroxy metabolites on progesterone, androgen and glucocorticoid receptors. Pharmacology. 2009; 84(2): 74-81.
  19. Schramm G., Heckes B. Switching hormonal contraceptives to a chlormadinone acetate-containing oral contraceptive. The Contraceptive Switch Study. Contraception. 2007; 76(2): 84-90.
  20. Schramm G., Steffens D. A 12-month evaluation of the CMA-containing oral contraceptive Belara: efficacy, tolerability and anti-androgenic properties. Contraception. 2003; 67(4): 305-12.
  21. Schramm G., Steffens D. Contraceptive efficacy and tolerability of chlormadinone acetate 2mg/ethinylestradiol 0.03mg (Belara®): results of a post-marketing surveillance study. Clin. Drug Invest. 2002; 22(4): 221-31.
  22. Spon J., Binder N., Hoschen K., Feichtinger W. Contraceptive efficacy and safety of a low-dose oral contraceptive, (0.03 mg ethinyl oestradiol and 2 mg chlormadinone acetate) Belara, over three medication cycles. Eur. J. Contracept. Reprod. Health Care. 2008; 13(1): 39-48.
  23. Terouanne B., Paris F., Servant N., Georget V., Sultan C. Evidence that chlormadinone acetate exhibits antiandrogenic activity in androgen-dependent cell line. Mol. Cell Endocrinol. 2002; 198(1-2): 143-7.
  24. Uras R., Orru M., Etzi R., Peppi G., Marotto M.F., Pilloni M. et al. Evidence that in healthy young women, a six-cycle treatment with oral contraceptive containing 30 mcg of ethinylestradiol plus 2 mg of chlormadinone acetate reduces fat mass. Contraception. 2009; 79(2): 117-21.
  25. Winkler U.H., Sudik R. The effects of two monophasic oral contraceptives containing 30 mcg of ethinyl estradiol and either 2 mg of chlormadinone acetate or 0.15 mg of desogestrel on lipid, hormone and metabolic parameters. Contraception. 2009; 79(1): 15-23.
  26. Worret I., Arp W., Zahradnik H.P., Andreas J.O., Binder N. Acne resolution rates: results of a single-blind, randomized, controlled, parallel Phase III trial with EE/CMA (Belara) and EE/ LNG (Microgynon). Dermatology. 2001; 203(1): 38-44.
  27. Zahradnik H.P. Belara - a reliable oral contraceptive with additional benefits for health and efficacy in dysmenorrhea. Eur. J. Contracept. Reprod. Health Care. 2005;10(Suppl.1): 12-8.
  28. Zahradnik H.P., Goldberg J., Andreas J.O. Efficacy and safety of the new antiandrogenic oral contraceptive Belara. Contraception. 1998; 57(2): 103-9.
  29. Zahradnik H.P., Hanjalic-Beck A. Efficacy, safety and sustainability of treatment continuation and results of an oral contraceptive containing 30 mcg ethinyl estradiol and 2 mg chlormadinone acetate, in long-term usage (up to 45 cycles) - an open-label, prospective, noncontrolled, office-based Phase III study. Contraception. 2008; 77(5): 337-43.
  30. Jackson M.C. Oral contraception in practice. J. Reprod. Fertil. 1963; 6: 153-73.

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