Use of progestin-only drospirenone-based pills in hyperandrogenic women with polycystic ovary syndrome.
Level 4 - case-series / case-control
Retrospective single-arm observational study (case series) without a control group
PubMed 40928522 · doi:10.1007/s00404-025-08083-7
What was done
This retrospective single-center observational study evaluated 25 hyperandrogenic women with polycystic ovary syndrome (PCOS) aged 16 to 35 years treated at a single clinic in Rome. Patients were prescribed drospirenone-only (DRSP) oral contraception for 6 months. Changes from baseline were measured for clinical hyperandrogenism via the Comprehensive Acne Severity Scale (CASS) and modified Ferriman-Gallwey (mFG) scores, pelvic ultrasonography, hormonal assays (17-OH-progesterone, basal LH), C-reactive protein (CRP), metabolic parameters, and bleeding patterns using two-tailed Wilcoxon signed-rank tests.
What was found
After 6 months of DRSP-only therapy, patients showed significant reductions in CASS acne scores (2.4 to 1.8, p = 0.02) and mFG hirsutism scores (12.31 to 6.31, p = 0.0053). Hormonal assays showed significant reductions in 17-OH-progesterone (0.6 to 0.3 ng/ml, p = 0.03) and basal LH (5.8 to 3.55 UI/ml, p = 0.01). CRP showed a non-significant decreasing trend (1.6 to 0.5 mg/l, p = 0.06). Initial spotting decreased over time, and the authors reported no worsening in metabolic parameters.
Why it matters
Drospirenone-only contraception may offer a viable therapeutic alternative for managing androgen excess in PCOS patients who have contraindications, cardiovascular risks, or intolerance related to estrogen-containing combined oral contraceptives.
Limits
The study is limited by a very small sample size (n = 25), a single-center retrospective design, and the absence of a control group. Follow-up was restricted to 6 months, and numerical values for metabolic parameters were not detailed in the abstract.
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- supports Slynd is a progestin-only birth control pill that is anti-androgenic.