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Attenuation of mild hyperandrogenic activity in postpubertal acne by a triphasic oral contraceptive containing low doses of ethynyl estradiol and d,l-norgestrel.
J Clin Endocrinol Metab. 1990 Jul; 71(1):8-14.JC

Abstract

The effect of a low dose triphasic oral contraceptive (OC) was evaluated during a 6-month treatment period in 41 patients (mean age, 25.4 +/- 0.7 yr) who had grade I-IV postpubertal acne and normal menses. The OC contained three dose levels of ethynyl estradiol and dl-norgestrel. Acne lesions were assessed, and serum androgen levels were measured during a control cycle and between days 17-21 of treatment cycles 1, 2, 3, and 6. Four patients dropped out after 3 months of treatment. Acne was significantly improved after the first OC cycle. After six cycles, the number of comedones had decreased by 79.6 +/- 3.2% (range, 50-100%) in 69.4% of the patients. Mean baseline levels of testosterone, 17-hydroxyprogesterone, and dehydroepiandrosterone sulfate were in the upper third of the normal range, with elevated individual values in 18.9%, 36.5%, and 26.8% of the women, respectively. Mean baseline levels of androstenedione, free testosterone (T), and 3 alpha-androstanediol glucuronide (3 alpha-diol-G) were above the normal range, with elevated individual values in 51.2%, 75.0%, and 85.4% of the patients, respectively. Sex hormone-binding globulin (SHBG) levels were below the normal range in 26.8% of the cases. At the end of the first OC cycle, there was a significant (P less than 0.01) decrease in all androgen precursors and a 2-fold increase in SHBG. Androstenedione and free T decreased into the normal range during OC intake. Serum 3 alpha-diol-G levels remained elevated, but had decreased by 34.5% at cycle 6 (P less than 0.05). These results show that the triphasic OC has significantly improved acne in postpubertal women for whom acne was the main manifestation of mild hyperandrogenic activity. The improvement in acne corresponded to a decrease in adrenal/ovarian androgens and free T, which led to a decreased metabolism to 3 alpha-diol-G, presumably by the sebaceous glands. The increase in SHBG is considered an estrogenic effect, and the triphasic formulation containing low dose dl-norgestrel is not androgenic but, rather, an estrogen-dominant formulation; as such, this product is recommended in women requiring contraception who also have idiopathic acne.

Authors+Show Affiliations

Département de Dermatologie, Hôpital St. Francois d'Assie, Université Laval, Quebec, Canada.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

2142494

Citation

Lemay, A, et al. "Attenuation of Mild Hyperandrogenic Activity in Postpubertal Acne By a Triphasic Oral Contraceptive Containing Low Doses of Ethynyl Estradiol and D,l-norgestrel." The Journal of Clinical Endocrinology and Metabolism, vol. 71, no. 1, 1990, pp. 8-14.
Lemay A, Dewailly SD, Grenier R, et al. Attenuation of mild hyperandrogenic activity in postpubertal acne by a triphasic oral contraceptive containing low doses of ethynyl estradiol and d,l-norgestrel. J Clin Endocrinol Metab. 1990;71(1):8-14.
Lemay, A., Dewailly, S. D., Grenier, R., & Huard, J. (1990). Attenuation of mild hyperandrogenic activity in postpubertal acne by a triphasic oral contraceptive containing low doses of ethynyl estradiol and d,l-norgestrel. The Journal of Clinical Endocrinology and Metabolism, 71(1), 8-14.
Lemay A, et al. Attenuation of Mild Hyperandrogenic Activity in Postpubertal Acne By a Triphasic Oral Contraceptive Containing Low Doses of Ethynyl Estradiol and D,l-norgestrel. J Clin Endocrinol Metab. 1990;71(1):8-14. PubMed PMID: 2142494.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Attenuation of mild hyperandrogenic activity in postpubertal acne by a triphasic oral contraceptive containing low doses of ethynyl estradiol and d,l-norgestrel. AU - Lemay,A, AU - Dewailly,S D, AU - Grenier,R, AU - Huard,J, PY - 1990/7/1/pubmed PY - 1990/7/1/medline PY - 1990/7/1/entrez KW - Acne--changes KW - Androgens--analysis KW - Biology KW - Contraception KW - Contraceptive Agents KW - Contraceptive Agents, Estrogen KW - Contraceptive Agents, Female KW - Contraceptive Agents, Progestin KW - Contraceptive Methods KW - Contraceptive Methods--side effects KW - Data Analysis KW - Dermatitis KW - Diseases KW - Endocrine System KW - Estradiol--analysis KW - Estrogens KW - Ethinyl Estradiol KW - Examinations And Diagnoses KW - Family Planning KW - Follicle Stimulating Hormone--analysis KW - Gonadotropins KW - Gonadotropins, Pituitary KW - Hormones KW - Incidence KW - Laboratory Examinations And Diagnoses KW - Luteinizing Hormone--analysis KW - Measurement KW - Norgestrel KW - Oral Contraceptives KW - Oral Contraceptives, Combined KW - Oral Contraceptives, Low-dose--side effects KW - Oral Contraceptives, Phasic KW - Oral Contraceptives--side effects KW - Physiology KW - Progestational Hormones KW - Progesterone--analysis KW - Research Methodology KW - Statistical Regression KW - Testosterone--analysis SP - 8 EP - 14 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 71 IS - 1 N2 - The effect of a low dose triphasic oral contraceptive (OC) was evaluated during a 6-month treatment period in 41 patients (mean age, 25.4 +/- 0.7 yr) who had grade I-IV postpubertal acne and normal menses. The OC contained three dose levels of ethynyl estradiol and dl-norgestrel. Acne lesions were assessed, and serum androgen levels were measured during a control cycle and between days 17-21 of treatment cycles 1, 2, 3, and 6. Four patients dropped out after 3 months of treatment. Acne was significantly improved after the first OC cycle. After six cycles, the number of comedones had decreased by 79.6 +/- 3.2% (range, 50-100%) in 69.4% of the patients. Mean baseline levels of testosterone, 17-hydroxyprogesterone, and dehydroepiandrosterone sulfate were in the upper third of the normal range, with elevated individual values in 18.9%, 36.5%, and 26.8% of the women, respectively. Mean baseline levels of androstenedione, free testosterone (T), and 3 alpha-androstanediol glucuronide (3 alpha-diol-G) were above the normal range, with elevated individual values in 51.2%, 75.0%, and 85.4% of the patients, respectively. Sex hormone-binding globulin (SHBG) levels were below the normal range in 26.8% of the cases. At the end of the first OC cycle, there was a significant (P less than 0.01) decrease in all androgen precursors and a 2-fold increase in SHBG. Androstenedione and free T decreased into the normal range during OC intake. Serum 3 alpha-diol-G levels remained elevated, but had decreased by 34.5% at cycle 6 (P less than 0.05). These results show that the triphasic OC has significantly improved acne in postpubertal women for whom acne was the main manifestation of mild hyperandrogenic activity. The improvement in acne corresponded to a decrease in adrenal/ovarian androgens and free T, which led to a decreased metabolism to 3 alpha-diol-G, presumably by the sebaceous glands. The increase in SHBG is considered an estrogenic effect, and the triphasic formulation containing low dose dl-norgestrel is not androgenic but, rather, an estrogen-dominant formulation; as such, this product is recommended in women requiring contraception who also have idiopathic acne. SN - 0021-972X UR - https://www.unboundmedicine.com/medline/citation/2142494/Attenuation_of_mild_hyperandrogenic_activity_in_postpubertal_acne_by_a_triphasic_oral_contraceptive_containing_low_doses_of_ethynyl_estradiol_and_dl_norgestrel_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jcem-71-1-8 DB - PRIME DP - Unbound Medicine ER -