Langzeituntersuchungen mit einem Antiandrogen/Östrogen-Kombinationspräparat zur Wirksamkeit, Leberverträglichkeit und Fettstoffwechsel bei Frauen

The usefulness of antiandrogenic therapy with cyproterone acetate for androgenisation signs and symptoms in women, when tumours are definitely not the cause, has now been confirmed world-wide in about 100,000,000 therapy cycles using the hormonal contraceptive Diane and its follow-up preparation Diane-35, which contains a lower level of oestrogen. Nowadays, low-dose hormonal contraceptives are preferred in order to minimise the so-called "internal" risk by reducing the level of the oestrogen component and, by careful selection of the progestin, minimising the residual androgenic effect. In an open study on 150 women with moderately severe symptoms of androgenisation, we assessed, for treatment periods of up to 36 cycles, the effect of the only oestrogen-reduced hormonal contraceptive with anti-androgenic activity (Diane-35), and also monitored biochemical parameters, which are indicative of high risk metabolic activity and permit an accurate characterisation of the hormonal contraceptive, especially with long-term use. Although the parameters of liver and fat metabolism occasionally yielded values close to the limit of the normal range, it was particularly favourable to note, that the lipoprotein fraction HDL exhibited a slightly rising tendency, whereas, at the same time, the LDL fraction dropped. Special attention has been paid to ultrasonographic monitoring of the liver, since the influence on the function of this organ has been frequently discussed in conjunction with prolonged use of 17-alpha-alkylated steroidal compounds, and because a possible connection between sex steroids and the development of liver tumours has been a point of discussions.(ABSTRACT TRUNCATED AT 250 WORDS)