Effect of Combined Oral Contraceptives or Metformin on Quality of Life in PCOS Patients with Hirsutism
Explore the impact of adding combined oral contraceptives or metformin to laser hair removal treatment on the quality of life of patients with polycystic ovarian syndrome (PCOS) and hirsutism. This randomized control trial, presented by Nevine Dorgham, MD, PhD, delves into the treatment options for managing hirsutism and PCOS, shedding light on the importance of addressing symptoms and underlying diseases to improve patient outcomes. The study conducted in Egypt involved laser sessions, metformin, and a combined oral contraceptive, emphasizing the need for comprehensive care in addressing hirsutism and PCOS-related concerns.
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The Effect of Adding Combined Oral Contraceptives or The Effect of Adding Combined Oral Contraceptives or Metformin to Laser Hair Removal Treatment on the Metformin to Laser Hair Removal Treatment on the Quality of Life of Polycystic Ovarian Patient with Quality of Life of Polycystic Ovarian Patient with Hirsutism: A Randomized Control Trial Hirsutism: A Randomized Control Trial Presented by Nevine Dorgham, MD, PhD Dept. of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt Developed by Infomedica Medical Education& Information 2020 AAD Virtual Meeting Experience content is made available to an international audience through a licensing agreement between Infomedica and the American Academy of Dermatology. Infomedica is an independent medical education provider that delivers medical information to healthcare professionals through conference coverage and online educational programs and activities.
A M E R I C A N A C A D E M Y O F D E R M A T O L O G Y V I R T U A L M E E T I N G E X P E R I E N C E O F F I C I A L H I G H L I G H T S Key messages Key messages Globally, hirsutism affects up to 20% of women, and has a major impact on quality of life. Treatment should aim to ameliorate symptoms, but also treat the underlying disease. Where polycystic ovarian syndrome is the cause, a combined oral contraceptive with adjunct laser treatment may be the best option. DEVELOPED BY
A M E R I C A N A C A D E M Y O F D E R M A T O L O G Y V I R T U A L M E E T I N G E X P E R I E N C E O F F I C I A L H I G H L I G H T S Background Background What do we already know about this topic? Hirsutism is growth of excessive terminal hair in androgen-dependent sites.1 This can be hormonal, idiopathic, or drug-induced but in 75% of cases, polycystic ovarian syndrome (PCOS) is the cause.2 1. Lumezi BG, Berisha VL, Pupovci HL, et al. Grading of hirsutism based on the Ferriman-Gallwey scoring system in Kosovar women. Postepy Dermatol Alergol 2018;35(6):631 5. 2. Gainder S, Sharma B. Update on Management of Polycystic Ovarian Syndrome for Dermatologists. Indian Dermatol Online J 2019;10(2):97 105 DEVELOPED BY
A M E R I C A N A C A D E M Y O F D E R M A T O L O G Y V I R T U A L M E E T I N G E X P E R I E N C E O F F I C I A L H I G H L I G H T S Background Background How was this study conducted? 150 patients with PCOS were recruited from clinics in Egypt and randomized into three groups for this 6-month trial All three groups received 6 laser sessions with a diode laser, 810 nm; Group 2 also received metformin, and Group 3 a combined oral contraceptive containing cyproterone and ethinyl estradiol. Patient quality of life was measured (Dermatological Life Quality Index and health-related quality of life), and physician assessment of hirsutism performed using a 5-point visual analogue scale. DEVELOPED BY
A M E R I C A N A C A D E M Y O F D E R M A T O L O G Y V I R T U A L M E E T I N G E X P E R I E N C E O F F I C I A L H I G H L I G H T S Findings Findings What does this study add? After 6 months, all three groups showed improvement across clinical measures, with good initial increases in quality of life. However, laser-only patients did not maintain their quality of life improvements over time. Results from Groups 2 and 3 suggest that metformin and combined oral contraceptives both affect the underlying mechanism of the disease. Patients in the contraceptive group showed the biggest overall improvement in quality of life, and this continued to increase out to 6 months. DEVELOPED BY
A M E R I C A N A C A D E M Y O F D E R M A T O L O G Y V I R T U A L M E E T I N G E X P E R I E N C E O F F I C I A L H I G H L I G H T S Perspectives Perspectives How does this study impact clinical practice? Physicians should investigate all patients presenting with hirsutism to establish the underlying cause. This study confirms that all hirsute patients will benefit from laser treatment, but the initial symptom relief may not be long-lived. To maintain long-term results in patients with PCOS, laser treatment should be given alongside a combined oral contraceptive. DEVELOPED BY
