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Oral contraceptives and cyproterone acetate in female acne treatment.

The sebaceous gland is a target of androgens, and hormonal influences play an important role in the multifactorial pathogenesis of acne. In both men and women, acne may be related to an excessive hypersensitivity of the sebaceous end organ to androgens. However, in women, the ovarian and adrenal production and the plasma transport of androgens may be implicated, particularly in late-onset or persistent acne or with associated hirsutism. Many reports have shown that females with acne frequently have abnormal levels of circulating androgens. Hormonal treatment is not usually the first line in female acne. But in relation to the possibilities, particularly the tetracyclines, this may be a choice when one prescribes a pill like Dianette to a young woman presenting a mild acne and who requests contraception. However, antiandrogen treatment is sometimes mandatory, especially in resistant acne in adult women and/or in female acne which is resistant or relapsing rapidly after treatment with Roaccutane and which is often related to hyperandrogenism. Finally, in severe prepubertal acne, the possible cause is an adrenal enzymatic block of which the only treatment is hormonal.

Acne Vulgaris↗

Effect of combined oral contraceptives on glycosylated haemoglobin.

Glycosylated haemoglobin (HbA), was measured in 164 Caucasian women aged 20-40 years who were using: (1) barrier contraceptive methods; (2) contraceptive pills with 30 micrograms ethinyloestradiol and 150 micrograms laevo-norgestrel; (3) contraceptive pills with 30-35 micrograms ethinyloestradiol and 0.5-1 mg norethisterone. Mean +/- 1 s.d. values for the three groups were 7.64 +/- 0.69, 7.56 +/- 0.56 and 7.27 +/- 0.74 respectively. Groups (1) and (2) did not differ significantly from one another but the mean value for group (3) was significantly lower than for the other groups (P less than 0.01). Age, percentage ideal body weight and smoking did not influence HbA, but the value was higher for parous than for nulliparous women (P = 0.02). These findings can be explained in terms of the known effects of oestrogens and progestogens on fasting blood glucose.

Adult↗

The mechanism of action of a normophasic oral contraceptive 'Fysioquens'.

Six women with normal menstrual cycles were treated over six cycles with Fysioquens, a normophasic contraceptive consisting of 7 tablets of ethinyloestradiol (EE) 0-050 mg and 15 tablets containing 1-0 mg lynestrenol + 0-050 mg EE. In the 1st, 3rd and 6th treatment cycles and in the cycles before and after treatment, hormonal assays and other tests were carried out to determine whether ovulation had occurred. No treatment cycles showed any signs of ovulation, but it did occur in the pre-and post-treatment cycles. Blood pressures and liver function tests remained normal, but two of the six volunteers showed a slight increase in body-weight.

Adult↗

Clinical trial of a low dose combined oral contraceptive ('Ovranette').

A combination of 150 mug. d-norgestrel with 30 mug. ethinyl oestradiol was administered to 120 women for a total of 767 cycles. No pregnancies occurred and cycle control was good, 99% of the cycles being within the range of 28 plus or minus 3 days. Breakthrough bleeding occurred in 7.2% of the cycles, spotting in 8.9% and amenorphoea in 0.8%. Side-effects were minimal.

Adolescent↗