Effects of two different oral contraceptives on homocysteine metabolism in women with polycystic ovary syndrome

PurposeThis study was conducted to evaluate the effects of two different oral contraceptives (OCs) on homocysteine (Hcy) metabolism in 20 women with polycystic ovary syndrome (PCOS).MethodsWomen were randomly allocated to receive either the biphasic OC containing 40/30 μg ethynylestradiol (EE)+25/125 μg desogestrel (DSG; n=10) or the monophasic OC containing 35 μg EE and 2 mg cyproterone acetate (CPA; n=10). Investigations were performed before and after 6 months of treatment. Fasting vitamin B12, folate, Hcy and insulin sensitivity (SI), and glucose utilization independent of insulin (Sg), by the minimal model method, were evaluated.ResultsFolate and vitamin B12 were not significantly modified by either OC. EE/DSG decreased SI (2.53±0.35 vs. 1.68±0.45; p<.05), without modifying Hcy (9.54±0.7 μmol/L vs. 9.18±0.6 μmol/L). EE/CPA improved SI (1.47±0.38 vs. 3.27±0.48; p<.04) and decreased Hcy (9.8±1.9 μmol/L vs. 7.9±0.9 μmol/L; p<.05). This study indicates that in women with PCOS, EE/CPA, but not EE/DSG, improves IS and decreases fasting Hcy.