The effects of oral contraceptives including low-dose estrogen and drospirenone on the concentration of leptin and ghrelin in polycystic ovary syndrome

ObjectiveTo evaluate short-term leptin and ghrelin concentrations in women with polycystic ovary syndrome (PCOS) who use low-dose oral contraceptives containing drospirenone.DesignProspective study.SettingDepartment of obstetrics and gynaecology in a university hospital.Patient(s)Twenty women with PCOS were enrolled in the study.Intervention(s)A low-dose oral contraceptive containing ethinyl estradiol and drospirenone was given for three cycles.Main Outcome Measure(s)Serum androstenedione, free T, T, dehydroepiandrosterone sulphate, sex hormone–binding globulin, FSH, LH, E2, lipid profiles, leptin, and ghrelin levels were measured in each subject. Insulin resistance was estimated by the homeostasis model assessment-insulin resistance (HOMA-IR).Result(s)While leptin concentrations did not change with therapy, ghrelin levels increased statistically. Baseline leptin concentrations were correlated positively with body mass index, waist-to-hip ratio, insulin, and HOMA-IR and negatively with ghrelin. After controlling for body mass index and waist-to-hip ratio in a partial correlation analysis, leptin levels were not correlated with these parameters. Ghrelin was inversely correlated with body mass index, waist-to-hip ratio, insulin, HOMA-IR, and free T.Conclusion(s)In patients with PCOS, an oral contraceptive containing ethinyl estradiol and drospirenone increases ghrelin levels but not leptin levels in a 3-month period. Ghrelin might be related to the metabolic and androgenic changes in patients with PCOS.