Polycystic Ovary Syndrome and Estroprogestins

October 2025 in “ Minerva Obstetrics and Gynecology ”

Stefano Lello, A Fagotti, M. Vignali, Laura Colonna, Anna Capozzi

estroprogestins polycystic ovary syndrome androgenetic alopecia anti-androgenic progestins cyproterone acetate drospirenone dienogest ethinylestradiol hyperandrogenic symptoms PCOS EPs CPA DRSP DNG EE

TLDR Choosing the right estroprogestin is crucial for effectively managing PCOS symptoms.

This review discusses the use of estroprogestins (EPs) in managing polycystic ovary syndrome (PCOS), which is characterized by symptoms such as menstrual irregularities, obesity, and androgenetic alopecia. EPs, particularly those containing anti-androgenic progestins like cyproterone acetate (CPA), drospirenone (DRSP), and dienogest (DNG) combined with ethinylestradiol (EE), are effective in reducing hyperandrogenic symptoms. However, due to a less favorable benefit-risk ratio of EE/CPA, other antiandrogenic progestins may be more suitable for treating PCOS, considering both hormonal and metabolic aspects. The review emphasizes the importance of selecting the most appropriate EP formulation based on the pharmacological profile and individual patient characteristics to effectively manage androgen excess in PCOS.

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