Progestin-only and antiandrogen agents used in the treatment of PCOS in adolescents

Drug type	Active ingredient	Examples	Major mechanism	Efficacy^*		Indications	Comments
Drug type	Active ingredient	Examples	Major mechanism	Hirsutism	Menstrual irregularity	Indications	Comments
Progestins	Medroxyprogesterone acetate	Provera	Prevents endometrial hyperplasia		+	Menstrual irregularity	Less efficacious than oral contraceptive pills.
	Norethindrone acetate	Aygestin
	Micronized progesterone	Prometrium
Antiandrogens	Spironolactone	Spironolactone Aldactone	Competitive inhibitor of androgen binding to the androgen receptor	+	±	Severe hirsutism	Use only with appropriate contraception because of adverse effects on fetus. Contraindicated in kidney or liver failure.
	Finasteride^¶	Proscar	Competitive 5 alpha-reductase inhibitor	+	±	Severe hirsutism	Use only with appropriate contraception because of adverse effects on fetus.
	Cyproterone acetate^¶	Cyproterone acetate Androcur	Competitive inhibitor of androgen binding to the androgen receptor	+	±	Severe hirsutism	Use only with appropriate contraception because of adverse effects on fetus.
	Flutamide^¶	Flutamide Apo-flutamide Euflex Eulexin	Nonsteroidal competitive inhibitor of androgen binding to the androgen receptor	+	±	Severe hirsutism	Use only with appropriate contraception because of adverse effects on fetus. Monitor for liver failure. Contraindicated in liver disease.

This table presents information about some of the progestin and antiandrogen agents used in the treatment of PCOS. Refer to related UpToDate content for additional details.

PCOS: polycystic ovary syndrome.

* +: usually effective; ±: marginally effective.

¶ These medications are second- or third-line options as compared with other medications in this grouping. Refer to related UpToDate content for additional details.

Graphic 67829 Version 10.0

خرید پکیج

Progestin-only and antiandrogen agents used in the treatment of PCOS in adolescents