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

Purpose: This 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). Methods: Women were randomly allocated to receive either the biphasic OC containing 40/30 mu g ethynylestradiol (EE)+25/125 mu g desogestrel (DSG; n = 10) or the monophasic OC containing 35 mu g EE and 2 mg cyproterone acetate (CPA; n = 10). Investigations were performed before and after 6 months of treatment. Fasting vitamin B-12, folate, Hcy and insulin sensitivity (SI), and glucose utilization independent of insulin (Sg), by the minimal model method, were evaluated. Results: Folate and vitamin B-12 were not significantly modified by either OC. EE/DSG decreased ST (2.53 +/- 0.35 vs. 1.68 +/- 0.45; p <.05), without modifying Hey (9.54 +/- 0.7 mu mol/L vs. 9.18 +/- 0.6 mu mol/L). EE/CPA improved SI (1.47 +/- 0.38 vs. 3.27 +/- 0.48; p <.04) and decreased Hcy (9.8 +/- 1.9 mu mol/L vs. 7.9 +/- 0.9 mu mol/L; p <.05). This study indicates that in women with PCOS, EE/CPA, but not EE/DSG, improves IS and decreases fasting Hey.