Effect of cyproterone acetate/ethinyl estradiol combination on periodontal status and high-sensitivity C-reactive protein levels in women with polycystic ovary syndrome: a cross-sectional study

Quintessence Int. 2024 Apr 25;55(4):274-285. doi: 10.3290/j.qi.b5013159.

Abstract

Objective: Polycystic ovary syndrome (PCOS) is widely reported among young females, and anti-androgens are used for treating hirsutism and acne in these patients. The protective effects of myo-inositol, oral contraceptives, and insulin sensitizers have been reported on the periodontium and high-sensitivity C-reactive protein (hsCRP) levels in PCOS females. However, cyproterone acetate/ethinyl estradiol (CPA/EE) has not yet been studied. This cross-sectional study explores the periodontal status and systemic inflammation in PCOS women on CPA/EE drug combination compared to females not on medication.

Method and materials: A total of 150 participants were enrolled into three groups: 50 newly diagnosed PCOS females not on medication (N-PCOS); 50 PCOS females consuming CPA/EE combination for the last 6 months (PCOS+CPA/EE); and 50 systemically healthy females (control group). Anthropometric, biochemical, periodontal parameters, and health-related quality of life questionnaires were recorded.

Results: N-PCOS and PCOS+CPA/EE groups showed a nonsignificant difference in hsCRP levels, Gingival Index, bleeding on probing, waist circumference, and waist-hip ratio (P > .05). Gingival thickness and keratinized tissue width were significantly greater in the PCOS+CPA/EE than the N-PCOS group (P ≤ .05); however, these were comparable with the control group (P > .05). Regression analysis showed significant association of bleeding on probing with Gingival Index, clinical attachment level, and hsCRP (P ≤ .05).

Conclusions: CPA/EE combination does not influence the periodontal and systemic inflammatory status in PCOS females, as similar levels of local and systemic inflammation were observed in CPA/EE consumers compared with PCOS females not on medication. However, it might play a role in increasing gingival thickness and keratinized tissue width in these patients.

Keywords: C-reactive protein; cyproterone acetate/ethinyl estradiol drug combination; gingivitis; periodontitis; phenotype; polycystic ovary syndrome.

MeSH terms

  • Adult
  • Androgen Antagonists / therapeutic use
  • C-Reactive Protein* / analysis
  • Cross-Sectional Studies
  • Cyproterone Acetate* / therapeutic use
  • Drug Combinations*
  • Ethinyl Estradiol* / therapeutic use
  • Female
  • Humans
  • Periodontal Index
  • Polycystic Ovary Syndrome* / complications
  • Polycystic Ovary Syndrome* / drug therapy
  • Quality of Life
  • Surveys and Questionnaires

Substances

  • C-Reactive Protein
  • Cyproterone Acetate
  • Ethinyl Estradiol
  • Drug Combinations
  • Cyproterone acetate, ethinyl estradiol drug combination
  • Androgen Antagonists