Differences in the use of combined oral contraceptives amongst women with and without acne

Hum Reprod. 2003 Mar;18(3):515-21. doi: 10.1093/humrep/deg090.

Abstract

Background: Cyproterone acetate combined with ethinyl estradiol (CPA/EE) provides a treatment option for women with acne, hirsutism or polycystic ovary syndrome (PCOS). CPA/EE may be prescribed as an oral contraceptive (OC), but is not licensed as such in the UK. The use of CPA/EE steadily increased after its introduction to the UK market in 1987, but there was a marked increase in its share of the OC market after 1995.

Methods: Using the General Practice Research Database, utilization patterns of CPA/EE and conventional oral contraceptives were compared in women aged 15-39 years, with or without acne or PCOS.

Results: Between 1994 and 1998, CPA/EE accounted for an increasing proportion of all OC use. The proportion of CPA/EE prescribed to women with acne declined between 1994 and 1998, whereas that prescribed to women with PCOS remained constant. The age-specific use of CPA/EE by women with acne or PCOS almost doubled. After 1995, there was a marked increase in the use of products containing levonorgestrel by women with acne or PCOS.

Conclusions: A large proportion of CPA/EE is prescribed to women with acne and/or PCOS, although this proportion decreased between 1992 and 1998. This has important implications in CPA/EE risk assessment studies.

MeSH terms

  • Acne Vulgaris / drug therapy*
  • Adolescent
  • Adult
  • Androgen Antagonists / therapeutic use*
  • Cohort Studies
  • Contraceptive Agents, Female / therapeutic use
  • Contraceptives, Oral, Combined / therapeutic use*
  • Cyproterone Acetate / therapeutic use*
  • Drug Prescriptions / statistics & numerical data
  • Estradiol Congeners / therapeutic use*
  • Ethinyl Estradiol / therapeutic use*
  • Female
  • Humans
  • Levonorgestrel / therapeutic use
  • Polycystic Ovary Syndrome / drug therapy*

Substances

  • Androgen Antagonists
  • Contraceptive Agents, Female
  • Contraceptives, Oral, Combined
  • Estradiol Congeners
  • Ethinyl Estradiol
  • Cyproterone Acetate
  • Levonorgestrel