Journal of Capital Medical University ›› 2026, Vol. 47 ›› Issue (4): 665-672.doi: 10.3969/j.issn.1006-7795.2026.04.005

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Effect of ethinylestradiol /drospirenone and dydrogesterone on body composition and lipid metabolism in overweight polycystic ovary syndrome patients

Li Yanqiu1 , Ruan Xiangyan1,2* , Gu Muqing1 , Jiang Lingling1 , Zhang Mingzhen1 , Alfred O. Mueck1,2   

  1. 1.Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026; 2.Department of Women's Health,  Research Centre for Women's Health and University Women's Hospital of Tuebingen,  University Hospitals of Tuebingen, Tuebingen D-72076, Germany
  • Received:2026-04-09 Revised:2026-05-07 Online:2026-08-21 Published:2026-07-26
  • Supported by:
    This study was supported by Beijing Municipal Administration of Hospitals “Dengfeng” Talent Training Program (DFL20181401), National Foreign Experts Individual Project, Establishment of Fertility Preservation and Consultation Center for Gynecological Endocrine Difficult Diseases (S20240236).

Abstract: Objective  To compare the effects of ethinyl estradiol/drospirenone(EE/DRSP) and dydrogesterone on body composition and lipid metabolism in overweight patients with polycystic ovary syndrome (PCOS). Methods  A total of 160 overweight (24≤body mass index (BMI)< 28 kg/m2) women of reproductive age (18-40 years) who were  diagnosed with PCOS and treated at the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, were recruited. The patients were randomly divided into two groups, with 80 patients in each group (EE/DRSP group, n=80; dydrogesterone group, n=80). Each group underwent three treatment cycles. The following parameters were observed before treatment and on days 2-5 of menstrual cycle after completing three cycles of treatment: anthropometric measurements (BMI, waist circumference, hip circumference); blood lipid parameters [triglycerides (TG), total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C)]; and body composition parameters (lower limb muscle distribution coefficient, fat percentage, fat distribution).Results  After three  treatment cycles, waist circumference, hip circumference, BMI, fat distribution, fat percentage, TC and LDL-C in the EE/DRSP group were significantly reduced compared to baseline (P all<0.05). While HDL-C was significantly increased (P < 0.05). In the dydrogesterone group, BMI, waist circumference, and hip circumference, fat percentage, TC and LDL-C were significantly decreased (P<0.05). When the groups were compared, EE/DRSP led to more significant reductions in waist circumference, hip circumference, BMI, fat distribution, and fat percentage. It also resulted in a more significant increase in HDL-C and a more significant reduction in LDL-C (P all < 0.05). Conclusion  While both EE/DRSP and dydrogesterone can improve the metabolic status of patients with polycystic ovary syndrome to some extent, EE/DRSP may offer more pronounced advantages in improving body composition and lipid metabolism.

Key words: polycystic ovary syndrome,  ethinyl estradiol/drospirenone, dydrogesterone, body composition, lipid metabolism, overweight

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