Do will still need anti-androgenic progestogens?

Johannes Bitzer (CH)

[Bitzer] Uni of Basel

Introduction: Hyperandrogenism in women leads to skin and hair disorders, metabolic disturbances and can increase cardiovascular and neoplastic risk. There are different treatment options including local and endocrine treatment. One of these is the use of antiandrogenic progestogens in combination with an estrogen in women wanting contraception. Antiandrogenic progestogens are however considered to increase thromboembolic risk to a higher degree than androgenic progestogens Objective: Defining the importance of the AEiW by summarizing the prevalence of Hyperandrogenic Skin Disorders and PCO Perform a narrative review of studies about the efficacy, health risks, tolerability, and possible health benefits of different treatment options. Results: Prevalence Acne: 80-95% in adolescents and 5% in women beyond 40 Hirsutism: 5-15% with regional differences PCO: 15% (most prevalent endocrine disorder) Local therapies have low and medium efficacy The combination of estrogen with an antiandrogenic progestogen is the most effective treatment targeting symptoms and endocrine dysregulation. The individual cardiovascular risk has to be assessed and balanced with the benefit