A 27-year-old woman with PCOS is prescribed a combined oral contraceptive pill for cycle regulation and hyperandrogenism. Which COCP formulation is preferred in PCOS for its anti-androgenic progestin component?

• A Levonorgestrel 150 mcg + ethinyl estradiol 30 mcg
• B Drospirenone 3 mg + ethinyl estradiol 30 mcg ✓
• C Norethisterone 1 mg + ethinyl estradiol 35 mcg
• D Desogestrel 150 mcg + ethinyl estradiol 30 mcg

Explanation

Drospirenone is an anti-androgenic progestin derived from spironolactone, making it preferred in PCOS for managing hirsutism and acne. Levonorgestrel is androgenic and may worsen hyperandrogenic symptoms. Desogestrel has low androgenic activity but lacks anti-androgenic properties. Norethisterone has moderate androgenic activity.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.