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News
Combined oral contraceptives significantly reduced androgen levels in adolescent and young females with congenital adrenal hyperplasia (CAH), a new study finds. The pill also raised cortisol levels, prompting nearly half of treating physicians to lower patients' hydrocortisone doses. Researchers say the findings support oral contraceptives as a potential add-on therapy for CAH patients struggling with persistent androgen excess.
A new multicentre observational study published in the European Journal of Endocrinology found that combined oral contraceptives (OCs) containing ethinyloestradiol and levonorgestrel significantly reduced androgen levels in adolescent and young females with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. The study enrolled 20 participants, with 17 completing the full protocol, and tracked steroid profiles before and during OC use over six cycles.
The results showed marked drops in plasma androgens — including testosterone, androstenedione, and DHEA — alongside a significant rise in cortisol levels. Urinary androgen metabolites also fell dramatically, with the total sum dropping from a median of 2,569 to 727 nmol/24h. These biochemical shifts were notable enough that 47% of treating physicians reduced patients' hydrocortisone doses.
By the Numbers:
Why it matters: CAH is a lifelong condition that can be difficult to manage, especially in adolescents with persistent androgen excess despite standard glucocorticoid therapy. These findings suggest oral contraceptives could serve as a valuable adjunctive treatment option for young females who are not seeking pregnancy — potentially reducing the burden of hormonal dysregulation and allowing lower steroid medication doses.
