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Journal of Endocrinological Investigation

, Volume 26, Issue 4, pp 347–352 | Cite as

Estroprogestinic pill normalizes IGF-I levels in acromegalic women

  • Renato Cozzi
  • M. Barausse
  • S. Lodrini
  • G. Lasio
  • R. Attanasio
Original Article

Abstract

In some acromegalic patients medical treatment does not succeed in normalizing GH/IGF-I values. Data showing IGF-I suppression in acromegaly by estrogen and by tamoxifen use prompted us to reevaluate the effects of estro-progestins (EP) supplementation on GH/IGF-I levels in acromegalic women resistant or only par-tially sensitive to medical treatment. Eight active acromegalic women (30–52 yr, 4 with regular menses) entered a prospective open pilot study. Three of them, resistant to medical treatment, were off therapy; the remaining five, partially sensitive, maintained it at the maximally effective dosages throughout the study. Patients were treated with a triphasic pill (ethynil-estradiol 30–40–30 μg/day and desogestrel 50–70–100 mg/day) for 13±7 months. IGF-I levels fell from 512 (median, interquartile 436–657) μg/l to 282 (244–526) μg/l (p=0.0414); the decrease was observed in 6 patients (75%), and normal values were reached in 4 (50%). GH levels did not change [basal 7.6 (6.2–8.6) μg/l, final 7.6 (6.5–8.3) μg/l]. Effectiveness of treatment was not dependent on concomitant anti-GH treatment or gonadal status. In all patients IGF-I levels re-increased after EP withdrawal. This pilot study shows a marked IGF-I lowering effect of pill in acromegalic women, and warrants a prospective randomized study in patients resistant or partially sensitive to other medical treatments.

Key-words

Acromegaly estrogen contraceptive pill GH IGF-I 

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Copyright information

© Italian Society of Endocrinology (SIE) 2003

Authors and Affiliations

  • Renato Cozzi
    • 1
  • M. Barausse
    • 1
  • S. Lodrini
    • 2
  • G. Lasio
    • 2
  • R. Attanasio
    • 1
  1. 1.Division of EndocrinologyNiguarda HospitalMilanoItaly
  2. 2.Division of NeurosurgeryNeurologic Institute Carlo BestaMilanItaly

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