Treatment of Virilization When Estrogen-Containing Therapies Are Contraindicated
Managing virilization becomes more complex when combined hormonal contraceptives (CHCs) cannot be used. A structured, evidence-based approach is needed to identify appropriate alternatives for these patients.
Clinical Scenario
This protocol applies to patients with virilization who have a contraindication to estrogen-containing therapies, including combined hormonal contraceptives — a subset of patients for whom standard first-line hormonal options are not available.
Treatment Approach (partial)
A progestogen-based approach has been recommended for use specifically in patients who cannot receive estrogen-containing therapies.
The full regimen — including options, routes, and clinical considerations — is available in the complete protocol.
References
Medroxyprogesterone acetate has been recommended for use in patients with contraindications to estrogen-containing therapies (i.e., CHCs).
Although short courses of oral medroxyprogesterone acetate (to induce a withdrawal bleed in individuals with PCOS) have been shown to reduce androgen levels, there are no studies assessing efficacy of long-term therapy.
DOI: 10.1016/j.jogc.2023.102272
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