Kindly suggest an alternative for Yasmin to control PCOS.

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Metyrapone (Metopirone) is an orphan medication that holds the FDA approval (Food and Drug Administration) for the diagnosis of Cushing’s syndrome and is occasionally used off-label for short-term treatment of Cushing’s syndrome prior to surgery. Metyrapone prevents cortisol synthesis by inhibiting 11 β-hydroxylase, the enzyme responsible for the conversion of deoxycortisol to cortisol. The restricted access and adverse reactions of Metyrapone are associated with increased androgen and mineralocorticoid production, which limits the use of this medication for the treatment of Cushing’s syndrome. It can cause a negative feedback increase of ACTH (adrenocorticotropic hormone) leading to acne, hirsutism excessive male pattern hair growth, hyperkalemia. However, Yasmin (Drospirenone and Ethinyl Estradiol) is a low dose sequential pill which has been given to regularize your cycles. They really do not actually affect the cortisol levels due to Cushing's and not really interact with Metyrapone either. It is often associated with weight gain. So, for that you may opt for Ginnete 35 (combination of Ethinyl Estradiol and Cyproterone acetate) tablet monthly for next 6 months to regularize cycles and balance hormones. There is no need at all for oophorectomy for PCOS (polycystic ovarian syndrome). It is never indicated. It can be controlled by medication as advised and revised now.

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Yes, I suggest Ginette 35. It is a nonsteroidal oral contraceptive pill and can be safely used. It will regulate your cyclical menstrual bleeding and will control on the androgen as well as will keep your acne and hirsutism low. Metyrapone as I mentioned is advised for long as a treatment but again there have to be break cycles to disallow a negative feedback after prolonged usage for Cushing's. So, evaluation has to be made every six months ideally in your case with regards to ACTH (adrenocorticotropic hormone) and other hormone levels.