Oral contraceptives, commonly used in the treatment of PCOS, both regulate menstruation in PCOS patients and reduce androgen levels and improve insulin resistance. The estrogen component of birth control pills raises sex hormone binding globulin, thereby reducing free testosterone. The androgen component of the pill, on the other hand, has inherent androgenic activity. Therefore, when choosing a contraceptive pill for PCOS patients, one should try to choose a pill with lower androgenic activity. Cyproterone acetate and drospirenone are known progestins with anti-androgenic effects. Desogestrel is a third generation progestin with weak anti-androgenic activity. The aim of this study: to compare the effects of oral contraceptives containing dexproterenol (momofolone), cyproterone acetate (daunorubicin-35), and drospirenone (eugenol) after 6-12 months of treatment for polycystic ovary syndrome (PCOS). Design: double-blind randomized controlled trial Patients: 171 hyperandrogenic PCOS patients Intervention: Body mass index, abdominal circumference, hirsutism score (m-FG), acne, acanthosis nigricans, blood pressure, serum total testosterone, sex hormone binding globulin (SHBG), fasting glucose, fasting insulin were recorded. Free androgen indexes FAI=[T(ng/ml)/SHBG(nmol/l)]*100*3.47, glucose-insulin ratio, insulin resistance HOMA=[glucose (mg%)*insulin (mcu/ml)]/405 were calculated. follow-up was performed after 6-12 months of treatment. Main measurements: absolute changes in free androgen index (FAI), clinical and other hormonal and biochemical parameters in the 3 groups. DATA AND METHODS: From April 2010 to April 2011, 233 patients meeting the diagnostic criteria for PCOS (based on the 2006 criteria of the Androgen Excess Society), aged 18-35 years, with scanty or scanty menstruation (≤6 menstrual cycles in 12 months) and excessive body hair were selected. Exclusion criteria: secondary hyperandrogenemia due to Cushing’s syndrome, adrenal hyperplasia, hypothyroidism, hyperprolactinemia; having contraindications to estrogen therapy; having used oral contraceptives in the last 3 months. 41 of 233 patients did not meet the inclusion criteria, 12 refused to participate, and 9 were excluded for other reasons (e.g., financial problems, fear of contraceptive side effects, etc.). The 171 patients who met the inclusion criteria were divided into 3 groups in a 1:1:1 ratio using a computerized random assignment table. The drugs were removed from commercial packaging and packaged in opaque sealed bags, inspected by the resident and nurse, with the group number indicated and distributed by the pharmacy to the patients in each group using a double-blind method of physicians and patients. each of the 3 groups was treated with momoflavone, daidzein-35, and eosin for PCOS patients with a sample size of 58, 57, and 56 cases each. Each patient was given 1 tablet daily for a total of 21 pills per month and continued for 7 days off the medication until 12 months. At the 6-month follow-up, 93% of the patients in the mafron group, 94% in the dalin-35 group, and 96% in the drospirenone group were still receiving treatment. at the 12-month follow-up, the case loss rate in each group was 16% in the mafron group, 9% in the dalin-35 group, and 13% in the drospirenone group. Side effects in the momfoolone group included three cases of body fat and weight gain, one case of nausea and headache, and one case of increased blood pressure. The side effects in the daunorubicin-35 group included one case of breast distension and one case of non-retreating bleeding after stopping the drug. The side effects in the drospirenone group included nausea, vomiting and vertigo in one patient and liver function impairment in another patient. there were no significant differences in the underlying clinical features, hormonal and biochemical parameters among the three groups. Results: 1. After 6 months of treatment, similar treatment effects were demonstrated. There were no significant changes in all study parameters in all 3 groups after 6 months of treatment. 2, Comparison of the parameters in the 3 groups after 12 months of treatment showed significant differences in the following: hirsutism m-FG score (P=.003), SHBG (P=.002), and FAI score (P=.01). 3, Daing-35 significantly decreased the hirsutism score (change=-5.29), mafron change=-1.69, and eosin change=-2.12; m-FG scores decreased in all 3 groups, but the decrease in m-FG scores in the Daing-35 group was significantly different compared with the other 2 groups. 4, Daing-35 significantly increased sex hormone-binding globulin (change=142.91), eusmin change=131.52; mafron change=99.53; there was a significant difference in sex hormone-binding globulin change in the daing-35 group compared with the mafron group, and also in the eusmin group compared with the mafron group. 5. Daying-35 significantly reduced the free androgen index FAI (change = -10.57) and mafron change = -5.58, with significant differences between the two groups. Conclusion: There was no significant difference in the effects of momofolone, daing-35, and eosin in polycystic ovary syndrome after 6 months of treatment. After 12 months of treatment, daing-35 showed the strongest anti-androgenic effect. the three contraceptives had the same effect on metabolic parameters. Discussion: The study found that the 3 contraceptives were equally effective in improving the clinical manifestations of hyperandrogenemia after 6 months of treatment. However, after 12 months of treatment, there were significant differences in 3 parameters: m-FG scores, SHBG levels, and FAI values in the 3 groups. Ethinyl estradiol in the contraceptive pill increased SHBG levels and decreased free androgen levels. However, the clinical androgen-lowering effect of the pill was blunted by the different androgenic activity of the progestins in the pill. Patients with PCOS require long-term treatment because the androgenic activity of desogestrel in third-generation contraceptives maximally blocks the estrogen-mediated increase in SHBG. There was little improvement in all androgenic parameters after 6 months of treatment with momoflavone and no improvement in the indicators of insulin resistance after 12 months of treatment with the three contraceptives, pending further and longer studies to determine the changes in biochemical parameters. In this study, some clinical parameters such as body mass index (BMI), abdominal circumference (AC), waist-to-hip ratio (WHR), and blood pressure did not change significantly in any of the 3 groups after 6-12 months of treatment with the contraceptives. After 6 months of treatment, the 3 contraceptives were equally effective in treating hirsutism and acne, lowering T levels, and raising SHBG. Therefore, the clinic was able to select any of the pills for short-term treatment. However, after 12 months of treatment, some differences can occur. If one wants to improve the total androgenic symptoms, Da Vine-35 is the best choice. Both cyproterone acetate and drospirenone block peripheral androgen receptors, and cyproterone acetate also accelerates the clearance of androgens through the induction of hepatic enzymes. Animal studies have shown that cyproterone acetate at 2 mg daily does not have a significant anti-androgenic effect, so increasing SHBG via ethinyl estradiol is an important factor (this is the combination of daine-35).