PIP: In women with preexisting virilization, it is advisable to prescribe contraceptive agents that do not provoke a further increase in free circulating androgens. This study evaluated the influence of 3 gestagens without androgenic effects on the endogenous sex hormone equilibrium and sex hormone-binding globulin (SHBG) concentrations. 122 women were administered 4 different combined contraceptives for up to 6 cycles. The estrogen component of each of the 4 preparations was estradiol estrogen (EE), while the gestagens were desogestrel (in 2 formulations in 2 different dosages), cyproterone acetate, and chlormadinone acetate. Most subjects had irregular cycles before treatment, and exhibited seborrhea, acne, and hirsutism. Luteinizing hormone, follicle-stimulating hormone, estrone, estradiol, progesterone, free testosterone, and dehydropeiandrosterone-sulfate levels were significantly reduced in all 4 treatment groups during tablet intake. However, SHBG concentrations increased in a highly significant manner during treatment. The elevation of SHBG is an expression of increased hepatic synthesis induced by EE. Concentrations of circulating SHBG determine the balance between estrogens and androgens. Since SHBG binds androgens better than estrogens, it effectively monitors androgenic activity. Because of their role in significantly lowering the active fraction of androgens, the preparations studied are considered appropriate contraceptives for androgenized women.