Chronic treatment regimens for hirsutism in women: effect on blood production rates of testosterone and on hair growth.
Twenty-five women with hirsutism were studied before and during treatment aimed empirically at suppresing testosterone production by adrenals, ovaries or both. Mean basal plasma testosterone was 70 plus or minus 30 ng/dl, significantly (P less than 0.01) higher than the mean of twenty-three normal women; basal metabolic clearance rate (MCR) of testosterone was also higher (P less than 0.01) than that reported for normal women. Production rate (PR) of testosterone exceeded 417 mug/24 h (1 SD above the mean reported for normal women), in nineteen of the twenty-five patients. After 4 months, small dose betamethasone therapy (0.5 mg at bed time) had reduced the mean PR of testosterone in thirteen patients from 509 mug/24 h to 356 mug/24 h (P = 0.05); anovulatory steroids reduced mean PR of testosterone in nine from 612 mug/24 h to 345 mug/24 h (P less than 0.05, greater than 0.025), and the combination of both therapies in ten reduced PR of testosterone from 528 mug/24 h to 148 mug/24 h (P less than 0.001). The latter regimen had moderate success in reducing hair growth (in six out of ten). Fourteen of the twenty-five claimed benefit in hirsutism and all thirteen with acne were improved. In individual cases, clinical benefit did not correlate well with reduction in PR of testosterone. Freedom from undesirable side effects allows these well-accepted forms of treatment to be given even longer trials.
D000152:Acne Vulgaris / Q000150:complications; D000293:Adolescent; D000311:Adrenal Glands / Q000187:drug effects; D000328:Adult; D001623:Betamethasone / Q000627:therapeutic use*; D004997:Ethinyl Estradiol / Q000627:therapeutic use*; D005260:Female; D006197:Hair / Q000187:drug effects*; D006628:Hirsutism / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008525:Medroxyprogesterone / Q000627:therapeutic use*; D008599:Menstruation Disturbances / Q000150:complications; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D013739:Testosterone / Q000096:biosynthesis / Q000097:blood* / Q000378:metabolism
D013739:Testosterone; D004997:Ethinyl Estradiol; D001623:Betamethasone; D008525:Medroxyprogesterone