Predictors of clinical response in hirsute women treated with spironolactone.
OBJECTIVE
To examine the clinical efficacy of low dose spironolactone in hirsute women.


METHODS
Retrospective.


METHODS
Outpatient endocrinology clinic.


METHODS
One hundred nine consecutive women prescribed 75 to 100 mg/d spironolactone for at least 4 months in whom adequate follow-up data were available.


RESULTS
Hirsutism improved in 72% of the women. Women with regular menses, whether or not they used oral contraceptives (OCs), had the highest response rate to spironolactone (78%), whereas women with irregular menses who did not use an OC had the lowest response rate (55%). Favorable responses were associated with increased severity of hirsutism (P = 0.04) and lower serum dehydroepiandrosterone sulfate levels (P = 0.05). Responders and nonresponders did not differ significantly in age (P = 0.10), duration of hirsutism (P = 0.14), pretreatment serum testosterone (T) (P = 0.48), or body mass index (P = 0.11). However, when each parameter was divided into subsets, trends toward decreasing response were observed with increasing age, duration of hirsutism over 15 years, and increasing serum T level.


CONCLUSIONS
Low-dose spironolactone improves hirsutism in a majority of hirsute women, irrespective of age, severity or duration of hirsutism, menstrual status, or serum hormone levels.
Crosby
P D
PD
Camp Hill Medical Centre, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Rittmaster
R S
RS
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D002648:Child; D003276:Contraceptives, Oral; D003687:Dehydroepiandrosterone / Q000031:analogs & derivatives / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate; D005260:Female; D006628:Hirsutism / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007044:Hysterectomy; D008597:Menstrual Cycle / Q000187:drug effects; D008875:Middle Aged; D009839:Oligomenorrhea / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D013148:Spironolactone / Q000627:therapeutic use*; D013739:Testosterone / Q000097:blood; D013997:Time Factors
D003276:Contraceptives, Oral; D013148:Spironolactone; D013739:Testosterone; D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate