Long-term treatment of hirsutism: desogestrel compared with cyproterone acetate in oral contraceptives.
OBJECTIVE
Effectiveness of 2-year treatment of hirsutism with low estrogen oral contraceptives (OCs) containing nonandrogenic or antiandrogenic progestogen. Evaluation of changes in plasma lipids.


METHODS
Ten patients treated with desogestrel 150 micrograms + 30 micrograms ethinyl estradiol, 6 with desogestrel 150 micrograms + 50 micrograms ethinyl estradiol, 10 with cyproterone acetate 2 mg + 35 micrograms ethinyl estradiol. Random allocation. Paired comparisons.


METHODS
19 normal women, not treated.


METHODS
Academic tertiary care.


METHODS
Women with hirsutism (idiopathic and/or polycystic ovary), 24 of 26 completed treatment.


METHODS
Two-year treatment.


METHODS
Hirsutism score, plasma testosterone, and lipids.


RESULTS
Initial hirsutism scores (11.8 +/- 0.6 SE) declined with treatment (-7.2 +/- 0.4, P less than 0.01) to 4.7 +/- 0.6, almost reaching control (3.6 +/- 0.3). Initial plasma cholesterol (4.33 mmol/L +/- 0.30 SE), similar to control (4.78 +/- 0.24), increased slowly over 2 years (+2.04 +/- 0.34, P less than 0.01). High-density lipoproteins cholesterol (1.05 mmol/L +/- 0.04 SE), similar to control (1.12 +/- 0.07), did not change the 1st year and increased at 2 years (+0.57 +/- 0.11, P less than 0.01). No differences appeared among treatment groups.


CONCLUSIONS
Treatment is very effective, 2 years for best results. The OCs tested are equally efficacious. Changes in plasma lipids are of some concern but of difficult interpretation.
Porcile
A
A
School of Medicine, University of Chile, Hospital del Salvador, Santiago.
Gallardo
E
E
D000328:Adult; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects / Q000627:therapeutic use*; D003534:Cyproterone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017373:Cyproterone Acetate; D003687:Dehydroepiandrosterone / Q000031:analogs & derivatives / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate; D017135:Desogestrel; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006628:Hirsutism / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D009652:Norpregnenes / Q000009:adverse effects / Q000627:therapeutic use*; D011388:Prolactin / Q000097:blood; D013739:Testosterone / Q000097:blood
D008076:Cholesterol, HDL; D003278:Contraceptives, Oral, Hormonal; D009652:Norpregnenes; D013739:Testosterone; D003687:Dehydroepiandrosterone; D017373:Cyproterone Acetate; D019314:Dehydroepiandrosterone Sulfate; D017135:Desogestrel; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D002784:Cholesterol; D003534:Cyproterone