title: The effects of two doses of spironolactone on serum androgens and anagen hair in hirsute women.
abstract: Spironolactone (S) has been used successfully for the treatment of hirsutism. We evaluated whether the effects of S on serum androgens and hair growth are dose-related and whether S affects secreted androgens to the same degree as peripherally derived androgens. Two groups of 15 hirsute patients, similarly matched, received either 100 or 200 mg S daily for 3 months. Serum total testosterone (T) decreased significantly (P less than 0.05) and to a similar degree with both dosages, whereas unbound T was unaltered. Dehydroepiandrosterone sulfate was unaltered, whereas androstenedione decreased with 200 mg S (P less than 0.05). Peripherally derived serum dihydrotestosterone decreased to a similar degree with 100 and 200 mg S (P less than 0.05), whereas 5 alpha-androstane-3 alpha-17 beta-diol (3 alpha-diol) increased (P less than 0.05) similarly with both dosages. Serum 3 alpha-diol glucuronide (3 alpha-diol-G) increased with both dosages, but not significantly. Anagen hair shaft diameters decreased significantly in both groups by 19% +/- 8% and 30% +/- 4% (P less than 0.05). No correlation was found between hair growth and serum androgens. Because serum unbound T was largely unaltered by S, it is suggested that the antiandrogenic effects of S are primarily related to its peripheral effect. However, there is no good clinical marker for this effect as levels of 3 alpha-diol and 3 alpha-diol-G increase.
mesh_terms: D000328:Adult; D000726:Androgen Antagonists; D000728:Androgens / Q000097:blood*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006197:Hair / Q000187:drug effects* / Q000254:growth & development; D006628:Hirsutism / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D013148:Spironolactone / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000726:Androgen Antagonists; D000728:Androgens; D013148:Spironolactone