Treatment of hirsutism with flutamide and a low-dosage oral contraceptive in polycystic ovarian disease patients.
OBJECTIVE
To evaluate the clinical and hormonal response of the antiandrogen flutamide (Eulexin, Schering Plough, Milan, SA, Italy) associated with a low dosage oral contraceptive (OC) in a group of hirsute women who were unresponsive to OC treatment.


METHODS
Twenty-two polycystic ovarian disease (PCOD) patients with hirsutism were treated with flutamide (250 mg twice/d) in association with ethinyl-E2 (0.030 mg/d) plus desogestrel (0.150 mg/d) (Practil 21; Organon, Rome, Italy) for 21 d/mo.


METHODS
Patients were recruited in the Institute of Obstetrical and Gynaecological Pathology, St. Bambino Hospital, University of Catania, Italy. Hormonal assays were performed in the Hormone Laboratories of St. Bambino Hospital, University of Catania, Catania, Italy.


METHODS
Every 2 months the hirsutism score was evaluated using the Ferriman-Gallwey hair density index. Mean plasma concentrations of LH, FSH, E2, total T, dihydrotestosterone (DHT), androstenedione (A), sex hormone-binding globulin, DHEAS were determined.


RESULTS
After 8 months treatment with flutamide and low dosage OC, the Ferriman-Gallwey score improved in all patients, mean values decreasing from 25.4 +/- 3.96 to 14.6 +/- 1.92. Plasma levels of total T and E2 were unchanged, whereas LH, FSH, A, and DHT values decreased significantly. Sex hormone-binding globulin levels showed a marked increase.


CONCLUSIONS
Flutamide, associated with low dosage OC, favorably influence the hirsutism in PCOD women who are unresponsive to OC treatment alone.
Department of Obstetrics and Gynaecology, Santo Bambino Hospital, University of Catania, Italy.
L
L
Ciotta
A
A
Cianci
E
E
Marletta
L
L
Pisana
A
A
Aglianò
G
G
Palumbo
D000293:Adolescent; D000328:Adult; D003276:Contraceptives, Oral / Q000008:administration & dosage* / Q000627:therapeutic use; D017135:Desogestrel / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004997:Ethinyl Estradiol / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005485:Flutamide / Q000009:adverse effects / Q000627:therapeutic use*; D012739:Gonadal Steroid Hormones / Q000097:blood; D006628:Hirsutism / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D016896:Treatment Outcome
D003276:Contraceptives, Oral; D012739:Gonadal Steroid Hormones; D004997:Ethinyl Estradiol; D005485:Flutamide; D017135:Desogestrel