The addition of dexamethasone to antiandrogen therapy for hirsutism prolongs the duration of remission.
OBJECTIVE
To determine whether the addition of dexamethasone to antiandrogen therapy prolongs the duration of remission in women with hirsutism.


METHODS
Follow-up study of patients treated with one of four regimens: spironolactone (100 mg/d) for 1 year, dexamethasone (0.37 mg/d) for 1 year, dexamethasone (0.37 mg/d) plus spironolactone (100 mg/d) for 1 year, or dexamethasone (0.37 mg/d) plus spironolactone (100 mg/d) for 2 years.


METHODS
Academic medical practice in reproductive endocrinology.


METHODS
Fifty-four women with hirsutism and hyperandrogenism.


METHODS
Ferriman-Gallwey-Lorenzo scores were obtained and serum levels of testosterone, unbound testosterone, and dehydroepiandrosterone sulfate were measured before therapy, every 6 months during therapy, and for 1 year after the withdrawal of therapy.


METHODS
Hirsutism scores and serum indices of hormonal changes were monitored.


RESULTS
Ferriman-Gallwey-Lorenzo scores and androgen levels remained low 1 year after the withdrawal of therapy in patients who were treated with dexamethasone, either alone or in combination with spironolactone. In patients who were treated with spironolactone alone, hirsutism scores had returned to baseline values after 1 year.


CONCLUSIONS
The addition of an agent that suppresses androgen levels may be useful to prolong the duration of remission of hirsutism in women with hyperandrogenism who are treated with antiandrogens.
Carmina
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E
Department of Obstetrics and Gynecology, College of Physicians and Surgeons of Columbia University, New York, New York 10032, USA.
Lobo
R A
RA
D000328:Adult; D000726:Androgen Antagonists / Q000627:therapeutic use*; D015331:Cohort Studies; D003907:Dexamethasone / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006628:Hirsutism / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology*; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications / Q000188:drug therapy; D012074:Remission Induction; D013148:Spironolactone / Q000627:therapeutic use*; D013997:Time Factors
D000726:Androgen Antagonists; D004338:Drug Combinations; D005938:Glucocorticoids; D013148:Spironolactone; D003907:Dexamethasone