Use of cyproterone acetate, finasteride, and spironolactone to treat idiopathic hirsutism.
OBJECTIVE
To compare the effectiveness of cyproterone acetate, finasteride, and spironolactone in the treatment of idiopathic hirsutism.


METHODS
Prospective randomized clinical study.


METHODS
University hospital.


METHODS
Forty-one women (median age, 21 years [range, 18-34 years]) with idiopathic hirsutism who had requested to use an oral contraceptive.


METHODS
Patients were randomly assigned to receive cyproterone acetate (12.5 mg/d for the first 10 days of the cycle), finasteride (5 mg/d), or spironolactone (100 mg/d) for 12 months. Follow-up was done at the end of therapy.


METHODS
Ferriman-Gallwey score before treatment, at 6 and 12 months of treatment, and 1 year after the end of treatment, and androgenic profile before and after treatment.


RESULTS
At the end of therapy, the Ferriman-Gallwey score decreased by 38.9%, 38.6%, and 38.5% in patients who used cyproterone acetate, finasteride, and spironolactone, respectively. One year after therapy, the Ferriman-Gallwey score of patients who used spironolactone was significantly lower (6.74 +/- 1.41) than that of patients who used either cyproterone acetate (7.92 +/- 1.08), or finasteride (9.08 +/- 0.99). The androgenic profile did not change significantly during treatment.


CONCLUSIONS
In patients with idiopathic hirsutism, the short-term results of treatment with cyproterone acetate, finasteride, and spironolactone are similar, but spironolactone is effective for a longer time.
Lumachi
Franco
F
Department of Surgical and Gastroenterological Sciences, University of Padua, School of Medicine, Padova, Italy. flumachi@unipd.it
Rondinone
Riccardo
R
D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000293:Adolescent; D000328:Adult; D000726:Androgen Antagonists / Q000627:therapeutic use*; D000735:Androstenedione / Q000097:blood; D017373:Cyproterone Acetate / Q000627:therapeutic use*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D018120:Finasteride / Q000627:therapeutic use*; D006628:Hirsutism / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D011446:Prospective Studies; D013148:Spironolactone / Q000627:therapeutic use*; D013739:Testosterone / Q000097:blood
D000726:Androgen Antagonists; D004791:Enzyme Inhibitors; D013148:Spironolactone; D013739:Testosterone; D000735:Androstenedione; D017373:Cyproterone Acetate; D019314:Dehydroepiandrosterone Sulfate; D018120:Finasteride; D019326:17-alpha-Hydroxyprogesterone