[Effectiveness of flutamide alone or combined with oral contraceptives in the treatment of hirsutism in women].
BACKGROUND
Flutamide is an antiandrogen devoid of other hormonal effects, except for a decrease in the secretion of adrenal androgens such as dehydroepidandrosterone sulphate (DHEA-s) and androstenedione.


OBJECTIVE
To assess the effectiveness of flutamide in the treatment of hirsutism, used as monotherapy or combined with oral contraceptives (OC).


METHODS
Women with peripheral hirsutism (defined as the presence of normal serum androgen levels and normal ovulatory menstrual cycles) were assigned to receive flutamide alone (500 mg/day) or flutamide plus an OC (ethynylestradiol 0.03 mg and desogestrel 150 microg). Hirsute with hyperandrogenism (polycystic ovary syndrome) were assigned to receive flutamide plus an OC. The degree of hirsutism was assessed using a clinical score (Moncada) at three, six and twelve months of therapy.


RESULTS
Twenty five women with peripheral hirsutism received flutamide alone and 18 receive flutamide plus the contraceptive. Eighteen women with polycystic ovary syndrome were studied. At three months, the reduction in hirsutism was 11.2, 15.9 and 24.7% in women with peripheral hirsutism receiving flutamide alone or flutamide plus OC and in hyperandrogenic women receiving flutamide plus OC, respectively. At twelve months, the figures were 57.2, 57.3 and 52.5% respectively. In hyperandrogenic women, at baseline and three months, serum testosterone levels were 0.96 and 0.42 ng/nl and serum DHEA-s levels were 2,980 and 1,490 ng/ml respectively. No collateral effects of treatment or elevations in serum transaminase levels were observed.


CONCLUSIONS
Flutamide is effective in the treatment of hirsutism in women with normal or elevated androgen levels. Adding OC did not improve the efficacy of the drug.
Devoto
Enzo
E
Facultad de Medicina de la Universidad de Chile, Campus Central, Servicio de Medicina, Sección Endocrinología, Hospital Clínico San Borja-Arriarán, Santiago de Chile. edevoto@vtr.net
Aravena
Lucía
L
D000293:Adolescent; D000328:Adult; D000726:Androgen Antagonists / Q000627:therapeutic use*; D000728:Androgens / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use*; D005260:Female; D005485:Flutamide / Q000627:therapeutic use*; D006628:Hirsutism / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D011085:Polycystic Ovary Syndrome / Q000150:complications; D016896:Treatment Outcome
D000726:Androgen Antagonists; D000728:Androgens; D015415:Biomarkers; D003277:Contraceptives, Oral, Combined; D005485:Flutamide
Eficacia de la flutamida en el tratamiento del hirsutismo. Contribución del uso combinado con anticonceptivos orales en mujeres normoandrogénicas.