Finasteride versus cyproterone acetate-estrogen regimens in the treatment of hirsutism.
OBJECTIVE
To compare the clinical and hormonal effects of finasteride and a combination regimen of cyproterone acetate (CPA) plus ethinyl estradiol (EE2) in the treatment of hirsutism.


METHODS
Forty hirsute women were enrolled in a prospective randomized trial. Twenty-nine had polycystic ovary syndrome (PCOS) and 11 had idiopathic hirsutism. Patients were randomly treated with finasteride (5 mg/day; n=20) or CPA plus EE2 [CPA (25 mg/day on days 5-14) plus EE2 (20 microg/day on days 5-25) n=20] for 9 months. Main outcome measurement was a reduction in hair growth. Hirsutism score and hormone levels were measured at the beginning and at the end of the study. The student t-test and Mann-Whitney U tests were used for analysis of the data.


RESULTS
The modified Ferriman-Gallwey scores for hirsutism decreased significantly at the end of the study from a mean+/-SD of 23.7+/-4.4 to 11.3+/-1.5; P=<0.001 in finasteride group and from 22.3+/-4.2 to 11.4+/-1.2; P=<0.001 in CPA plus EE2 group. Improvement of hirsutism induced by the two treatment methods was similar (47.6 % vs. 51.1%; P=0.2). Treatment with CPA plus EE2 significantly decreased serum total and free T, A, DHEAS, and DHT and increased SHBG levels. Finasteride significantly increased total T but reduced DHT levels.


CONCLUSIONS
Finasteride and CPA plus EE2 are equally effective in decreasing hirsutism, despite significantly different effects on serum hormone levels.
Beigi
A
A
Department of Obstetrics and Gynecology, Arash Maternity Hospital, Tehran University of Medical Sciences, Tehran, Iran. beigi_a@yahoo.com
Sobhi
A
A
Zarrinkoub
F
F
D000293:Adolescent; D000328:Adult; D000726:Androgen Antagonists / Q000627:therapeutic use*; D017373:Cyproterone Acetate / Q000627:therapeutic use*; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D004997:Ethinyl Estradiol / Q000627:therapeutic use; D005260:Female; D018120:Finasteride / Q000627:therapeutic use*; D006628:Hirsutism / Q000188:drug therapy*; D006801:Humans; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy; D011446:Prospective Studies
D000726:Androgen Antagonists; D004791:Enzyme Inhibitors; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; D018120:Finasteride