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.
Department of Obstetrics and Gynecology, Arash Maternity Hospital, Tehran University of Medical Sciences, Tehran, Iran. beigi_a@yahoo.com
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Beigi
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Sobhi
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Zarrinkoub
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