Cyproterone acetate or drospirenone containing combined oral contraceptives plus spironolactone or cyproterone acetate for hirsutism: randomized comparison of three regimens.
OBJECTIVE
To compare the effectiveness of three different combinations of combined oral contraceptives (COCs) and anti-androgens in the treatment of hirsutism.


METHODS
A total of 134 women with moderate and severe hirsutism were randomly assigned to three treatment regimens: Group I received 30 μg of ethinyl estradiol (EE)/3 mg of drospirenone (DRSP) plus 100 mg of cyproterone acetate (CPA) (n = 45); group II received 30 μg of EE/3 mg of DRSP plus 100 mg of spironolactone (n = 44); and group III received 35 μg of EE/2 mg of CPA plus 100 mg of CPA (n = 45), daily for 6 months. The decrease in the modified Ferriman-Gallwey hirsutism score (mFGS) was the main outcome measure.


RESULTS
The mean decrease in mFGS after 3 and 6 months of the treatment course was 26% and 49% in group I (both p < 0.01), 27% and 49% in group II (both p < 0.01), and 25% and 45% in group III (both p < 0.01), respectively, when compared with baseline. Although the mFGS was significantly decreased in all groups, there was no significant difference between groups.


CONCLUSIONS
CPA or DRSP containing COCs in combination with CPA or spironolactone have similar effects for the treatment of hirsutism.
Dermatology Clinic, Numune Education and Research Hospital, Seyhan Practice Center, Adana, Turkey. drhandankelekci@yahoo.com
Kiymet Handan
KH
Kelekci
Sefa
S
Kelekci
Irem
I
Yengel
Sule
S
Gul
Bulent
B
Yilmaz
D000293:Adolescent; D000328:Adult; D000726:Androgen Antagonists / Q000627:therapeutic use*; D000736:Androstenes / Q000627:therapeutic use; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use*; D017373:Cyproterone Acetate / Q000627:therapeutic use*; D004967:Estrogens / Q000627:therapeutic use*; D004997:Ethinyl Estradiol / Q000627:therapeutic use*; D005260:Female; D006628:Hirsutism / Q000188:drug therapy*; D006801:Humans; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013148:Spironolactone / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D000726:Androgen Antagonists; D000736:Androstenes; D003277:Contraceptives, Oral, Combined; D004967:Estrogens; D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; C035144:drospirenone