To investigate the effect of low-doses of
glucocorticoids on
androgen and
cortisol secretion during the course of the day, we evaluated clinical signs of
hyperandrogenism and total, free and bioavailable
testosterone, SHBG, and
cortisol following two different protocols: A) fourteen patients received
betAmethasone 0.6 mg/day (n=8) or
methylprednisolone 4 mg/day (n=6), as single daily oral dose at 11.00 PM, during 30 days, B) fourteen patients were evaluated under
betamethasone 0.3 mg in a single daily dose at 11.00 PM during six months, 11 out of whom were re-evaluated six months later. Twenty eight women with
hyperandrogenism were included and seven normal females were used as control. Blood samples were taken in follicular phase at 8 AM and 7 PM to determine SHBG,
cortisol, total, free and bioavailable
testosterone. In both protocols, a significant morning and evening decrease in
cortisol and
testosterone (p<0.05 to < 0.01), which was more marked with
betamethasone (p<0.05), was shown. In protocol B, morning SHBG levels showed a significant increase (p<0.05) and
betamethasone also improved clinical
hyperandrogenism along the trial. Although morning and evening
cortisol significantly decreased during treatment, no side effects were reported. The 11 patients reevaluated after
therapy withdrawal, showed a rise in serum total
testosterone and its fractions to pre-treatment values and a normalization of
cortisol levels. It is concluded that
glucocorticoids in low-doses effectively normalize serum
androgens, independently of their origin. They may be used therapeutically, mainly whenever a hyperandrogenic woman presents with cycle irregularities or seeking fertility.