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Comparison of spironolactone-oral contraceptive versus cyproterone acetate-estrogen regimens in the treatment of hirsutism.

AbstractOBJECTIVE:
To compare the efficacy of two antiandrogens, cyproterone acetate (CPA) and spironolactone, in the treatment of hirsutism.
DESIGN:
Prospective randomized single-blinded study.
SETTING:
A tertiary hirsutism clinic.
PATIENTS:
Forty-two premenopausal patients with hirsutism were selected.
INTERVENTIONS:
Subjects were randomized to receive either 100 mg spironolactone and an oral contraceptive (OC) containing 150 microg desogestrel and 30 microg ethinyl E2 or 50 mg CPA daily on days 1 to 10 of the menstrual cycle, which was administered with 35 microg ethinyl E2 daily on days 1 to 21.
MAIN OUTCOME MEASURES:
Hirsutism scores were measured according to Ferriman-Gallwey scoring system and side effects were monitored for 9 months of treatment. Blood samples were taken at each visit for assessment of endocrine, biochemical, and hematologic parameters.
RESULTS:
Hirsutism scores were decreaded significantly in both groups at the end of 9 months. The percent of change in hirsutism scores in CPA and spironolactone group were as follows: 19.23% +/- 14.77% and 24.48% +/- 14.27% at 3 months; 39.01% +/- 19.77% and 37.46% +/- 16.90% at 6 months; and 51.89% +/- 20.87% and 46.39% +/- 16.10% at 9 months, respectively. There was a trend toward a better response with CPA treatment, which did not achieve significance. None of the patients stopped treatment because of side effects.
CONCLUSION:
The present data suggest that both spironolactone and CPA were similarly effective in treatment of hirsutism.
AuthorsM Erenus, D Yücelten, O Gürbüz, F Durmuşoğlu, S Pekin
JournalFertility and sterility (Fertil Steril) Vol. 66 Issue 2 Pg. 216-9 (Aug 1996) ISSN: 0015-0282 [Print] United States
PMID8690104 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References
  • Contraceptives, Oral, Synthetic
  • Hydroxyprogesterones
  • Mineralocorticoid Receptor Antagonists
  • Progesterone Congeners
  • Spironolactone
  • Testosterone
  • Ethinyl Estradiol
  • Cyproterone Acetate
  • 17-alpha-Hydroxyprogesterone
  • Desogestrel
  • Luteinizing Hormone
  • Follicle Stimulating Hormone
Topics
  • 17-alpha-Hydroxyprogesterone
  • Adolescent
  • Adult
  • Contraceptives, Oral, Synthetic (therapeutic use)
  • Cyproterone Acetate (therapeutic use)
  • Desogestrel (therapeutic use)
  • Drug Therapy, Combination
  • Ethinyl Estradiol (therapeutic use)
  • Female
  • Follicle Stimulating Hormone (blood)
  • Hirsutism (blood, drug therapy)
  • Humans
  • Hydroxyprogesterones (blood)
  • Luteinizing Hormone (blood)
  • Mineralocorticoid Receptor Antagonists (therapeutic use)
  • Progesterone Congeners (therapeutic use)
  • Prospective Studies
  • Single-Blind Method
  • Spironolactone (therapeutic use)
  • Testosterone (blood)

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