Increased
5 alpha-reductase activity has been found in hair follicles of hirsute women, suggesting a pathogenetic role. The aim of the present study was to evaluate the effect of
finasteride in the treatment of idiopathic
hirsutism. Twenty-seven women with idiopathic
hirsutism, aged 16-35 years, were treated for 6 months with
finasteride, 5 mg once daily. Fourteen patients were on
finasteride alone (group A), while the remaining received in addition an
oral contraceptive (group B). Clinical, hormonal and biochemical evaluation were performed before, and after 3 and 6 months of treatment. Clinical evaluation was repeated 6 months after
drug discontinuation in seven patients. Treatment was well tolerated by all patients; no side effects or adverse reactions were reported. A significant improvement of
hirsutism was obtained by
finasteride; clinical score observed at the 6th month of
therapy was reduced from 11.71 +/- 2.23 to 7.92 +/- 1.81 (p < 0.05) and from 14.92 +/- 6.13 to 9.3 +/- 2.75 (p < 0.05) in group A and B, respectively. Clinical score in seven patients was still 8.61 +/- 2.28 (p < 0.05) 6 months after the end of
therapy.
Finasteride treatment alone (group A) induced a slight increase, though not significant, in serum
androgens; DHT and SHBG did not change. In group B (
finasteride plus
oral contraceptive) total
testosterone and free
testosterone showed no significant decrease; after 6 months of
therapy DHT was reduced significantly, while SHBG levels were increased. These data demonstrate that
5 alpha-reductase inhibition may be an effective treatment in women suffering from idiopathic
hirsutism. This approach may be attractive due to the absence of adverse reactions, although the necessity of an adequate
contraception should be kept in mind.