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Finasteride versus cyproterone acetate–estrogen regimens in the treatment of hirsutism
Author(s) -
Beigi A.,
Sobhi A.,
Zarrinkoub F.
Publication year - 2004
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2004.06.003
Subject(s) - hirsutism , cyproterone acetate , medicine , finasteride , cyproterone , antiandrogen , polycystic ovary , ethinylestradiol , endocrinology , urology , sex hormone binding globulin , regimen , gynecology , hormone , androgen , population , prostate , insulin resistance , insulin , environmental health , cancer , research methodology
Objectives : 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 μg/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. Conclusion : Finasteride and CPA plus EE2 are equally effective in decreasing hirsutism, despite significantly different effects on serum hormone levels.