GONADOTROPIN-RELEASING-HORMONE ANALOG PLUS AN ORAL-CONTRACEPTIVE CONTAINING DESOGESTREL IN WOMEN WITH SEVERE HIRSUTISM - EFFECTS ON HAIR, BONE, AND HORMONE PROFILE AFTER 1-YEAR USE

To evaluate the usefulness of D-Trp-6-luteinizing hormone-releasing ho rmone (LHRH) (triptorelin), a gonadotropin-releasing hormone (GnRH) an alog (GnRHa), plus an oral contraceptive (OC) in the treatment of seve re hirsutism, a total of 48 women between 19 and 35 years of age suffe ring from polycystic ovary syndrome (PCOS) with severe hirsutism were studied, Hyperandrogenism of adrenal origin was excluded in all subjec ts. Twenty-three patients received 3.75 mg D-Trp-6-LHRH intramuscularl y monthly for 1 year plus an OC containing 30 mu g ethinyl-estradiol a nd 150 mu g desogestrel. A second group of 25 subjects received an OC containing 35 mu g ethinyl-estradiol and 2 mg cyproterone acetate (CPA ). Immediately before and after months 6 and 12 of therapy, bone miner al density (BMD) and Ferriman-Gallwey scores were evaluated and follic le-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) , prolactin (PRL), testosterone (T), androstenedione (A), dehydroepian drosterone sulfate (DHEAS), 17-OH-progesterone (17-OHP), and sex hormo ne-binding globulin (SHBG) were determined, After 1 year of follow-up study, the combination of a GnRHa plus OC resulted in a decrease of hi rsutism similar to that observed in the CPA group (41.9% v 40.5%) and in a suppression of gonadotropins and ovarian steroids in all treated women, without significant changes in bone density. The GnRHa-OC combi nation can potentially be used in the treatment of hirsutism and hyper androgenism. Copyright (C) 1997 by W.B. Saunders Company.