M. Erenus et al., COMPARISON OF SPIRONOLACTONE-ORAL CONTRACEPTIVE VERSUS CYPROTERONE ACETATE-ESTROGEN REGIMENS IN THE TREATMENT OF HIRSUTISM, Fertility and sterility, 66(2), 1996, pp. 216-219
Objective: To compare the efficacy of two antiandrogens, cyproterone a
cetate (CPA) and spironolactone, in the treatment of hirsutism. Design
: Prospective randomized single-blinded study. Setting: A tertiary hir
sutism clinic, Patients: Forty-two premenopausal patients with hirsuti
sm were selected. Interventions: Subjects were randomized to receive e
ither 100 mg spironolactone and an oral contraceptive (OC) containing
150 mu g desogestrel and 30 mu g ethinyl E(2) or 50 mg CPA daily on da
ys 1 to 10 of the menstrual cycle, which was administered with 35 mu g
ethinyl E(2) 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 w
ere taken at each visit for assessment of endocrine, biochemical, and
hematologic parameters. Results: Hirsutism scores were decreased signi
ficantly in both groups at the end of 9 months. The percent of change
in hirsutism scores in CPA and spironolactone group were as follows: 1
9.23% +/- 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 simila
rly effective in treatment of hirsutism.