CLINICAL AND ENDOCRINE EFFECTS OF FLUTAMIDE IN HYPERANDROGENIC WOMEN

Objective: To investigate the clinical and endocrine effects of the an tiandrogen flutamide in hirsute women. Design: Hirsutism was assessed before and after 3 months of treatment with flutamide 500 mg/d. Endocr ine evaluations were performed before and during the 2nd month of trea tment with flutamide 500 mg or 750 mg/d. Setting: Department of Obstet rics and Gynecology, Pisa, Italy. Participants: Eighteen hirsute women were studied: nine women were hyperandrogenic, and the other 9 had an idiopathic hirsutism. Interventions: Women were randomly treated with flutamide 500 mg/d (9 patients) or 750 mg/d (9 patients) for 3 and 2 months, respectively. Six received placebo 1 month before flutamide tr eatment. Main Outcome Measures: Hirsutism was assessed by measuring ha ir diameter. Follicle-stimulating hormone and LH responses to GnRH wer e evaluated. Basal plasma levels of T, androstenedione (A), 17-hydroxy progesterone (17-OHP), DHEAS, cortisol (F), and sex hormone-binding gl obulin (SHBG) were evaluated. The same hormones were determined after a single dose of flutamide (250 or 500 mg) or placebo throughout a 12- hour period and in samples collected 60 and 120 minutes after ACTH int ravenous injection. Results: Hair diameter was reduced by 30%. Both do sages of flutamide did not change basal and stimulated gonadotropin, T , A, 17-OHP, F, and SHBG levels. Both dosages reduced stimulated DHEAS levels. Conclusions: Flutamide may have a beneficial effect on hirsut ism. This effectiveness is mainly due to its peripheral antiandrogen a ction. However, an effect on the adrenal gland seems to be present.