THE USE OF FLUTAMIDE IN THE MANAGEMENT OF HIRSUTISM

The aim of our study was to evaluate the clinical efficacy of flutamid e (Flu), when used alone, on the course of hirsutism and to assess its effect on hormonal secretion. Thirty-six hirsute women [11 patients w ere affected by polycystic ovarian syndrome (PCOs), and 25 were classi fied as having idiopathic hirsutism (IH)] were treated with Flu, 375 m g daily for a 4-month period. We found a marked clinical improvement i n the degree of hirsutism in all patients. Testosterone and free testo sterone fell significantly in both groups, while SHBG concentrations s howed an increase in PCOs. In these patients, a reduction in androsten edione levels was also evident. Basal DHEAS concentrations showed a si gnificant decrease only in PCO women. No significant modifications in gonadotropin response to LHRH nor in adrenal steroid response to ACTH stimulation were observed in 12 of the IH women before therapy and aft er the first month. Although the main action of flutamide is attribute d to its peripheral antiandrogenic properties, the decrease in circula ting androgen levels observed during treatment suggests that it can al so modulate androgen production and /or metabolism.