COMPARISON OF THE EFFICACY OF SPIRANOLACTONE VERSUS FLUTAMIDE IN THE TREATMENT OF HIRSUTISM

Objective: To compare the efficacy of two antiandrogens, spironolacton e and flutamide, in the treatment of hirsutism. Patients, Participants : Twenty women with idiopathic hirsutism were randomized to receive ei ther flutamide or spironolactone. Design: Twenty hirsute women were re cruited from patients presenting to the hirsutism clinic in Marmara Un iversity, Istanbul. Each patient underwent a complete medical and gyne cological examination as well as endocrine profile, hematologic, hepat ic, and renal function analyses. Hirsutism scores were determined acco rding to the Ferriman-Gallwey scoring system. These tests were then re peated at 3, 6, and 9 months of therapy. Ten patients received 250 mg of flutamide two times per day, and 10 patients received 100 mg of spi ronolactone for 9 months. Results: Ferriman-Gallwey scores were decrea sed significantly in both groups at the end of 9 months. The percent o f change in hirsutism scores in flutamide and spironolactone group wer e as follows: 26.4% and 20.9% at 3 months; 39.5% and 32.9% at 6 months ; and 46.4% and 39.6% at 9 months, respectively. There was a trend tow ard a better response with flutamide that did not achieve significance . None of the hormonal parameters changed significantly during this pe riod of time. Irregular bleeding was observed in five patients (50%) o f the spironolactone group, whereas none of the patients in the flutam ide group experienced menstrual irregularity. Conversely, dry skin and increased appetite were experienced by two patients (20%) in the flut amide group but not in the spironolactone group. Conclusion: These dat a suggest that both spironolactone and flutamide were similarly effect ive in treatment of hirsutism, and the pure antiandrogen flutamide is a safe and effective alternative in treatment.