TREATMENT OF HIRSUTISM WITH FLUTAMIDE AND A LOW-DOSAGE ORAL-CONTRACEPTIVE IN POLYCYSTIC OVARIAN DISEASE PATIENTS

Objective: To evaluate the clinical and hormonal response of the antia ndrogen flutamide (Eulexin, Schering Plough, Milan, SA, Italy) associa ted with a low dosage oral contraceptive (OC) in a group of hirsute wo men who were unresponsive to OC treatment. Design: Twenty-two polycyst ic ovarian disease (PCOD) patients with hirsutism were treated with fl utamide (250 mg twice/d) in association with ethinyl-E(2) (0.030 mg/d) plus desogestrel (0.150 mg/d) (Practil 21; Organon, Pome, Italy) for 21 d/mo. Setting: Patients were recruited in the Institute of Obstetri cal and Gynaecological Pathology, St. Bambino Hospital, University of Catania, Italy. Hormonal assays were performed in the Hormone Laborato ries of St. Bambino Hospital, University of Catania, Catania, Italy. M ain Outcome Measure: Every 2 months the hirsutism score was evaluated using the Ferriman-Gallwey hair density index. Mean plasma concentrati ons of LH, FSH, E(2), total T, dihydrotestosterone (DHT), androstenedi one (A), sex hormone-binding globulin, DHEAS were determined. Results: After 8 months treatment with flutamide and low dosage OC, the Ferrim an-Gallwey score improved in all patients, mean values decreasing from 25.4 +/- 3.96 to 14.6 +/- 1.92. Plasma levels of total T and E(2) wer e unchanged, whereas LH, FSH, A, and DHT values decreased significantl y. Sex hormone-binding globulin levels showed a marked increase. Concl usion: Flutamide, associated with low dosage OC, favorably influence t he hirsutism in PCOD women who are unresponsive to OC treatment alone.