Effect of finasteride in idiopathic hirsutism

Increased 5 alpha-reductase activity has been found in hair follicles of hi rsute women, suggesting a pathogenetic role. The aim of the present study w as to evaluate the effect of finasteride in the treatment of idiopathic hir sutism. Twenty-seven women with idiopathic hirsutism, aged 16-35 years, wer e treated for 6 months with finasteride, 5 mg once daily. Fourteen patients were on finasteride alone (group A), while the remaining received in addit ion an oral contraceptive (group B). Clinical, hormonal and biochemical eva luation were performed before, and after 3 and 6 months of treatment. Clini cal evaluation was repeated 6 months after drug discontinuation in seven pa tients. Treatment was well tolerated by all patients; no side effects or ad verse reactions were reported. A significant improvement of hirsutism was o btained by finasteride; clinical score observed at the 6(th) month of thera py was reduced from 11.71+/-2.23 to 7.92+/-1.81 (p<0.05) and from 14.92+/-6 .13 to 9.3+/-2.75 (p<0.05) in group A and B, respectively. Clinical score i n seven patients was still 8.61+/-2.28 (p<0.05) 6 months after the end of t herapy. Finasteride treatment alone (group A) induced a slight increase, th ough not significant, in serum androgens; DHT and SHBG did not change. In g roup B (finasteride plus oral contraceptive) total testosterone and free te stosterone showed no significant decrease; after 6 months of therapy DHT wa s reduced significantly, while SHBG levels were increased. These data demon strate that 5 alpha-reductase inhibition may be an effective treatment in w omen suffering from idiopathic hirsutism. This approach may be attractive d ue to the absence of adverse reactions, although the necessity of an adequa te contraception should be kept in mind. (J. Endocrinol. Invest. 21: 694-69 8, 1998) (C)1998, Editrice Kurtis.