COMPARISON OF FINASTERIDE VERSUS SPIRONOLACTONE IN THE TREATMENT OF IDIOPATHIC HIRSUTISM

Objective: To compare the efficacy of finasteride and spironolactone i n the treatment of idiopathic hirsutism. Design: Prospective, randomiz ed, single-blind study. Setting: A tertiary hirsutism clinic. Patient( s): Forty-women with idiopathic hirsutism were selected. Intervention( s): Patients were assigned randomly to receive either 5 mg of finaster ide or 100 mg of spironolactone for 9 months. Main Outcome Measure(s): Hirsutism scores were measured according to the Ferriman-Gallwey scor ing system, and side effects were monitored for 9 months of treatment. Blood samples were taken at each visit for assessment; of endocrine, biochemical, and hematologic parameters. Result(s): Hirsutism scores w ere decreased significantly in both groups at the end of 9 months. The mean percent change (+/-SD) in hirsutism scores in the finasteride an d spironolactone groups was as follows: 5.91% +/- 7.18% and 20.60% +/- 12.59% at 3 months, 10.61% +/- 12.18% and 32.57% +/- 15.68% at 6 mont hs, and 15.15% +/- 15.38% and 42.36% +/- 12.31% at 9 months, respectiv ely. There was a significantly better response with spironolactone tre atment at the end of 9 months. Eleven (55%) of 20 patients in the spir onolactone group experienced side effects. However, none of them stopp ed treatment because of side effects. Conclusion(s): The present data suggest that both finasteride and spironolactone are effective in the treatment of idiopathic hirsutism. However, it appears that the spiron olactone group responded significantly better. (C) 1997 by American So ciety for Reproductive Medicine.