THE ADDITION OF DEXAMETHASONE TO ANTIANDROGEN THERAPY FOR HIRSUTISM PROLONGS THE DURATION OF REMISSION

Objective: To determine whether the addition of dexamethasone to antia ndrogen therapy prolongs the duration of remission in women with hirsu tism. Design: Follow-up study of patients treated with one of four reg imens: spironolactone (100 mg/d) for I year, dexamethasone (0.37 mg/d) far 1 year, dexamethasone (0.37 mg/d) plus spironolactone (100 mg/d) for 1 year, or dexamethasone (0.37 mg/d) plus spironolactone (100 mg/d ) for 2 years. Setting: Academic medical practice in reproductive endo crinology. Patient(s): Fifty-four women with hirsutism and hyperandrog enism. Intervention(s): Ferriman-Gallwey-Lorenzo scores were obtained and serum levels of testosterone, unbound testosterone, and dehydroepi androsterone sulfate were measured before therapy, every 6 months duri ng therapy, and for I year after the withdrawal of therapy. Main Outco me Measure(s): Hirsutism scores and serum indices of hormonal changes were monitored. Result(s): Ferriman-Gallwey-Lorenzo scores and androge n levels remained low 1 year after the withdrawal of therapy in patien ts who were treated with dexamethasone, either alone or in combination with spironolactone. In patients who were treated with spironolactone alone, hirsutism scores had returned to baseline values after I year. Conclusion(s): The addition of an agent that suppresses androgen leve ls may be useful to prolong the duration of remission of hirsutism in women with hyperandrogenism who are treated with antiandrogens. (C) 19 98 by American Society for Reproductive Medicine.