V. De Leo et al., Hormonal and clinical effects of GnRH agonist alone, or in combination with a combined oral contraceptive or flutamide in women with severe hirsutism, GYNECOL END, 14(6), 2000, pp. 411-416
The objective of this prospective randomized study was to evaluate and comp
are the hormonal and clinical effects of long-acting gonadotropin-releasing
hormone (GnRH) agonist and a combination of GnRH agonist with combined ova
l contraceptive (COC) or flutamide in women with polycystic ovary syndrome
(PCOS).
Thirty-five hirsute women with PCOS, ranging in age from 19-27 years, were
randomly divided into three groups: group A treated with GnRH agonist (n =
12), group B (n = 12) treated with GnRH agonist plus COC and group C (n = 1
1) treated with GnRH agonist plus flutamide for 6 months. Before, at the en
d and 6 months after the end of treatment, blood samples were drawn from al
l women (in early follicular phase in those with menstrual cycles) to measu
re ovarian and adrenal androgens, gonadotropins luteinizing hormone (LH) an
d follicle-stimulating hormone (FSH), estradiol and esr, one plasma levels.
The results showed that all three protocols had good therapeutic efficacy.
A significant reduction in hirsutism was observed in all patients after 6 m
onths of therapy, the Ferriman-Gallwey scores dropping to 9 +/- 3 in group
A, 10 +/- 4 in group B and 11 +/- 5 in group C. Six months after the end of
therapy, the hirsutism score continued to be significantly reduced in all
groups. After 6 months of therapy, a reduction in plasma levels of LH, FSH,
estrone, estradiol, testosterone, free testosterone, androstenedione anti
dehydroepiandrosterone sulfate (DHEAS) was observed in all groups although
this was move pronounced in group B and group C.
These therapies may be the basis of future treatments that quickly reduce h
irsutism and remove its causes by reducing the secretion of ovarian and adr
enal androgens and by blocking androgen receptors.