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Title
Comparison of sequential cyproterone acetate/estrogen versus spironolactone/oral
contraceptive in the treatment of hirsutism.
Author
O'Brien RC, Cooper ME, Murray RM, Seeman E, Thomas AK, Jerums G
Address
Department of Endocrinology, Austin Hospital, Heidelberg, Victoria, Australia.
Source
J Clin Endocrinol Metab, 72: 5, 1991 May, 1008-13
Abstract
The effects of the antiandrogen drugs cyproterone acetate (CPA) and spironolactone on
hair growth and androgen levels were compared in a randomized study of 48 hirsute women.
Twenty six subjects completed 6 months of therapy with 100 mg/day CPA and 19 subjects
completed 6 months of 100 mg/day spironolactone. All except 10 subjects received
concomitant estrogen therapy. Measured objectively, total hair diameter fell by 17.1% with
spironolactone (P less than 0.001), and by 16.8% with CPA (P less than 0.001). The
diameter of the hair medulla fell by 17.8% with spironolactone (P less than 0.01), and by
31.7% with CPA (P less than 0.001). There was no difference between the drugs in their
effect on hair diameter. Plasma testosterone levels also fell significantly with both
drugs. As a subjective assessment of treatment efficacy, the frequency with which subjects
performed cosmetic measures was recorded. This fell by 38% with spironolactone and by
44.7% with CPA (P less than 0.001 both drugs), and again there was no difference between
the drugs. Side effects caused cessation of treatment in one subject taking CPA and two
subjects taking spironolactone, and milder side effects were noted in two further subjects
from each treatment group. We conclude that spironolactone and CPA, in the dosages used in
this study, are effective and well tolerated agents for the treatment of hirsutism, and
that neither drug demonstrates a particular advantage over the other.
Language of Publication
English
Unique Identifier
91217178
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