Comparison of spironolactone-oral contraceptive versus cyproterone acetate-estrogen regimens in the treatment of hirsutism.

ABSTRACT

OBJECTIVE: To compare the efficacy of two antiandrogens, cyproterone acetate (CPA) and spironolactone, in the treatment of hirsutism. DESIGN: Prospective randomized single-blinded study. SETTING: A tertiary hirsutism clinic. PATIENTS Forty-two premenopausal patients with hirsutism were selected. INTERVENTIONS: Subjects were randomized to receive either 100 mg spironolactone and an oral contraceptive (OC) containing 150 microg desogestrel and 30 microg ethinyl E2 or 50 mg CPA daily on days 1 to 10 of the menstrual cycle, which was administered with 35 microg ethinyl E2 daily on days 1 to 21. MAIN OUTCOME MEASURES: Hirsutism scores were measured according to Ferriman-Gallwey scoring 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. RESULTS: Hirsutism scores were decreaded significantly in both groups at the end of 9 months. The percent of change in hirsutism scores in CPA and spironolactone group were as follows 19.23% +/- 14.77% and 24.48% +/- 14.27% at 3 months; 39.01% +/- 19.77% and 37.46% +/- 16.90% at 6 months; and 51.89% +/- 20.87% and 46.39% +/- 16.10% at 9 months, respectively. There was a trend toward a better response with CPA treatment, which did not achieve significance. None of the patients stopped treatment because of side effects. CONCLUSION: The present data suggest that both spironolactone and CPA were similarly effective in treatment of hirsutism.

ABSTRACT

PIP The authors compared the efficacy of two antiandrogens, cyproterone acetate (CPA) and spironolactone, in the treatment of hirsutism. 42 premenopausal patients with hirsutism were randomized to receive either 100 mg spironolactone and an oral contraceptive (OC) containing 150 mcg desogestrel and 30 mcg ethinyl E2 or 50 mg CPA daily on the first 10 days of the menstrual cycle, which was administered with 35 mcg ethinyl E2 daily for the first 21 days. Hirsutism scores were measured according to the Ferriman-Gallwey scoring system and side effects monitored for nine months of treatment. Blood samples were taken at each visit to assess endocrine, biochemical, and hematologic parameters. Hirsutism scores were significantly lower in both groups at the end of nine months. The percent of change in hirsutism scores in the CPA and spironolactone groups were as follows 19.23% and 24.48% at 3 months, 39.01% and 37.46% at 6 months, and 51.89% and 46.39% at 9 months, respectively. The trend toward a better response with CPA treatment was insignificant. No patient stopped treatment because of side effects.