Androgen Metabolism in Hirsute Patients Treated with Cyproterone Acetate

    March 1984 in “ Journal of steroid biochemistry/Journal of Steroid Biochemistry ”
    Irène Mowszowicz, Françoise Wright, M Vincens, Catherine Rigaud, K Nahoul, Philippe Mavier, S Guillemant, Frédérique Kuttenn, P Mauvais-Jarvis
    TLDR Cyproterone acetate effectively reduced hair growth in hirsute patients by lowering androgen levels and altering androgen metabolism.
    The study investigated the effects of cyproterone acetate (CPA) combined with estradiol on 150 hirsute patients over 6 months to 3 years, showing significant clinical improvement. Plasma testosterone (T) and androstenedione (A) levels decreased significantly, while T glucuronide (TG) and 3α-androstanediol (Adiol) levels remained high. T 5α-reductase activity in pubic skin also decreased. The study measured testosterone production rate (PR) and metabolic clearance rate (MCR) in 7 patients, finding a decrease in PR and an increase in MCR, explaining the plasma T concentration drop and high TG and Adiol excretion. CPA's mechanisms included reducing androgen input to target cells, competing for receptor binding sites, and decreasing androgen-dependent skin 5α-R, enhancing its antiandrogenic effect.
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