Combined Oral Contraception and Bicalutamide in Polycystic Ovary Syndrome and Severe Hirsutism: A Double-Blind Randomized Controlled Trial

    Costanzo Moretti, Laura Guccione, Paola Di Giacinto, Ilaria Simonelli, C. Exacoustós, Vincenzo Toscano, Cecilia Motta, Vincenzo De Leo, Felice Petraglia, Andrea Lenzi
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    TLDR Birth control pills combined with bicalutamide are more effective at reducing excessive hair growth in women with PCOS than birth control pills alone.
    In the 2017 study involving 70 women with polycystic ovary syndrome (PCOS) and severe hirsutism, researchers found that combined oral contraception (OCP) plus bicalutamide (BC) at a dose of 50 mg/day was more effective in reducing hirsutism than OCP plus placebo (P) over a 12-month period. The primary outcome was measured using videodermoscopy and the modified Ferriman and Gallwey (mF&G) total score. The OCP + BC group showed a significantly higher reduction in hirsutism, particularly in androgen-sensitive areas such as the chin, thorax/upper abdomen, and lower abdomen. The study concluded that the combination therapy was well tolerated, with the main adverse effect being an increase in total cholesterol and low-density lipoprotein in the OCP + BC group. No significant changes in body composition were observed between the two groups. The study suggests that OCP + BC is a more effective treatment for severe hirsutism in women with PCOS.
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