Cost-Effective Therapy in Patients with Idiopathic Hirsutism

June 2004 in “ Expert review of pharmacoeconomics & outcomes research ”

Franco Lumachi, E. Zulian, Carla Scaroni

idiopathic hirsutism oral contraceptives androgen receptor blockers cyproterone acetate spironolactone flutamide 5α-reductase inhibitors finasteride gonadotrophin-releasing hormone analogs Ferriman–Gallwey score birth control pills androgen blockers Propecia

TLDR Cheap treatments for excessive hair growth in women can improve symptoms by 35-40% after one year.

The document reviews the condition of idiopathic hirsutism, which is characterized by excessive hair growth in women with normal androgen levels and ovarian function, affecting over 20% of hirsute women. Various medical therapies for this condition include oral contraceptives, androgen receptor blockers like cyproterone acetate, spironolactone, and flutamide, 5α-reductase inhibitors such as finasteride, and gonadotrophin-releasing hormone analogs. After one year of treatment with these drugs, there is an expected improvement in hirsutism symptoms and a reduction in the Ferriman–Gallwey score by 35–40%. The review also discusses the causes of hirsutism and evaluates the cost-effectiveness of each therapy for patients with idiopathic hirsutism.

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research Use of Cyproterone Acetate, Finasteride, and Spironolactone to Treat Idiopathic Hirsutism

56 citations , April 2003 in “Fertility and Sterility”

All three treatments reduce hirsutism, but spironolactone works best long-term.

research Comparison of Spironolactone and Spironolactone Plus Finasteride in the Treatment of Hirsutism

12 citations , December 2002 in “Fertility and Sterility”

Spironolactone plus finasteride works better for treating hirsutism.

research Relapse of Hirsutism Following Long-Term Successful Treatment with Estrogen-Progestogen Combination

22 citations , March 2000 in “Clinical endocrinology”

Most patients experienced hirsutism again after stopping hormone treatment, indicating long-term treatment is needed to maintain results.

research Comparison of Finasteride and Flutamide in the Treatment of Idiopathic Hirsutism

32 citations , July 1999 in “Fertility and Sterility”

Finasteride and flutamide both reduce hair growth, but finasteride has fewer side effects.

research A Prospective Randomized Trial Comparing Low Dose Flutamide, Finasteride, Ketoconazole, and Cyproterone Acetate-Estrogen Regimens in the Treatment of Hirsutism

113 citations , April 1999 in “The Journal of Clinical Endocrinology and Metabolism”

Cyproterone acetate-estrogen most effective for hirsutism, but consider side effects and patient needs.

research Treatment of Hirsutism: Comparisons Between Different Antiandrogens with Central and Peripheral Effects

75 citations , March 1999 in “Fertility and sterility”

Finasteride, CPA, and flutamide are all equally effective in reducing excessive hair growth in women.

research Effect of Finasteride in Idiopathic Hirsutism

27 citations , November 1998 in “Journal of Endocrinological Investigation”

Finasteride significantly reduces hair growth in women with idiopathic hirsutism.

research Comparison of Cyproterone Acetate Plus Ethinyl Estradiol and Finasteride in the Treatment of Hirsutism

49 citations , June 1998 in “Journal of Endocrinological Investigation”

Cyproterone acetate plus ethinyl estradiol is generally more effective in treating hirsutism, but consider side effects and patient characteristics.

research Comparison of Finasteride Versus Spironolactone in the Treatment of Idiopathic Hirsutism

76 citations , December 1997 in “Fertility and Sterility”

Finasteride reduces hair growth better, but spironolactone has more side effects.

research Gonadotrophin-Releasing Hormone Agonist Therapy for Hirsutism Is as Effective as High Dose Cyproterone Acetate but Results in a Longer Remission

49 citations , April 1997 in “Human reproduction”

Hormone therapy for excessive hair growth is as good with GnRHa as with high-dose CPA, but GnRHa has longer-lasting results.

research Finasteride in the Treatment of Hirsutism: New Therapeutic Perspectives

50 citations , July 1996 in “Fertility and Sterility”

Finasteride effectively treats hirsutism in women, but more research needed for long-term results.

research Clinical Efficacy and Safety of Low-Dose Flutamide Alone and Combined with an Oral Contraceptive for the Treatment of Idiopathic Hirsutism

36 citations , November 1995 in “Clinical endocrinology”

Low-dose flutamide helps reduce excessive hair growth and is even more effective with birth control, without bad effects on blood fats.

research Finasteride

187 citations , January 1994 in “The New England Journal of Medicine”

Finasteride treats enlarged prostate and may help with baldness, but effects on sexual function and male fetuses are unclear.

research Cyproterone Acetate for Severe Hirsutism: Results of a Double-Blind Dose-Ranging Study

94 citations , July 1991 in “Clinical endocrinology”

Cyproterone acetate at 2mg daily is as effective as higher doses for treating excessive hair growth in women.

research Hair Follicles and Associated Glands as Androgen Targets

53 citations , May 1986 in “Clinics in endocrinology and metabolism”

Androgens like testosterone affect hair growth and oil production differently across body parts and individuals.

research Biology of Hair Growth

46 citations , May 1986 in “Seminars in Reproductive Medicine”

Testosterone and dihydrotestosterone affect hair growth, and new techniques like the folliculogram help study it, but fully understanding hair growth is still complex.

1 / 1 results

research Metformin or Antiandrogen in the Treatment of Hirsutism in Polycystic Ovary Syndrome

192 citations , September 2003 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

Metformin is effective for treating excessive hair growth in women with PCOS and may work better than the standard treatment in some ways.