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

From the encyclopedia

Cyproterone →

a synthetic anti-androgen and weak progestogen that inhibits DHT binding to androgen receptor

Spironolactone →

powerful topical and oral anti-androgen used mostly by women

Finasteride →

Frontline, gold standard treatment for combatting androgenic alopecia

Studysummary This review discusses the causes and treatment options for idiopathic hirsutism and reports that various therapies may reduce hirsutism severity and the Ferriman–Gallwey score by 35–40% after one year.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

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 cited in this study

17 / 17 results

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

56 citations , April 2003 in “Fertility and Sterility”

This study found that while cyproterone acetate, finasteride, and spironolactone had similar short-term effects in treating idiopathic hirsutism, spironolactone provided more lasting benefits one year after treatment.

research Progestogens With Antiandrogenic Properties

164 citations , January 2003 in “Drugs”

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

12 citations , December 2002 in “Fertility and Sterility”

In this study, a combination of spironolactone and finasteride was found to significantly improve hirsutism scores without increasing side effects compared to spironolactone alone.

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

22 citations , March 2000 in “Clinical endocrinology”

This study found that while ethinyl oestradiol and cyproterone acetate effectively treated hirsutism in 90% of patients, 80% experienced relapse within six months after stopping treatment, suggesting long-term use is necessary.

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

32 citations , July 1999 in “Fertility and Sterility”

This study found that both finasteride and flutamide effectively reduced hirsutism, with flutamide being more effective than finasteride in decreasing hirsutism scores and hair diameter over 12 months.

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

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”

This study found that all four treatments—flutamide, finasteride, ketoconazole, and EE-CPA—significantly reduced hirsutism, but EE-CPA and flutamide appeared most effective, with varying effects on androgen levels and side-effect profiles.

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

75 citations , March 1999 in “Fertility and sterility”

This study concluded that finasteride, cyproterone acetate, and flutamide were similarly effective at reducing hirsutism in women, though they acted through different mechanisms.

research Effect of Finasteride in Idiopathic Hirsutism

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

This study reported that 6 months of finasteride treatment significantly improved idiopathic hirsutism in women, with benefits persisting 6 months post-treatment and no adverse reactions observed.

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

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

In this study, both cyproterone acetate-estrogen combination (Diane®) and finasteride were effective in reducing hirsutism, but Diane® showed greater long-term efficacy and cost-effectiveness.

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

76 citations , December 1997 in “Fertility and Sterility”

This study found that spironolactone was significantly more effective than finasteride in reducing hirsutism scores over 9 months, despite more side effects occurring in the spironolactone group.

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

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”

This study found that both a high dose of CPA and GnRHa are effective for treating hirsutism in hyperandrogenic women, but GnRHa with add-back therapy may lead to a longer remission period.

research Finasteride in the Treatment of Hirsutism: New Therapeutic Perspectives

50 citations , July 1996 in “Fertility and Sterility”

This study found that finasteride significantly reduced hirsutism scores in women with idiopathic hirsutism and PCOS, despite no changes in serum androgen levels.

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

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”

This study found that a low dose of flutamide, both alone and combined with an oral contraceptive, effectively reduced hirsutism in women, with the combination showing more lasting effects post-treatment.

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”

In this study, cyproterone acetate at 2 mg daily was found to be as effective as higher doses in reducing hair growth for hirsute women over 12 months.

research Hair Follicles and Associated Glands as Androgen Targets

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

This review discusses the influence of androgens on hair and sebaceous growth, emphasizing that response may depend more on peripheral sensitivity than on hormone levels; it reports no new empirical results.

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.