Cyproterone Acetate as Initial Treatment and Maintenance Therapy for Hirsutism

In a study from 1985, 34 hirsute patients were treated with 100 mg of cyproterone acetate (CA) and a combination oral contraceptive for 9 months, followed by a 12-month double-blind trial comparing low-dose CA with placebo for maintenance therapy. The initial high-dose treatment resulted in a subjective improvement in 92% of patients, with a 40% improvement in objective hirsutism grade and a 13% reduction in hair growth rate. Side effects were reported by 64% of patients, with 11% experiencing severe side effects. Upon switching to low-dose CA, there was a 33% subjective relapse rate, although objective measures of hirsutism did not significantly deteriorate. Plasma testosterone and related hormone levels significantly decreased with high-dose CA and remained low during the low-dose therapy. The study concluded that high-dose CA is effective for treating hirsutism, but a third of patients felt their condition worsened on low-dose therapy, suggesting that maintenance therapy is beneficial after initial remission with high-dose CA.