Cyproterone Acetate for Hirsutism

October 2003 in “ Cochrane library ”

Zephne M van der Spuy, Paul A. le Roux, Mushi Matjila

cyproterone acetate ethinyl estradiol hirsutism ovarian hyperandrogenism ketoconazole spironolactone

From the encyclopedia

Cyproterone →

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

Ketoconazole →

antifungal with some anti-androgenic benefits, often used as a shampoo

Spironolactone →

powerful topical and oral anti-androgen used mostly by women

Studysummary This review found that adding cyproterone acetate to estradiol showed a subjective improvement in hirsutism versus placebo, but comparisons with other therapies revealed no clinical differences.

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

The review investigated the effectiveness of cyproterone acetate, alone or with ethinyl estradiol, in treating hirsutism in women due to ovarian hyperandrogenism. Nine randomized studies were included, with only one having over 100 participants. The review found that cyproterone acetate combined with ethinyl estradiol significantly reduced hair growth compared to placebo, though the confidence limits were large. No significant clinical differences were noted when comparing cyproterone acetate to other drugs like ketoconazole and spironolactone. The studies were too small and lacked standardized assessments to draw definitive conclusions. Larger, well-designed studies are needed to better compare the efficacy and safety of treatments for hirsutism. Cyproterone acetate appeared as effective as other medications, but there was insufficient data to compare side effects.

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Research cited in this study

23 / 23 results

research Parenteral and Oral Cyproterone Acetate Treatment in Severe Hirsutism

5 citations , March 2010 in “Gynecologic and obstetric investigation”

This study found that parenteral administration of cyproterone acetate was more effective than high-dose oral treatment in reducing facial hair diameter and improving dermatological parameters in patients with severe hirsutism, despite similar androgen suppression.

research An Open Randomized Comparative Study of an Oral Contraceptive Containing Ethinyl Estradiol and Cyproterone Acetate with and without the GnRH Analogue Goserelin in the Long-Term Treatment of Hirsutism

18 citations , March 2010 in “Gynecologic and obstetric investigation”

This study found that both combined therapy with goserelin and oral contraceptives, and oral contraceptives alone, significantly reduced hair diameter in severe hirsutism without a significant difference between treatments.

research Comparison of Diane 35 and Diane 35 Plus Finasteride in the Treatment of Hirsutism

50 citations , April 2000 in “Fertility and Sterility”

This study found that a combination therapy of Diane 35 with finasteride was more effective at reducing hirsutism scores in women with idiopathic hirsutism or polycystic ovary syndrome after 3 months compared to Diane 35 alone.

research Antiandrogen Treatment of Polycystic Ovary Syndrome

52 citations , June 1999 in “Endocrinology and Metabolism Clinics of North America”

This review concludes that antiandrogens with ovarian suppression may significantly improve hirsutism and androgenetic alopecia in women with PCOS, but treatment needs to continue unless the underlying PCOS cause is addressed.

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 Hirsutism II: Treatment

15 citations , August 1998 in “Australasian journal of dermatology”

This review discusses various treatments for hirsutism, including cosmetic techniques, anti-androgens like spironolactone, and new drugs such as finasteride and flutamide, but it reports no new clinical results.

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 Oral Contraceptives and Cyproterone Acetate in Female Acne Treatment

30 citations , January 1998 in “Dermatology”

This review discusses hormonal influences and treatment considerations in female acne, particularly highlighting the role of androgens in persistent or resistant cases, and reports no new clinical findings.

research Treatment of Androgen Excess in Females: Yesterday, Today, and Tomorrow

9 citations , January 1997 in “Gynecological Endocrinology”

This review discusses the regulation of hair growth, causes of excessive androgen secretion, and current safe solutions for hyperandrogenism manifestations in women but reports no new clinical results.

Acceptability, Tolerance, and Quality of Life Impact of Cyproterone Acetate Treatment in Female Hirsutism: Comparison of Two Protocols with Oral or Transdermal Estradiol

research Acceptability, Tolerance, and Quality of Life Impact of Cyproterone Acetate Treatment in Female Hirsutism: Comparison of Two Protocols with Oral or Transdermal Estradiol

4 citations , December 1994 in “PubMed”

This study found that treatment with cyproterone acetate and estradiol improved emotional well-being and acceptance of being viewed among women with hirsutism, with no significant differences between oral and transdermal estradiol groups.

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 Comparison of Sequential Cyproterone Acetate/Estrogen Versus Spironolactone/Oral Contraceptive in the Treatment of Hirsutism

68 citations , May 1991 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

This study found that both cyproterone acetate and spironolactone effectively reduced hair diameter and plasma testosterone levels in hirsute women, with no significant differences between the two treatments.

research Hirsutography: Photographic Measurement of Linear Hair Growth in Hirsute Women During Comparison of Anti-Androgen Treatments

4 citations , January 1991 in “Journal of obstetrics and gynaecology”

This study found that both spironolactone with Ovysmen and cyproterone acetate with ethinyloestradiol significantly reduced hair growth in hirsute women, with no difference in effect between treatments.

research Anti-Androgens in Gynecological Practice

7 citations , September 1988 in “Baillière's clinical obstetrics and gynaecology”

This article discusses the mechanisms of hirsutism and acne in women, highlighting cyproterone acetate with ethinyloestradiol as an effective anti-androgen therapy in the UK, but it reports no new clinical findings.

research Cyproterone Acetate as Initial Treatment and Maintenance Therapy for Hirsutism

18 citations , August 1985 in “European journal of endocrinology”

This study found that high-dose cyproterone acetate was effective for treating hirsutism, but 33% of patients felt their condition worsened on low-dose maintenance therapy, despite no significant change in objective measures of hair growth.

research The Hair Cycle on the Human Thigh and Upper Arm

67 citations , July 1985 in “British journal of dermatology/British journal of dermatology, Supplement”

This study found that males have significantly longer hair on their thighs compared to females, mainly due to a longer anagen phase and a greater rate of growth.