Cyproterone acetate for hirsutism

In a review from 2003, researchers investigated the effectiveness of cyproterone acetate, alone or with ethinyl estradiol, in treating hirsutism in women. Eleven studies met the inclusion criteria, but only nine were analyzed due to insufficient information in two. Only one study included more than 100 women. No clinical trials compared cyproterone acetate alone to placebo, but one small study showed a significant subjective reduction in hair growth when combined with ethinyl estradiol. Comparisons between cyproterone acetate and other drugs like ketoconazole, spironolactone, flutamide, finasteride, and GnRH analogues showed no clinical outcome differences, although there were endocrine differences. The review concluded that cyproterone acetate with estradiol subjectively improves hirsutism compared to placebo, but no clinical differences were found when compared to other medical therapies. The small study sizes, lack of standardized assessment, and absence of objective improvement measures were noted as limitations. The authors called for larger, well-designed studies to compare the efficacy and safety of different drug therapies for hirsutism.