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

In a study involving 60 hyperandrogenic women with hirsutism, treatment with either cyproterone acetate (CPA) or a gonadotrophin-releasing hormone agonist (GnRHa) with add-back therapy was compared for effectiveness and duration of remission. Participants were divided into three groups: a Diane group treated with CPA 2 mg and ethinylestradiol 35 microg, a CPA group treated with CPA 50 mg and ethinylestradiol 50 microg, and a GnRHa group treated with Decapeptyl 3.75 mg and add-back therapy of conjugated oestrogen and medroxyprogesterone acetate. After one year of treatment, hirsutism decreased in all groups, with the CPA and GnRHa groups showing greater improvement than the Diane group. Serum luteinizing hormone (LH) and testosterone levels were lowest in the GnRHa group. Upon treatment cessation, hirsutism increased rapidly in the Diane and CPA groups, returning to pretreatment levels after 6 months, while in the GnRHa group, the increase was more gradual, and after one year, hirsutism levels were still significantly lower than pretreatment values. The study concluded that GnRHa with add-back therapy is as effective as high-dose CPA in treating hirsutism and offers a longer remission period post-treatment.