The Evaluation of the Role of Androgens in Hirsutism and the Use of a New Anti-Androgen Cyproterone Acetate for Therapy

    A. A. A. Ismail, D. W. Davidson, A. R. Souka, Erin Barnes, W. J. Irvine, H. Kilimnik, Y.E. Vanderbeeken
    TLDR Cyproterone acetate combined with ethinyl estradiol significantly reduced hirsutism in women.
    In a study from 1974, researchers found that hirsutism in women was associated with elevated testosterone levels, as evidenced by a significant difference in mean plasma testosterone between normal women (14 participants) and hirsute women (26 participants). Short-term adrenal stimulation and suppression tests yielded inconsistent results, but long-term suppression with dexamethasone or an oral contraceptive pill showed a dual contribution of the adrenal glands and ovaries to androgen levels, without significant improvement in hirsutism. However, treatment with the anti-androgen cyproterone acetate (CA), in combination with ethinyl estradiol (EE) to maintain menstrual cycle regularity and prevent pregnancy, led to a marked reduction in hirsutism in 5 patients over 12 months. This treatment decreased the frequency of shaving from 3 times per week to 3 times per month, although hair growth rate increased again after stopping CA. Plasma and urinary testosterone levels were also reduced during therapy.
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