Treatment of Hyperandrogenism in Polycystic Ovary Syndrome

    October 2010 in “ Cambridge University Press eBooks
    Alison M. Layton
    From the encyclopedia
    Cyproterone →

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

    Metformin →

    diabetes drug with anti-inflammatory, immunomodulatory, and insulin-sensitizing properties

    Spironolactone →

    powerful topical and oral anti-androgen used mostly by women

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    Studysummary This review discusses strategies for managing dermatological symptoms of hyperandrogenism in PCOS by reducing androgen levels and actions, and reports no new clinical results.
    Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer
    The 2010 document outlines various treatments for hyperandrogenism in women with polycystic ovary syndrome (PCOS), focusing on dermatological issues like acne, hirsutism, and female-pattern hair loss. It highlights the effectiveness of hormonal therapies, particularly combined oral contraceptives (COCs) and antiandrogens, in managing these symptoms. For acne, COCs with cyproterone acetate showed a 91% improvement at 12 months, but carry a risk of venous thromboembolism. Low-dose glucocorticoids can reduce sebum production, and insulin-sensitizing drugs like metformin are mentioned, though less effective for serum androgen levels. Hirsutism treatments include cosmetic methods, medical treatments like topical eflornithine hydrochloride, and systemic therapies such as spironolactone, finasteride, and flutamide. For female-pattern hair loss, oral contraceptives with antiandrogenic activity and topical 2% minoxidil are recommended. A 2005 study with 80 women showed that treatment with spironolactone or cyproterone acetate resulted in hair regrowth in 44%, no change in 44%, and continued hair loss in 12%. The document emphasizes the chronic nature of PCOS, the need for ongoing treatment, and the psychological impact of these conditions, calling for more randomized controlled trials to confirm treatment effectiveness.
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