Treatment of Hirsutism by Oral Cyproterone Acetate and Percutaneous Estradiol

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Abstract
Birsute women (20) were treated with 50 mg cyproterone acetate orally, administered from the 5th-25th day of the menstrual cycle, along with 3 mg 17.beta.-estradiol administered p.c. from days 16-25. 17.beta.-Estradiol was used rather than ethinylestradiol in order to avoid the side effects of oral administration of synthetic estrogens. From a clinical point of view there was a dramatic improvement of hirsutism after 3-6 mo. of treatment. Biologically, plasma testosterone decreased markedly (P < 0.01) from 64.6 .+-. 24.2 ng/dl (n = 20) to 25.2 .+-. 11.8 (n = 20), 26.1 .+-. 16.6 (n = 16) and 13.3 .+-. 10.8 ng/dl (n = 14) after 3, 6 and 9 mo. of treatment. There was also a significant decrease in .DELTA.4-androstenedione from 251.0 .+-. 110.2 ng/dl to 129.9 .+-. 66.5, 114.2 .+-. 45.8 and 62.0 .+-. 21.5 ng/dl after the same periods. From these results, it may be assumed that this therapeutic combination has an antigonadotropic effect, as confirmed by the decrease in plasma estradiol, FSH [follicle-stimulating hormone, follitropin] and LH [lutenizing hormone, lutropin] and the absence of a significant progesterone level in all cases. Plasma and urinary cortisol, lipids and hepatic tests remained normal. The good clinical and biological tolerance of this treatment makes it interesting to consider for use in the management of hirsutism.