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Treatment of Hirsutism by Oral Cyproterone Acetate and Percutaneous Estradiol

Department of Reproductive Endocrinology, Hopital Necker 75730 Paris Cedex 15; Department of Biochemistry, Hopital Pitie-Salpetriere 75013 Paris, France

Address requests for reprints to: P. Mauvais-Jarvis, Hopital Necker, 149, rue de Sevres, 75730 Paris Cedex 15, France.

Twenty hirsute women were treated with 50 mg cyproterone acetate orally, administered from the 5th to the 25th day of the menstrual cycle, along with 3 mg 17²-estradiol administered percutaneously from days 16-25. Percutaneously administered 17²-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 months 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 months of treatment. There was also a significant decrease in A4-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, and LH 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. {J Clin Endocrinol Metab 51: 1107, 1980)

Received February 6, 1980.

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