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Comment on Spironolactone, But Not Flutamide, Administration Prevents Bone Loss in Hyperandrogenic Women Treated with Gonadotropin-Releasing Hormone Agonist

Medical Centre Ljubljana, Endocrinology 1000 Ljubljana, Slovenia

We read with interest the paper by Moghetti et al. (1) where they found that spironolactone, in contrast to flutamide, could prevent bone loss in hyperandrogenic women treated with GnRH. We found it surprising as the results of this study are at variance with our findings, where treatment with spironolactone in combination with linestrenol in hirsute women caused a significant decrease in bone mineral density (2).

As the number of patients and their age were comparable in both studies, there must be other factors influencing the surprisingly different effect on bone mineral density in the two studies. At the moment, only speculations could be made about the causes. Nevertheless, these results stress the need for cautiousness when applying seemingly equal treatment regimens in different conditions.

We fully agree with the author’s statement that additional studies are necessary to assess this bone-protective effect in other conditions and add before it could be recommended as a possible protective agent of bone loss.

References

1. Moghetti P, Castello R, Zamberlan N, et al. 1999 Spironolactone, but not flutamide, administration prevents bone loss in hyperandrogenic women treated with gonadotropin-releasing hormone agonist. J Clin Endocrinol Metab. 84:1250–1254.[Abstract/Free Full Text]
2. Prezelj J, Kocijancic A. 1994 Antiandrogen treatment with spironolactone and linestrenol decreases bone mineral density in eumenorrhoeic women with androgen excess. Horm Metab Res. 26:46–48.[Medline]

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