The effect of cyproterone acetate on pituitary-ovarian function and clinical symptoms in hirsute women

Ten hirsute women in fertile age were given 50 mg cyproterone acetate (CA) on day 5--14 and 50 micrograms ethinyl oestradiol (EE2) on day 5--21 except during the first treatment cycle when EE2 was given on day 15--21. The treatment lasted for 12 months. Clinical examination and hormone analysis were undertaken every third month. LRH tests were performed prior to treatment with CA in late follicular phase and after one week of administration of the drug. Subjective improvement of hypertrichosis was reported in 7 women, objectively a significant decrease in hair scores was observed. Short-term effects of CA alone included significantly decreased serum levels of oestrogens while FSH, LH, 4-androstene-3,17-dione and testosterone remained unaffected. Long-term administration of CA and EE2 resulted in significantly decreased serum levels of FSH, LH and oestrogens whereas 4-androstene-3,17-dione and testosterone were not affected. The gonadotrophin response to LRH did not reveal any significant difference before and after treatment. 4-Androstene-3,17-dione and testosterone did not change during the LRH tests but increased levels of oestrogens were observed at the end of the test during the CA treatment. Since CA alone causes decreased oestrogen levels without any suppression of the basal gonadorrohin levels, it is speculated that CA directly affects the ovarian steroid biosynthesis. On the other hand the adrenal androgens seem to be unaffected by the drug.