[Treatment of hirsutism with cyproterone acetate and percutaneous estradiol]

One-hundred and fifty hirsute women (68 with type I or II polycystic ovary syndrome and 82 with idiopathic hirsutism) were treated for periods of 6 to 48 months with oral cyproterone (CPA), a drug with peripheral antiandrogenic, antigonadotrophic and progestative properties, and 17 beta-estradiol given percutaneously to ensure estrogenic impregnation. CPA was administered in daily doses of 50 mg from day 5 to day 25 of the menstrual cycle, and E 2 (3 mg/day) from day 16 to day 25. The dramatic regression of hirsutism observed after 3 to 6 months of treatment was paralleled by a marked decrease of plasma testosterone and delta 4-androstenedione levels and a decrease of the androgen-dependent skin testosterone 5 alpha-reductase. The CPA-percutaneous E 2 combination also has contraceptive properties. Beside its remarkable therapeutic effectiveness, it has the advantages of avoiding the adverse reactions reported with higher doses of CPA and the metabolic and vascular effects of synthetic estrogen administered orally.