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Spironolactone as a single agent for long-term therapy of hirsute patients.
Clin Endocrinol (Oxf). 2000 May; 52(5):587-94.CE

Abstract

OBJECTIVE

To assess the androgen-suppressing effect of spironolactone, and the use of this drug as a single agent in the long-term therapy of hirsute patients with either polycystic ovary syndrome (PCOS) or idiopathic hirsutism (IH). Standard cyproterone acetate (CPA) treatment was used to evaluate the results obtained with spironolactone.

DESIGN

Prospective randomized study.

PATIENTS

Forty-six hirsute women were separated randomly into two groups, stratified for polycystic ovary syndrome. For 12 months, Group 1 (21 patients, 10 PCOS) received spironolactone only (200 mg/day). Group 2 (23 patients, nine PCOS) received CPA (50 mg/day) with ethinyl oestradiol (35 microgram/day).

MEASUREMENTS

Ferriman-Gallwey clinical score for hirsutism and serum testosterone, androstenedione, and LH levels.

RESULTS

In IH patients, hirsutism regressed equally with spironolactone (21 +/- 2-14.5 +/- 2) and CPA (23 +/- 2-13 +/- 2). In PCOS patients, the mean score for hirsutism after 12 months was significantly lower with CPA (12 +/- 1) than with spironolactone (16 +/- 1). Testosterone levels did not change with spironolactone; with CPA there was a decrease from baseline in PCOS (47% and 51%, 6 and 12 months) and IH patients (31% and 30%). Androstenedione levels also declined from baseline in CPA-treated PCOS patients (38% and 39%, 6 and 12 months). Androgen levels were significantly different between the groups after 6 and 12 months. LH levels decreased with CPA (72%) but not with spironolactone.

CONCLUSION

Our results suggest that spironolactone used as a single agent is as effective as cyproterone acetate combined with oestradiol for long-term treatment of patients with idiopathic hirsutism. In PCOS patients, spironolactone is still effective for reducing hirsutism; however, for treatment of the hormonal or metabolic manifestations associated with PCOS, it may be necessary to combine spironolactone with either an antigonadotrophic agent or a drug that improves peripheral insulin sensitivity.

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Authors+Show Affiliations

Spritzer PM
Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Brazil. spritzer@vortex.ufrgs.br
Lisboa KO
No affiliation info available
Mattiello S
No affiliation info available
Lhullier F
No affiliation info available

MeSH

AdolescentAdultAndrogen AntagonistsAndrostenedioneCyproterone AcetateDrug Therapy, CombinationEstradiol CongenersEthinyl EstradiolFemaleHirsutismHumansLuteinizing HormonePolycystic Ovary SyndromeProspective StudiesSpironolactoneTestosterone

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10792338

Citation

Spritzer, P M., et al. "Spironolactone as a Single Agent for Long-term Therapy of Hirsute Patients." Clinical Endocrinology, vol. 52, no. 5, 2000, pp. 587-94.
Spritzer PM, Lisboa KO, Mattiello S, et al. Spironolactone as a single agent for long-term therapy of hirsute patients. Clin Endocrinol (Oxf). 2000;52(5):587-94.
Spritzer, P. M., Lisboa, K. O., Mattiello, S., & Lhullier, F. (2000). Spironolactone as a single agent for long-term therapy of hirsute patients. Clinical Endocrinology, 52(5), 587-94.
Spritzer PM, et al. Spironolactone as a Single Agent for Long-term Therapy of Hirsute Patients. Clin Endocrinol (Oxf). 2000;52(5):587-94. PubMed PMID: 10792338.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spironolactone as a single agent for long-term therapy of hirsute patients. AU - Spritzer,P M, AU - Lisboa,K O, AU - Mattiello,S, AU - Lhullier,F, PY - 2000/5/3/pubmed PY - 2000/8/6/medline PY - 2000/5/3/entrez SP - 587 EP - 94 JF - Clinical endocrinology JO - Clin Endocrinol (Oxf) VL - 52 IS - 5 N2 - OBJECTIVE: To assess the androgen-suppressing effect of spironolactone, and the use of this drug as a single agent in the long-term therapy of hirsute patients with either polycystic ovary syndrome (PCOS) or idiopathic hirsutism (IH). Standard cyproterone acetate (CPA) treatment was used to evaluate the results obtained with spironolactone. DESIGN: Prospective randomized study. PATIENTS: Forty-six hirsute women were separated randomly into two groups, stratified for polycystic ovary syndrome. For 12 months, Group 1 (21 patients, 10 PCOS) received spironolactone only (200 mg/day). Group 2 (23 patients, nine PCOS) received CPA (50 mg/day) with ethinyl oestradiol (35 microgram/day). MEASUREMENTS: Ferriman-Gallwey clinical score for hirsutism and serum testosterone, androstenedione, and LH levels. RESULTS: In IH patients, hirsutism regressed equally with spironolactone (21 +/- 2-14.5 +/- 2) and CPA (23 +/- 2-13 +/- 2). In PCOS patients, the mean score for hirsutism after 12 months was significantly lower with CPA (12 +/- 1) than with spironolactone (16 +/- 1). Testosterone levels did not change with spironolactone; with CPA there was a decrease from baseline in PCOS (47% and 51%, 6 and 12 months) and IH patients (31% and 30%). Androstenedione levels also declined from baseline in CPA-treated PCOS patients (38% and 39%, 6 and 12 months). Androgen levels were significantly different between the groups after 6 and 12 months. LH levels decreased with CPA (72%) but not with spironolactone. CONCLUSION: Our results suggest that spironolactone used as a single agent is as effective as cyproterone acetate combined with oestradiol for long-term treatment of patients with idiopathic hirsutism. In PCOS patients, spironolactone is still effective for reducing hirsutism; however, for treatment of the hormonal or metabolic manifestations associated with PCOS, it may be necessary to combine spironolactone with either an antigonadotrophic agent or a drug that improves peripheral insulin sensitivity. SN - 0300-0664 UR - https://www.unboundmedicine.com/medline/citation/10792338/Spironolactone_as_a_single_agent_for_long_term_therapy_of_hirsute_patients_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0300-0664&date=2000&volume=52&issue=5&spage=587 DB - PRIME DP - Unbound Medicine ER -