Anti androgen cyproterone acetate is an effective treatment for hirsutism

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Cyproterone Acetate for Hirsutism

Cyproterone acetate (CSA) is a powerful and persistent progestin, which acts as anti-androgen at the peripheral level. Its androgen blocking capacity causes a reduction in serum testosterone and androstenedione concentration achieved by a decrease in circulating LH levels. It has proved effective in the treatment of hirsutism. It is not available in the USA, however, it is available in Europe, Canada, Australia and masny other countries.

Dosage and effectiveness

Cyproterone acetate is generally prescribed in daily measures of 50–100 mg (on days 5 to 15 of the menstrual cycle) and combined with 30–35 µg ethinyl estradiol (on days 5 to 25 or during the first 10 days of an oral contraceptive cycle) for the best results in the treatment of hirsutism. This combination has proved as beneficial as the combination of spironolactone (100 mg per day) and an oral contraceptive pill (OCP) in the treatment of hirsutism.

Another comparative analysis concluded that an oral contraceptive pill (OCP) containing cyproterone acetate (2 mg per day) when used in combination with ethinyl estradiol (35 µg per day) (sold as Diane-35 in Europe and Canada and Dianette in the United Kingdom by Schering AG [Berlin, Germany] and Berlex Canada [Lachine, Que´bec, Canada]) proved less beneficial than a daily dose of 100 mg of spironolactone.

Due to persevering and strong progestin activity, short frequencies of usage is advisable, in order to prevent irregularity in menstruation. Females who do not have a uterus can also use CSA continuously in a daily amount of 5 mg.

Side effects

The side effects of CSA are adrenal deficiency and reduced libido. Generally, the side effects of CSA are associated with progestational activity and result in moderate symptoms of nausea, breast tenderness, fluid retention, headache, mood swings and menstrual irregularity. Higher, isolated doses of the drug cause amenorrhea and are more common when used for a period of over 10 days of the OCP cycle.