Antiandrogenic properties of spironolactone. Clinical trial in the management of female hirsutism

Abstract

The effect of spironolactone on female hirsutism was studied in 18 patients. The drug was administered at the dose of 400 mg for the first ten days and 300-200 mg later on in a first group of women (Group A); a second group (Group B) was given 200 mg spironolactone for the whole length of therapy. A significant decrease of the index of Ferriman and Gallwey (p = 0.01) was noted from the 100th day of treatment; acne and seborrhoea improved concomitantly. Plasma total testosterone values fell from 0.64 +/- 0.24 ng/ml to 0.32 +/- 0.12 ng/ml (p = 0.002) during the first 5 days only in the patients of Group A; in the other patients no significant changes were observed. PRL did not significantly change from pretreatment values; FSH and LH values at the 5th, 10th, and 15th day of therapy did not show a uniform course in both groups. On the basis of these results spironolactone administration appears promising in the therapy of female hirsutism.

Oral Spironolactone for Acne Vulgaris in Adult Females: A Hybrid Systematic Review

“…The location of lesions was reported in only three case series [48, 54, 57]. Seven studies did not make a clear statement about concomitant medications, making attribution of any clinical effect to spironolactone uncertain [41, 43–45, 49, 51, 55]. Further details are reported in Table 3.…”

Female Hirsutism: Pathophysiological Considerations and Therapeutic Implications*

“…f The behavior of gonadotropins after SP seems to differ among sexes. Whereas, in men FSH and LH were observed to rise (149), an irregular and anovulatory pattern was seen in hirsute females (188). As mentioned before, "Blffignandi et al (139) have reported an increase in free estradiol coupled with a decrease in free T after in vitro mcubation of plasma from healthy males with SP.…”

“…After this initial report, a number of papers appeared (169,188,(190)(191)(192)(193)(194). The role of this drug for this particular indication is well established now.…”

“…There were no instances of arterial hypotension or electrolyte abnormalities. Hormonal profiles after SP have been described in detail (169,188). Total T did show a significant and early fall from pretreatment values which appeared dose-dependent, since it occurred only after higher (400 mg/day) doses.…”

Antiandrogens and Hirsutism

“…After this initial report a number of papers from both our group and other researchers appeared, and now the role of SP for this particular indication is well established [8].…”