Cyproterone Acetate and Adrenocortical Function

The Effect of Cyproterone Acetate on the Pituitary-Adrenal Axis in Hirsute Women

“…We have no explanation for these discrepancies, although it has to be realized, that precocious puberty in many studies is a syndrome caused by variable pathologies (Jeffcoate et al 1976) rather than a well defined disease entity and that in the studies, dealing with adverse effects of cyproterone acetate normality of pituitary reserve of ACTH at the start of the study was not always documented very well. One ex¬ planation for the discrepancy with the literature data might be that the suppressive effect of cyproterone acetate on pituitary-adrenal function is time-and dose-dependent (von Miihlendahl et al 1977). In 4 of the patients sustained cyproterone acetate treatment for 3 months also not significantly influenced basal plasma cortisol levels.…”

Effects of Cyproterone Acetate on Adrenal Steroidogenesis in vitro

“…Yet at a concentration of 0.5 pg/ml, CA began to have a visible effect on steroidogenesis. Plasma cortisol levels measured in children under CA treatment were found to be significantly reduced [7,8,10,15]. A decrease in cortisol would imply that CA has either an anticortitrophic effect or a direct inhibitory effect on steroidogenesis, or a combination of the two.…”

“…It was particularly in children undergoing lengthy treatment with CA for precocious puberty that adrenal insufficiency was sus pected. This was based rather on decreased plasma cortisol levels than on clinical symp toms [5,7,8,15]. Apart from some com plaints of increased fatigue, signs of obvious adrenal insufficiency were not reported, which suggests that, apart from the suppres sive effect of CA on ACTH.…”

Effect of Cyproterone Acetate on Structure of Adrenal Cortex in Hypophysectomized, ACTH Treated Mice

“…The antiandrogen cyproterone acetate decreased plasma corticosteroid binding capacity [2], decreased plasma corticosterone [ 1 I], and cortisol [8]. Cyproterone acetate also inhibited the steroidogenic parameters of adrenocortical cells in the intact animal by increasing lipid content, decreasing mitochondrial content, and diminishing the smooth endoplasmic reticulum [7].…”