Evaluation and Therapy of Polycystic Ovarian Syndrome

Loy, Randall A.; Seibel, Machelle M.

doi:10.1016/s0889-8529(18)30410-9

Cited by 22 publications

(16 citation statements)

References 160 publications

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“…The other two antiandrogens used commonly in the treatment of hirsutism are cyproterone acetate (CPA) and spironolactone [1,2,13]. CPA is a synthetic progestin and its primary mechanism of action is through competitive inhibition of testosterone and dihydrotestosterone at androgen receptors [13].…”

Section: Discussionmentioning

confidence: 99%

“…CPA is a synthetic progestin and its primary mechanism of action is through competitive inhibition of testosterone and dihydrotestosterone at androgen receptors [13]. CPA has been commonly used with estrogen for many years in Europe, and the combination of ethinyl estradiol with CPA significantly reduces plasma testosterone, androstenedione and gonadotropin levels [1,2,13,14].…”

Section: Discussionmentioning

confidence: 99%

“…It also has mild glucocorticoid activity and may reduce DHEAS levels [13]. This combination allows regular menstruation, provides contraception and is effective even in severe hirsutism [13,14].…”

Section: Discussionmentioning

confidence: 99%

“…This combination allows regular menstruation, provides contraception and is effective even in severe hirsutism [13,14]. CPA has also been reported as effective in the treatment of hirsutism as a sole agent [15].…”

Section: Discussionmentioning

confidence: 99%

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The Use of Antiandrogen Flutamide in the Treatment of Hirsutism.

et al. 1994

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Abstract.In this study the efficacy of flutamide, an antiandrogen which does not have a steroid structure, or progestational and estrogenic activities, on hirsutism and hormone levels in polycystic ovary syndrome (PCOS) and idiopathic hirsutism (IH) was investigated.Ten patients with PCOS and nine patients with IH between 19 and 36 years of age were selected for the study. They were given a 500 mg daily dose of flutamide and were followed up for clinical and hormonal effects at the second, sixth, eighth and twelfth months of the treatment.The severity of hirsutism was assessed according to the Ferriman-Gallwey's score. There was a slight decrease to below the pre-treatment level in serum LH at the end of the eighth month (P<0.05) and there was also a persistent decrease in progesterone (P) after the second month of the treatment (P<0.05). No other significant change was observed in ovarian or adrenal androgens.Clinical examinations revealed that after six months of the therapy the dose of flutamide had caused a significant alleviation of hirsutism and this continued during the following months.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Use of Antiandrogen Flutamide in the Treatment of Hirsutism.

et al. 1994

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“…Considerou-se normal ovário com volume até 9cm 3 com menos de 5 folículos periféricos menores que 8mm (10).…”

Section: Pacientes E Métodosunclassified

Importância da dosagem da 17OH-progesterona na síndrome dos ovários policísticos

Pinheiro

Clapauch

2001

Arq Bras Endocrinol Metab

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RESUMOA dosagem da 17-hidroxiprogesterona (17OHP) é usada para screening de hiperplasia congênita de adrenal (HCSR) por defeito da 21-hidroxilase e, nesta situação, se encontra muito aumentada. Pode estar alterada em mulheres com síndrome de ovários policísticos (SOP), porém a freqüência e a magnitude desta alteração foram pouco descritas. Analisamos retrospectivamente queixas, índice de massa corpórea (IMC), dosagens na fase folicular precoce de LH, FSH, testosterona livre, 17OHP, sulfato de deidroepiandrosterona (SDHEA) e volume ovariano ao ultra-som de 83 mulheres no menacme com SOP, antes de iniciar tratamento. HCSR foi excluída pela prova de ACTH nas que apresentaram valores basais de 17OHP maiores que 200ng/dL. A 17OHP esteve acima do valor de referência em 67,5% dos casos comparada a 38,6% para o LH; 10,8% para testosterona livre e 4,9% para SDHEA. A relação LH/FSH esteve maior que 1 em 50,6% das mulheres. O volume de pelo menos um dos ovários esteve aumentado em 53,5% das pacientes. O aumento médio da 17OHP foi de 30% acima do limite superior da normalidade (mediana 18%). Correlacionou-se inversamente com os valores de FSH e houve uma tendência de relação direta com os níveis de SDHEA. Das dosagens analisadas, a 17OHP foi a mais freqüentemente aumentada, sugerindo que além de funcionar como screening para HCSR, aumentos discretos desse hormônio possam apoiar o diagnóstico de SOP dentro de um quadro clínico compatível. ABSTRACT 17-Hydroxyprogesterone (17OHP) is measured to screen for congenital adrenal hyperplasia (CAH) caused by 21-hydroxylase deficiency, in which 17OHP levels are extremely elevated. It can also be abnormal in PCO but the frequency and magnitude of this alteration is poorly described. We analyzed retrospectively: complaints, body mass index (BMI), follicular phase levels of LH, FSH, testosterone (T), 17OHP, dehydroepiandrosterone sulfate (DHEAS) and ovarian volume by ultrasound from 83 PCO patients not previously treated. CAH has been excluded by ACTH testing if basal 17OHP levels were > 200ng/dL. Hormone levels were above reference values in 67.5% for 17OHP; 38.6% for LH; 10.8% for T and 4.9% for DHEAS. LH/FSH ratio was above 1 in 50.6% of the women. At least one of the ovaries was increased in 53.5% of the patients. The mean increase in 17OHP was 30% above the normal limit (median 18%). There was a negative correlation with FSH and a positive correlation trend with DHEAS. 17OHP was the most frequently elevated hormone, suggesting that in addition to screening for CAH, mild increases of this hormone can be used to support PCO diagnosis in an appropriate clinical setting. (Arq Bras Endocrinol Metab 2001;45/4:361-368)

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