Hormonal and clinical effects of GnRH agonist alone, or in combination with a combined oral contraceptive or flutamide in women with severe hirsutism

Leo, Vincenzo De; Fulghesu, Anna Maria; Marca, Antonio La; Morgante, Giuseppe; Pasqui, L.; Talluri, B.; Torricelli, Michela; Caruso, Alessandro

doi:10.3109/09513590009167712

Cited by 21 publications

(8 citation statements)

References 17 publications

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“…(63) Clinically, a number of antiandrogens including cyproterone acetate, flutamide, spironolacton, and finasteride have been used to treat hyperan-drogenism in women with or without PCOS. (64)(65)(66)(67)(68)(69) Despite slight worsening of glucose tolerance, a combination of estrogen and cyproterone acetate is an efficient treatment for women with hyperandrogenism and hirsutism. (64,70) As with cyproterone acetate, spironolactone is effective for improving hyperandrogenism and reducing hirsutism in PCOS patients.…”

Section: Treatment With Antiandrogens In Pcosmentioning

confidence: 99%

Diagnosis of Polycystic Ovary Syndrome

Chang¹,

Katz²

1999

Endocrinology and Metabolism Clinics of North America

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Section: Treatment With Antiandrogens In Pcosmentioning

confidence: 99%

Diagnosis of Polycystic Ovary Syndrome

Chang¹,

Katz²

1999

Endocrinology and Metabolism Clinics of North America

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“…The conditions are chronic anovulation with or without polycystic ovarian disease (PCOD) and adrenarche in which serum adrenal androgen levels are elevated when ACTH levels are in the normal range [13][14][15][16][17]. These elevated levels can be decreased by treatment with GnRH agonists [18][19][20]. Pregnancy is another condition in which serum and urinary adrenal steroid hormone levels increase during pregnancy when ACTH levels are low and hCG levels are high [21].…”

Section: Introductionmentioning

confidence: 99%

Functional Luteinizing Hormone/Chorionic Gonadotropin Receptors in Human Adrenal Cortical H295R Cells

Rao

Zhou

Lei

2004

Biology of Reproduction

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Previous studies have suggested that activation of normal human adrenal and adrenal tumor luteinizing hormone (LH)/chorionic gonadotropin (hCG) receptors results in an increased secretion of steroid hormones. Since it is not feasible to test this suggestion on normal human adrenal cells, we used human adrenal cortical carcinoma H295R cells, which are similar in some respects to normal adrenal cortical cells. These cells contained LH/hCG receptor transcripts and receptor protein that can bind (125)I-hCG in a hormone-specific manner. Culturing the cells with highly purified hCG resulted in a time- and dose-dependent significant increase in dehydroepiandrosterone sulfate (DHEAS) secretion as compared with the controls. The DHEAS response was hormone as well as steroid specific. Since hCG treatment did not increase DHEA secretion, we suspected that the hCG might increase DHEA sulfotransferase (ST). Consistent with this possibility, hCG treatment increased steady-state DHEA-ST mRNA levels. The hCG effects require its receptors, as inhibition of their synthesis by treatment with antisense phosphorothioate oligodeoxynucleotides (ODN) made from the LH/hCG receptor sequence resulted in loss of DHEA-ST and DHEAS responses. The findings that 1) hCG treatment increased cAMP levels and activated protein kinase A (PKA), 2) 8-bromo cAMP mimicked hCG, and 3) blocking PKA activation prevented hCG as well as 8-bromo cAMP from increasing both DHEA-ST mRNA and DHEAS levels suggested that cAMP/PKA signaling was involved in the hCG actions. In conclusion, H295R cells contain LH/hCG receptors, which are coupled to increasing DHEAS secretion through upregulating the ST enzyme mRNA level. This action is mediated by the cAMP/PKA signaling pathway. These findings support the concept that adrenal function in normal and pathological conditions could be influenced by LH and hCG.

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“…Greatest changes were seen in the abdomen (25%) and mid-thigh (20%) and objective results correlated with patients' own qualitative assessment of improvement in hirsutism at 12 months [45]. Golland and Elstein [51] also reported correlation between objective and patient assessment.…”

Section: Efficacy In Hyperandrogenic Skin Symptoms Of Pcosmentioning

confidence: 52%

“…Seven women experienced complete resolution of symptoms and a further six women experienced significant symptom improvement with CPA/EE after 12 months. Two studies described the return of hyperandrogenic skin symptoms following cessation of treatment with CPA/EE treatment by six months [33,51].…”

Section: Efficacy In Hyperandrogenic Skin Symptoms Of Pcosmentioning

confidence: 99%

The use of cyproterone acetate/ethinyl estradiol in hyperandrogenic skin symptoms – a review

Bitzer

Römer

Filho³

2017

The European Journal of Contraception & Reproductive Health

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Introduction: Hyperandrogenism affects approximately 10-20% of women of reproductive age. Hyperandrogenic skin symptoms such as hirsutism, acne, seborrhea and alopecia are associated with significant quality of life and psychological impairment. Women with abnormalities in androgen metabolism may have accompanying anovulation and/or polycystic ovary syndrome (PCOS), both of which have reproductive and metabolic implications if left untreated. Cyproterone acetate (CPA), combined with ethinylestradiol (EE), is indicated for the treatment of moderate to severe acne related to androgen-sensitivity (with or without seborrhea) and/or hirsutism, in women of reproductive age. Objective: To review the data on the efficacy and safety of CPA 2 mg/EE 35 lg for the treatment of hyperandrogenic skin symptoms in women. Methods: A non-systematic narrative review based on a literature search of the PubMed database. Results: Seventy-eight studies were identified. The majority of sufficiently powered studies show a high efficacy of CPA 2 mg/EE 35 lg in the treatment of severe acne and hirsutism. Studies show that therapeutic response in women with hirsutism requires a long-term approach and that hyperandrogenic skin symptoms in patients with PCOS are efficiently treated. Additional benefits include cycle control and, in some women, improvement in mood and perception of body image. Safety and tolerability data are summarized by the pharmacovigilance risk assessment committee (PRAC) of the European Medicine's Agency's (EMA). Conclusions: This review provides a comprehensive overview about the efficacy of CPA 2 mg/EE 35 lg in the treatment of hyperandrogenic skin symptoms, thus allowing both health care professionals and women to balance the risks and benefits of treatment based on evidence.

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Hormonal and clinical effects of GnRH agonist alone, or in combination with a combined oral contraceptive or flutamide in women with severe hirsutism

Cited by 21 publications

References 17 publications

Diagnosis of Polycystic Ovary Syndrome

Diagnosis of Polycystic Ovary Syndrome

Functional Luteinizing Hormone/Chorionic Gonadotropin Receptors in Human Adrenal Cortical H295R Cells

The use of cyproterone acetate/ethinyl estradiol in hyperandrogenic skin symptoms – a review

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