Treatment of moderate and severe hirsutism by gonadotropin-releasing hormone agonists in women with polycystic ovary syndrome and idiopathic hirsutism

An Open Randomized Comparative Study of an Oral Contraceptive Containing Ethinyl Estradiol and Cyproterone Acetate with and without the GnRH Analogue Goserelin in the Long-Term Treatment of Hirsutism

“…Rittmaster and Thompson [26], by weighing shaved hair, showed a higher efficacy of leuprolide in patients with hir sutism secondary to PCOS compared to patients with idiopathic hirsutism. This finding was not confirmed by Falsetti and Pasinetti [29], who reported similar objective and subjective responses in patients with PCOS or idio pathic hirsutism. In the present study no difference in activity was evident with either treatment in patients with PCOS or idiopathic hirsutism.…”

“…Andreyko et al [25] reported some activ ity of nafarelin in decreasing the mean hair diameter, without quantifying the effect. Falsetti and Pasinetti [29] reported a mean decrease in hair diameter of 16-33% with both leuprolide and leuprolide + OCs; surprisingly, a 16-23% decrease was also reported for the forearm. Rittmaster and Thompson [26], by weighing shaved hair, showed a higher efficacy of leuprolide in patients with hir sutism secondary to PCOS compared to patients with idiopathic hirsutism.…”

“…Of the previous reports on the treatment of hirsutism with LH-releasing hormone analog or OCs, only Andreyko ct al. [25] and Falsetti and Pasinetti [29] assessed the hair diameter of treated patients. Andreyko et al [25] reported some activ ity of nafarelin in decreasing the mean hair diameter, without quantifying the effect.…”

Hirsutism, Acne, and Hair Loss: Management of Hyperandrogenic Cutaneous Manifestations of Polycystic Ovary Syndrome

“…GnRH analogs should be reserved for use in women who do not respond or tolerate combined hormone therapies in the management of severe hirsutism. A study that compared the effectiveness of leuprolide and leuprolide plus ethinyl estradiol/ cyproterone acetate containing combined oral contraceptives demonstrated that both treatments were effective in patients with moderate to severe hirsutism (42).…”

The Management of Polycystic Ovary Syndrome

“…The rationale behind combining estro‐progestins with a GnRH analog agonist is to achieve complete suppression of the ovarian function. The results of clinical studies of this combination are divergent: some have recorded an improvement of the endocrine profile, but without a concomitant improvement of the hirsutism score in comparison with the use of the pill on its own,67 while for other authors the clinical markers of hyperandrogenism regressmore rapidly and last longer 68,69. Castelo Branco70 studied women with severe hirsutism that was treated with tryptorelin combined with a preparation containing desogestrel, as compared with the cyproterone acetate preparation: the modifications in the hormonal profile in the two groups are comparable in terms of the reduction of the androgen index and of the SHBG increase; significant variations of the bone mineral density were not observed; at a clinical level, better results were obtained after 6 months of the combined treatment, but at 12 months the results were comparable between the two groups.…”