Treatment with Flutamide, Metformin, and Their Combination Added to a Hypocaloric Diet in Overweight-Obese Women with Polycystic Ovary Syndrome: A Randomized, 12-Month, Placebo-Controlled Study

Abstract

These findings add relevance to the usefulness of metformin and flutamide in the treatment of dieting overweight-obese PCOS women and provide a rationale for targeting different therapeutic options according to the required outcomes in the long term.

Retrospective observational study on the effects and tolerability of flutamide in a large population of patients with various kinds of hirsutism over a 15-year period

“…The limited utility of the fT assay (due to its low sensitivity) did not impugn the results. The evident decrease in serum androgen levels was in agreement with ours and other previous reports (6,18,19,21,22,25,31,32,34,(36)(37)(38), and in disagreement with others (16,23,27,29,30) using different doses of Flu and smaller sizes of the subject sample enrolled. Hence, although Flu is considered a pure anti-androgen, the main action of which is attributed to its peripheral antiandrogenic properties, our data also confirm a direct inhibitory effect on androgen secretion, resulting from a blockade of the steroidogenic enzymes of androgen biosynthesis in both ovarian thecal and adrenal corticoreticular cells, as has been reported already (18,21,24).…”

Ovarian function and obesity—Interrelationship, impact on women's reproductive lifespan and treatment options

“…This is further supported by the effects of anti-androgens like spironolactone, which appear to reduce IR in some (Diamanti-Kandarakis and Panidis, 2007) but not all studies (Cenk Sayin et al, 2003). Also, in a placebo controlled study, the pure anti-androgen flutamide when administered in conjunction with a low-calorie diet to obese women with PCOS, improved hirsutism and hyperandrogenaemia and decreased intraabdominal fat depots (Gambineri et al, 2004;Gambineri et al, 2006). Conversely, molecules which are secreted by the intraabdominal adipose tissue (adipokines) may also promote ovarian androgen production.…”

Reproduction and Metabolism: Insights from Polycystic Ovary Syndrome

“…In normal postmenopausal women, administration of a weak synthetic androgen also increases visceral fat [88]. Consistent with these observations, blocking androgen action with a receptor antagonist in women with PCOS can improve insulin sensitivity, visceral adiposity, and dyslipidemia [89,90]. Additional factors contribute to insulin resistance, since suppression of androgens improves but does not completely restore normal insulin sensitivity in PCOS [91,92].…”