Comparison of sequential cyproterone acetate/estrogen versus spironolactone/oral contraceptive in the treatment of hirsutism

Abstract

The effects of the antiandrogen drugs cyproterone acetate (CPA) and spironolactone on hair growth and androgen levels were compared in a randomized study of 48 hirsute women. Twenty six subjects completed 6 months of therapy with 100 mg/day CPA and 19 subjects completed 6 months of 100 mg/day spironolactone. All except 10 subjects received concomitant estrogen therapy. Measured objectively, total hair diameter fell by 17.1% with spironolactone (P < 0.001), and by 16.8% with CPA (P < 0.001). The diameter of the hair medulla fell by 17.8% with spironolactone (P < 0.01), and by 31.7% with CPA (P < 0.001). There was no difference between the drugs in their effect on hair diameter. Plasma testost..