cyproterone and Edema

The influence of cyproterone acetate (CPA) containing drugs on the endometrium has not yet been investigated. Therefore, endometrial biopsies were obtained in 22 hirsute patients between day 14 and 28 of the cycle after 7-18 months of oral antiandrogen therapy. The effects of various regimens consisting of different doses of CPA in combination with ethinylestradiol (EE) were evaluated. The low-dose standard regimen (50 micrograms of EE plus 2 mg of CPA daily from day 5 to 25) caused regressive changes in the endometrium, i.e., sparse atrophic glands, relatively compact stroma, islands of stromal edema. These alterations correspond to those induced by conventional balanced low-dose combined oral contraceptives. High-dose reversed sequential regimen (40 micrograms of EE daily from day 5 to 25 plus 100 mg of CPA daily from day 5 to 14) resulted in pseudodeciduation and massive stromal edema. Pseudodeciduation during the early secretory phase is taken as a sign of the progestational depot effect of CPA, while the stromal edema is regarded as a result of the relatively unopposed estrogen intake during the second half of the treatment cycle. Thus, the effects of CPA containing drug on the endometrium depend essentially on their type, dosage and mode of administration.. The influence of cyproterone acetate (CPS) containing drugs on the endometrium has not yet been investigated. Therefore, endometrial biopsies were obtained in 22 hirsute patients between days 14-28 of the cycle after 7-18 months of antiandrogen oral therapy. The effects of various regimens consisting of different doses of CPA in combination with ethinyl estradiol (EE) were evaluated. The low dose standard regimen (50 mcg EE plus 2 mg CPA daily from days 5-25) caused regressive changes in the endometrium; i.e., sparse atrophic glands, relatively compact stroma, islands of stromal edema. These alterations correspond to those induced by conventional balanced low dose combined oral contraceptives. High dose reversed sequential regimen (40 mcg of EE daily from days 5-25 plus 100 mg CPA daily from days 5-14) resulted in pseudodeciduation and massive stromal edema. Pseudodeciduation during the early secretory phase is taken as a sign of the progestational depot effect of CPA, while the stromal edema is regarded as a result of the relatively unopposed estrogen intake during the 2nd 1/2 of the treatment cycle. Thus, the effects of a CPA containing drug on the endometrium depend essentially on their type, dosage, and mode of administration.

Topics: Adult; Atrophy; Biopsy; Cyproterone; Edema; Endometrium; Ethinyl Estradiol; Female; Hirsutism; Humans

The effect of oral administration of 17 alpha-acetoxy-6-chloro-1,2 alpha-methylene-4,6]pregnadiene-3,20-dione (cyproterone acetate, Androcur) on the adrenal function in male hypersexual subjects and in female rhesus monkey was investigated on the basis of cortisol and ACTH levels in serum or plasma and excretion of cortisol and 17-ketosteroids. In addition, cyproterone acetate and its main metabolite alcohol of the main metabolite were characterized for treatment of male hypersexual subjects and female rhesus monkeys did not reveal any signs of adrenal suppression. Cyproterone acetate and its metabolites gave on indication of any appreciable anti-inflammatory effect in the adjuvant edema test in rats. However, there was a general increase in the level of blood glucose and liver glycogen as well as a reduction in body weight and organ weight (spleen, thymus and adrenal) in rats, in which 15 beta-hydroxy cyproterone was slightly more active with the exception of adrenal weight tests. It can be concluded that adult man and rhesus monkey are much less sensitive, is so at all, to some corticosteroid-like activities of cyproterone acetate and its main metabolites than the rat.

Topics: 17-Ketosteroids; Adolescent; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Animals; Cyproterone; Cyproterone Acetate; Edema; Female; Humans; Hydrocortisone; Macaca mulatta; Male; Middle Aged; Organ Size; Rats