cyproterone and Hypertrichosis

Topics: Alopecia; Anabolic Agents; Androgens; Chlormadinone Acetate; Contraceptives, Oral; Cyproterone; Estrogens; Female; Gonadal Steroid Hormones; Hirsutism; Humans; Hypertrichosis; Male

Topics: Acne Vulgaris; Alopecia; Androgen Antagonists; Bone Development; Cyproterone; Female; Growth; Hirsutism; Humans; Hypertrichosis; Libido; Male; Prostate; Prostatic Neoplasms; Puberty, Precocious; Seminal Vesicles; Sexual Dysfunction, Physiological; Skin

Membranous dysmenorrhea is an unusual clinical entity. It is characterized by the expulsion of huge fragments of endometrium during the menses, favored by hormonal abnormality or drug intake. This report describes a case with clinical, US, and MRI findings before the expulsion. Differential diagnoses are discussed.

Topics: Adult; Cyproterone; Diagnosis, Differential; Dysmenorrhea; Endometrium; Female; Humans; Hypertrichosis; Magnetic Resonance Imaging; Metrorrhagia; Ultrasonography

Topics: Cyproterone; Drug Therapy, Combination; Ethinyl Estradiol; Female; Hirsutism; Humans; Hypertrichosis

The use of antiandrogens (principally cyproterone acetate CPA) to treat women with symptoms of hypersecretion of androgens is discussed. Several therapy schemata are presented. A high dosage "reverse sequential" therapy of 100 mg CPA on the 5th-14th days of the menstrual cycle and 40 mcg ethinyl estradiol (EE) on the 5th-25th days is used in severe cases. Low dosage (2mg CPA, 50 mcg EE) preparations are used for light cases of androgen hypersecretion. Parenteral application of 300 mg CPA per cycle with supplementary EE administration has also been tested. Hirsuitism is treated with good results in 65%-80% of those who use high dosage preparations and 50% of those who use the low dosage preparations. The effects of the therapy are apparent 9-12 months after it begins; the therapy is not as successful among patients whose problems are not related to their hormonal balance. Seborrhea and endogenous acne can be effectively treated with all types of antiandrogen preparations. Androgenetic alopecia can also be treated in a majority of cases with CPA preparations. CPA treatment should not last longer than 12 months. High dosage CPA use by ovulating women causes suppression of the preovulatory LH and FSH peaks but has little effect on basal levels; in postmenopausal women, the basal LH and FSH levels are significantly reduced. Use of CPA by itself causes a significant decrease in the levels of testosterone and delta-4-andostendion 3,17-dion. Use of CPA/EE combinations causes an increase in SHBG and the blood cortisol levels. Protein metabolism, hematopoesis, blood coagulation, and liver function are not affected by CPA use. Reduced glucose utilization and an increase in triglyceride levels are observed during CPA use. Pregnant women and women over 40 or with androgen-producing tumors should not use CPA.

Topics: Acne Vulgaris; Adrenocorticotropic Hormone; Alopecia; Androgen Antagonists; Cyproterone; Cyproterone Acetate; Dermatitis, Seborrheic; Dose-Response Relationship, Drug; Drug Therapy, Combination; Ethinyl Estradiol; Female; Follicle Stimulating Hormone; Hirsutism; Humans; Hypertrichosis; Luteinizing Hormone; Pregnancy; Prolactin; Virilism

Hirsutism (increased masculine-type sexual hair growth) is to be distinguished from hypertrichosis (generalized increase of body hair) and from virilism (organ changes tending towards masculinity) in which marked hormonal changes are alwasy observable. Hirsutism depends on age, race, heredity, hairfolicle sensitivity to testosterone, and on circulating testosterone and its precursors. The main source of testosterone and androstanedione formation is not the adrenal cortex, as previously assumed, but, as catheterization has demonstrated, the ovary. Mild forms can best be treated externally by plucking, shaving or electrolysis. In forms associated with amenorrhea the amenorrhea responds to corticoids but over a prolonged period of treatment the maximum regression of hirsutism is one-third. Good results are obtainable by reverse-sequence therapy with the competitive androgen antagonists cyproterone acetate and ethinyl estradiol (100 mg cyproterone acetate from 5th-14th day of menstrual cycle and 50 mug ethinyl estradiol from 5th-21st day). This therapy is however costly and not without side effects; it should therefore be used only for particularly troublesome cases.

Topics: Adrenal Cortex Hormones; Amenorrhea; Androstenedione; Cyproterone; Diagnosis, Differential; Ethinyl Estradiol; Female; Hirsutism; Humans; Hypertrichosis; Ovary; Testosterone; Virilism