cyproterone and Ovarian-Cysts

In a 6 1/2-month-old girl with McCune-Albright syndrome, gonadotropin-independent isosexual precocity and recurrent ovarian cysts, the short-term effects of surgical therapy, cyproterone acetate (120 mg/m2/d), combined medroxyprogesterone acetate (10 mg/d), and spironolactone (50-75 mg/d) treatment, and testolactone (40 mg/kg/d) were evaluated sequentially. No significant reduction of cyst frequency was achieved with any of the medical treatments. The rate of bone maturation (delta BA/delta CA) was increased and the height standard deviation score (SDS) for bone age as a potential indicator of final height was decreased with surgical treatment alone and combined medroxyprogesterone acetate and spironolactone. Both parameters normalized with cyproterone acetate and testolactone. Height velocity SDS, however, was higher with testolactone (0.97 vs. 0.45).

Topics: Androgen Antagonists; Body Height; Bone Development; Combined Modality Therapy; Cyproterone; Cyproterone Acetate; Drug Therapy, Combination; Female; Fibrous Dysplasia of Bone; Fibrous Dysplasia, Polyostotic; Follow-Up Studies; Humans; Infant; Medroxyprogesterone; Medroxyprogesterone Acetate; Ovarian Cysts; Ovarian Function Tests; Spironolactone; Testolactone

A "transient" precocious puberty with ovarian follicular cysts was observed in four girls. Each girl presented with several successive and transient episodes of development of secondary sex characters: breast development, areolar pigmentation, brown abdominal median line were the clinical signs of oestrogen secretion. At the time of referral, plasma and urinary gonadotropins levels were low in the prepubertal range while plasma oestradiol concentrations were elevated, in the pubertal range. At this time, as well as during each episode of "pubertal" development, the gonadotropins response to GnRH stimulation was blunted. In contrast, a prepubertal or pubertal response was observed when the clinical symptoms of estrogenization had resumed. Ultrasonography showed one or several ovarian follicular cysts. In two cases, the treatment with the GnRH agonist, D-TRP 6 GnRH [Decapeptyl (R)], was successful, suggesting a central dysfunction

Topics: Child; Child, Preschool; Cyproterone; Estradiol; Female; Gonadotropin-Releasing Hormone; Gonadotropins; Humans; Ovarian Cysts; Ovarian Follicle; Pituitary Hormone-Releasing Hormones; Puberty, Precocious; Remission, Spontaneous; Triptorelin Pamoate

Because of the variety and inconstancy of the clinical symptoms, it is difficult to establish a classification of the clinical forms. However, the laboratory profile, essentially a raised serum LH, is fairly constant in every case. The pathophysiology of the disequilibrium of androgen and gonadotrophin secretion can be explained on the basis of various initial functional abnormalities, such as an excess of adrenal androgens or LH or, conversely, a deficiency of FSH. Cystic disease is very common in veterinary medicine and presents a number of specific features. The treatment of polycystic ovaries depends on the symptoms (hirsutism, amenorrhea, sterility). In the case of sterility, inducers of ovulation are effective, but are very difficult to manipulate. A number of authors propose surgical excision (removal of the larger of the two ovaries).

Topics: Adrenal Cortex Hormones; Animals; Cattle; Cattle Diseases; Clomiphene; Cyproterone; Dexamethasone; Estrogens; Female; Follicle Stimulating Hormone; Horse Diseases; Horses; Humans; Ovarian Cysts; Polycystic Ovary Syndrome; Pregnancy; Progestins

Hyperandrogenic states have to be treated according to their etiology. But, idiopathic hirsutism represents the majority of observed cases. Its pathophysiology is still under discussion. The ovary and/or adrenal origin has led to various treatments with corticoids or combined estrogen-progestogen preparations. However, practical problems are different. After ruling out a tumoral process or mild congenital adrenal hyperplasia, a rational and efficient treatment must be proposed. It has now become possible with the use of both antiandrogen and antigonadotropin drugs. Cyproterone acetate is the best therapeutic agent because of its antiandrogen, antigonadotropin and progestogen properties. Because of its antiestrogen effects, cyproterone acetate must be used in combination with estrogens as a substitutive therapy to permit regular bleeding.

Topics: Androgens; Cyproterone; Cyproterone Acetate; Drug Therapy, Combination; Estrogens; Female; Hirsutism; Humans; Ovarian Cysts; Testosterone

Topics: Adrenal Hyperplasia, Congenital; Androgens; Contraceptives, Oral; Cyproterone; Female; Hair Removal; Hirsutism; Humans; Ovarian Cysts; Testosterone

76 women with virilizing features (68 women suffering from hirsutism and 8 from acne) were treated on average for 25 months according to different models of Androcur medication. Success of treatment was clinically assessed as good in 3/4 of the cases and slight in the remaining 1/4. However, treatment is more successful in cases of adrenal hirsutism than in idiopathic hirsutism. Moreover, success of treatment seems to be better in women below 35 than over 35 years of age. Side effects, mostly bleeding anomalies and fatigue, were found in 31 women; these must be attributed to the gestagenic component of cyproterone acetate. By contrast, 12 women showed positive side effects such as weight reduction, improvement in depression states and reversal of hair loss, which must be attributed to the antiandrogenic component. The selected continuation rate in all subjects was 86% and the unselected 72%, over a treatment period of 4.5 years. Furthermore, hormonal controls were carried out under treatment. These showed, on average, a depression of plasma androstendione of 17%, of total plasma testosterone of 47%, as well as an inhibition of the testosterone/sex hormone-binding globulin quotient of 58%. These inhibition effects speak in favour of alterations taking place in steroid metabolism. However, by inhibition of androgenic serum levels, the mechanism of cyproterone acetate is only assisted, while the main mechanism is based on peripheral receptor inhibition. Furthermore, as additional component in this action a slight increase in plasma binding capacity was found during combined cyproterone-oestrogen treatment.

Topics: Acne Vulgaris; Adult; Androgen Antagonists; Androstenedione; Cyproterone; Cyproterone Acetate; Female; Hirsutism; Humans; Middle Aged; Ovarian Cysts; Testosterone; Virilism

Topics: Androgen Antagonists; Animals; Animals, Newborn; Castration; Cerebral Cortex; Corpus Luteum; Cyproterone; Estradiol; Female; Feminization; Hydroxysteroid Dehydrogenases; Hypothalamus; In Vitro Techniques; Leydig Cells; Male; Ovarian Cysts; Ovary; Pituitary Gland; Pregnadienes; Rats; Testis; Testosterone; Tritium