The influence of long-term treatment with cyproterone acetate or a cyproterone acetate-ethinyl oestradiol combination on androgen levels in blood of hirsute women

Thirty-five women with hirsutism, either idiopathic or due to polycystic ovary syndrome, were treated with cyproterone acetate (CA) (50 mg daily) or with a combination of cyproterone acetate (100 mg) and ethinyl oestradiol (50 μg) in a reversed sequential regimen (CA + EE). The levels of androstenedione (A), testosterone (T), dihydrotestosterone (DHT). and the binding capacity of sex hormone binding globulin (SHBG) were measured before and during treatment. Before treatment, the mean androgen levels were elevated compared with normal levels and the binding capacity for T and DHT was decreased. During treatment with CA + EE. A and DHT levels returned to normal within eight months, whereas T values only showed a tendency to decrease. SHBG binding capacity rose within two months to the level seen in women taking oral contraceptives containing oestrogens. Treatment with only CA had the same effect on A and DHT but also lowered T to normal levels. As a consequence of this normalization of the androgen levels, the SHBG binding capacity showed a slight increase. No clinical differences were observed in the regression rate of hair growth between the two treatment groups. Hair growth started to diminish after approx. 6 months of treatment under both regimens.