THE EFFECT OF SPIRONOLACTONE ON HIRSUTISM AND FEMALE ANDROGEN METABOLISM

An objective evaluation of the anti‐androgen effects of spironolactone was performed in a consecutive series of 12 hirsute patients receiving a daily dose of 150 mg; nine completed the study. Using a computer assisted image analyser, hair diameter on two weekly shavings decreased significantly over a 12 month period in three of the patients, although growth rate and mean diameter did not change in the group as a whole. Plasma testosterone fell significantly to a mean of 53% of basal levels. The mean free testosterone (derived) fell significantly to 64% of basal by the sixth month (P= > 0·005) and remained significantly depressed for the remainder of the study. There was subjective benefit in hair growth and greasiness and a significant reduction in the semi‐objective Ferriman‐Gallwey index in nine of 10 subjects assessed for at least 9 months. We conclude that although spironolactone was not consistently successful, it may represent effective therapy for a sub group of patients with hirsutism.

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