Finasteride in the Treatment of Hirsutism

Abstract

Objective To determine of the clinical and hormonal effects of finasteride (Proscar; Merck, Sharp, and Dohme, Rahway, NJ) in the treatment of idiopathic hirsutism and hirsutism in patients with polycystic ovary syndrome (PCOS). Design Controlled clinical study. Setting Istitute of Obstetrics and Gynecology, University of Naples Federico II. Patients Ten women affected by idiopathic hirsutism and 15 women with PCOS. Interventions Finasteride was administered orally at a daily dose of 5mg for a period of 6 months. Main Outcome Measures Rating of hirsutism with the Ferriman-Gallwey method; serum androgen assays. Results Finasteride produced a reduction in the average hirsutism scores (>50% in all patients), whereas no change was observed in serum T, androstenedione, and DHEAS levels. A significant reduction was measured in serum dihydrotestosterone and 3 α ,17 β -androstenediol glucuronide levels. Conclusions This study demonstrates that symptomatic hirsutism has to be considered as a skin disease associated with the increased activity of the 5 α -reductase. It also indicates that the selective 5 α -reductase inhibitor, finasteride, is very effective and well tolerated in the treatment of both idiopathic hirsutism and of hirsutism in patients with PCOS.