Masahashi T, Wu M C, Ohsawa M, Asai M, Ichikawa Y, Hanai K, Kikkawa H, Mizutani S, Narita O, Tomoda Y
Nihon Sanka Fujinka Gakkai Zasshi. 1986 Jan;38(1):95-101.
Seventeen patients with irregular menstrual periods and androgenic symptoms such as excessive hair growth, acne, and oily skin were treated with spironolactone. The basal levels of serum testosterone (T), dihydrotestosterone (DHT), estradiol (E2), and luteinizing hormone (LH) were significantly higher in the patients than in the controls. After a 4-week treatment with spironolactone, serum T and DHT showed significant decreases. Before treatment, the serum sex hormone binding globulin (SHBG) levels were significantly lower in the patients than in the controls. After initiation of the spironolactone treatment, the SHBG levels tended to increase but not significantly. Spironolactone treatment resulted in the improvement or disappearance of acne in 4 of 5 patients who suffered from this ailment. Improvement of hirsutism was obtained in 2 of 10 patients. Although 4 oligomenorrheic patients and 6 amenorrheic patients showed anovulatory bleeding but did not ovulate, 2 patients in the amenorrheic group ovulated. Two patients complained of tiredness and weakness, and 2 others of polyuria and polydipsia. Both groups showed only temporary symptoms, so treatment was not interrupted. Spironolactone has beneficial effects on ovarian function and few side effects, so it may prove to be an effective anti-androgen, especially for hyperandrogenic anovulatory patients.
17例月经周期不规律且伴有多毛、痤疮和油性皮肤等雄激素症状的患者接受了螺内酯治疗。患者血清睾酮（T）、双氢睾酮（DHT）、雌二醇（E2）和促黄体生成素（LH）的基础水平显著高于对照组。经过4周的螺内酯治疗后，血清T和DHT显著降低。治疗前，患者血清性激素结合球蛋白（SHBG）水平显著低于对照组。开始螺内酯治疗后，SHBG水平有升高趋势，但不显著。螺内酯治疗使5例患有痤疮的患者中有4例的痤疮得到改善或消失。10例多毛患者中有2例多毛症状改善。虽然4例月经过少患者和6例闭经患者出现无排卵性出血但未排卵，但闭经组中有2例患者排卵。2例患者主诉疲倦和虚弱，另外2例主诉多尿和多饮。两组均仅出现短暂症状，因此未中断治疗。螺内酯对卵巢功能有有益作用且副作用较少，因此可能被证明是一种有效的抗雄激素药物，尤其适用于高雄激素性无排卵患者。
