Finasteride in the treatment of hirsutism: new therapeutic perspectives.

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 5 mg 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 alpha, 17 beta-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 alpha-reductase. It also indicates that the selective 5 alpha-reductase inhibitor, finasteride, is very effective and well tolerated in the treatment of both idiopathic hirsutism and of hirsutism in patients with PCOS.