Comprehensive clinical management of hirsutism

Gynecological Endocrinology

Volumn 26, Issue 7, 2010, Pages 484-493

  Castelo Branco, Camil ^a   Jesús Cancelo, María ^b  

^a UNIVERSITY OF BARCELONA   (Spain)

^b HOSPITAL UNIVERSITARIO DE GUADALAJARA   (Spain)

Author keywords

Androgens; Antiandrogens; Hirsutism; Polycystic ovary syndrome; Therapeutic options

Indexed keywords

ANABOLIC AGENT; ANDROGEN; ANTIANDROGEN; CARBAMAZEPINE; CHLORMADINONE ACETATE; CORTICOTROPIN; CYPROTERONE ACETATE; DANAZOL; DIAZOXIDE; DIENOGEST PLUS ETHINYLESTRADIOL; DROSPIRENONE; EFLORNITHINE; ETHINYLESTRADIOL; ETHINYLESTRADIOL PLUS LEVONORGESTREL; ETHINYLESTRADIOL PLUS NORELGESTROMIN; FINASTERIDE; FLUTAMIDE; GLITAZONE DERIVATIVE; GLUCOCORTICOID; INSULIN; LEVONORGESTREL; METFORMIN; METYRAPONE; MINOXIDIL; ORNITHINE DECARBOXYLASE INHIBITOR; PHENYTOIN; PIOGLITAZONE; ROSIGLITAZONE; SPIRONOLACTONE; UNINDEXED DRUG;

ADRENAL SUPPRESSION; ANDROGEN SYNTHESIS; BEHAVIOR THERAPY; BURNING SENSATION; CARDIOVASCULAR DISEASE; CORTICOSTEROID INDUCED OSTEOPOROSIS; CREAM; DRUG FATALITY; DRUG MEGADOSE; DRUG WITHDRAWAL; ESTHETICS; GASTROINTESTINAL SYMPTOM; HIRSUTISM; HUMAN; HYPERKALEMIA; IMPAIRED GLUCOSE TOLERANCE; LIFESTYLE MODIFICATION; LIVER TOXICITY; LOW DRUG DOSE; LOW LEVEL LASER THERAPY; MENSTRUAL IRREGULARITY; PRIORITY JOURNAL; PSYCHOLOGICAL ASPECT; RECOMMENDED DRUG DOSE; REVIEW; SIDE EFFECT; SOCIAL ASPECT; TERATOGENICITY; TREATMENT INDICATION; TREATMENT OUTCOME; VENOUS THROMBOEMBOLISM; WEIGHT GAIN;

CONTRACEPTIVES, ORAL, COMBINED; EFLORNITHINE; FEMALE; HAIR REMOVAL; HIRSUTISM; HUMANS; WEIGHT LOSS;

EID: 77953649133     PISSN: 09513590     EISSN: 14730766     Source Type: Journal    
DOI: 10.3109/09513591003686353     Document Type: Review

References (93)

1. Rittmaster RS, Loriaux DL. Hirsutism. Ann Intern Med 1987;106:95-107.
2. Azziz R, Carmina E, Sawaya ME. Idiopathic hirsutism Endocr Rev 2000;21:347-362.
3. Mofid A, Seyyed Alinaghi SA, Zandieh S, Yazdani T. Hirsutism. Int J Clin Pract 2008;62:433-443.
4. Somani N, Harrison S, Bergfeld WF. The clinical evaluation of hirsutism. Dermatol Ther 2008;21:376-391.
5. Ferriman, D, Gallwey, JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab 1961;21:1440.
6. Blume-Peytavi U, Hahn S. Medical treatment of hirsutism. Dermatol Ther 2008;21:329-339.
7. Gambineri A, Pelusi C, Vicennati V, Pagotto U, Pasquali R. Obesity and the polycystic ovary syndrome. Int J Obes Relat Metab Disord 2002;26:883-896.
8. Hernández-Núnez A, Daudén E, García-F- Villalta MJ, Ríos- Buceta L, García-Díez A. Hirsutism secondary to topical testosterone: report of two cases and review of the literature. J Eur Acad Dermatol Venereol 2004;18:208-210.
9. Basaria S, Dobs AS. Safety and adverse effects of androgens: how to counsel patients. Mayo Clin Proc 2004;79:S25-S32.
10. Knopp RH, Broyles FE, Cheung M, Moore K, Marcovina S, Chandler WL. Comparison of the lipoprotein, carbohydrate, and hemostatic effects of phasic oral contraceptives containing desogestrel or levonorgestrel. Contraception 2001;63:1-11.
11. Scheinfeld N. Impact of phenytoin therapy on the skin and skin disease. Expert Opin Drug Saf 2004;3:655-665.
12. Shapiro J, Lui H. Treatments for unwanted facial hair. Skin Therapy Lett 2005;10:1-4.
13. Richards RN, Meharg GE. Electrolysis: observations from 13 years and 140,000 hours of experience. J Am Acad Dermatol 1995;33:662-666.
14. Richards RN. Electrolysis for the treatment of hypertrichosis and hirsutism. Skin Therapy Lett 1999;4:3-4.
15. Elghblawi E. Idiopathic hirsutism: excessive bodily and facial hair in women. Br J Nurs 2008;17:192-197.
16. Sadighha A, Mohaghegh Zahed G. Meta-analysis of hair removal laser trials. Lasers Med Sci 2007. [Epub ahead of print].
17. Clayton, WJ, Lipton, M, Elford, J, Rustin, M, Sherr, L. A randomized controlled trial of laser treatment among hirsute women with polycystic ovary syndrome. Br J Dermatol 2005;152:986-992.
18. Moreno-Arias GA, Castelo-Branco C, Ferrando J. Side-effects after IPL photodepilation. Dermatol Surg 2002;28:1131-1134.
19. Moreno-Arias G, Castelo-Branco C, Ferrando J. Paradoxical effect after IPL photoepilation. Dermatol Surg 2002;28:1013-1016.
20. Radmanesh M. Paradoxical hypertrichosis and terminal hair change after intense pulsed light hair removal therapy. J Dermatolog Treat 2008;14:1-3.
21. Haedersdal M, Gøtzsche PC. Laser and photoepilation for unwanted hair growth. Cochrane Database Syst Rev 2006:CD004684.
22. Jackson J, Caro JJ, Caro G, Garfield F, Huber F, Zhou W, Lin CS, Shander D, Schrode K; Eflornithine HCl Study Group. The effect of eflornithine 13.9% cream on the bother and discomfort due to hirsutism. Int J Dermatol 2007;46:976-981.
23. Balfour JA, McClellan K. Topical eflornithine. Am J Clin Dermatol 2001;2:197-201.
24. Blume-Peytavi U, Hahn S. Medical treatment of hirsutism. Dermatol Ther 2008;21:329-339.
25. Hamzavi I, Tan E, Shapiro J, Lui H. A randomized bilateral vehicle-controlled study of eflornithine cream combined with laser treatment versus laser treatment alone for facial hirsutism in women. J Am Acad Dermatol 2007;57:54-59.
26. Shaw JC. Hormonal therapy in dermatology. Dermatol Clin 2001;19:169-178.
27. O'Connell K, Westhoff C. Pharmacology of hormonal contraceptives and acne. Cutis 2008;81:8-12.
28. Mathur RS, Moody LO, Landgrebe SC, Peress MR, Rust PF, Williamson HO. Sex-hormone-binding globulin in clinically hyperandrogenic women: association of plasma concentrations with body weight. Fertil Steril 1982;38:207-211.
29. Kuhnz W, Sostarek D, Gansau C, Louton T, Mahler M. Single and multiple administration of a new triphasic oral contraceptive to women: pharmacokinetics of ethinyl estradiol and free and total testosterone levels in serum. Am J Obstet Gynecol 1991;165:596-602.
30. Wiegratz I, Kuhl H. Managing cutaneous manifestations of hyperandrogenic disorders: the role of oral contraceptives. Treat Endocrinol 2002;1:372-386.
31. Darney PD. OC practice guidelines: minimizing side effects. Int J Fertil Womens Med 1997;Suppl 1:158-169.
32. Gregoriou O, Papadias K, Konidaris S, Bakalianou K, Salakos N, Vrachnis N, Creatsas G. Treatment of hirsutism with combined pill containing drospirenone. Gynecol Endocrinol 2008;24:220-223.
33. Raudrant D, Rabe T. Progestogens with antiandrogenic properties. Drugs 2003;63:463-492.
34. Breitkopf DM, Rosen MP, Young SL, Nagamani M. Efficacy of second versus third generation oral contraceptives in the treatment of hirsutism. Contraception 2003;67:349-353.
35. Wiegratz I, Kuhl H. Managing cutaneous manifestations of hyperandrogenic disorders: the role of oral contraceptives. Treat Endocrinol 2002;1:372-386.
36. Batukan C, Muderris II, Ozcelik B, Ozturk A. Comparison of two oral contraceptives containing either drospirenone or cyproterone acetate in the treatment of hirsutism. Gynecol Endocrinol 2007;23:38-44.
37. Kaunitz AM. Clinical practice. Hormonal contraception in women of older reproductive age. N Engl J Med 2008;358: 1262-1270.
38. Martin KA, Chang RJ, Ehrmann DA, Ibanez L, Lobo RA, Rosenfield RL, Shapiro J, Montori VM, Swiglo BA. Evaluation and treatment of hirsutism in premenopausal women: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2008;93:1105-1120.
39. Gregoriou O, Papadias K, Konidaris S, Bakalianou K, Salakos N, Vrachnis N, Creatsas G. Treatment of hirsutism with combined pill containing drospirenone. Gynecol Endocrinol 2008;24:220-223.
40. Batukan C, Muderris II. Efficacy of a new oral contraceptive containing drospirenone and ethinyl estradiol in the long-term treatment of hirsutism. Fertil Steril 2006;85:436-440.
41. Van der Spuy ZM, le Roux PA. Cyproterone acetate for hirsutism. Cochrane Database Syst Rev 2003:CD001125.
42. Franks S, Layton A, Glasier A. Cyproterone acetate/ethinyl estradiol for acne and hirsutism: time to revise prescribing policy. Hum Reprod 2008;23:231-232.
43. Sänger N, Stahlberg S, Manthey T, Mittmann K, Mellinger U, Lange E, Kuhl H, Wiegratz I. Effects of an oral contraceptive containing 30 mg ethinyl estradiol and 2 mg dienogest on thyroid hormones and androgen parameters: conventional vs. extended-cycle use. Contraception 2008;77:420-425.
44. Abrams LS, Skee DM, Natarajan J, Wong FA, Lasseter KC. Multiple-dose pharmacokinetics of a contraceptive patch in healthy women participants Contraception 2001;64:287-294.
45. White T, Jain JK, Stanczyk FZ. Effect of oral versus transdermal steroidal contraceptives on androgenic markers. Am J Obstet Gynecol 2005;192:2055-2059.
46. Graziottin A. A review of transdermal hormonal contraception: focus on the ethinylestradiol/norelgestromin contraceptive patch. Treat Endocrinol 2006;5:359-365.
47. Martindale. The extra pharmacopoeia. 30th ed. London: Pharmaceutical Press; 1993. p 827.
48. Cumming DC, Yang JC, Rebar RW, Yen SS. Treatment of hirsutism with spironolactone. JAMA 1982;247:1295-1298.
49. Christy NA, Franks AS, Cross LB. Spironolactone for hirsutism in polycystic ovary syndrome. Ann Pharmacother 2005;39:1517-1521.
50. Spritzer PM, Lisboa KO, Mattiello S, Lhullier F. Spironolactone as a single agent for long-term therapy of hirsute patients. Clin Endocrinol (Oxf) 2000;52:587-594.
51. Farquhar C, Lee O, Toomath R, Jepson R. Spironolactone versus placebo or in combination with steroids for hirsutism and/or acne. Cochrane Database Syst Rev 2003:CD000194.
52. Kele timur F, Everest H, Unlü hizarci K, Bayram F, Sahin Y. A comparison between spironolactone and spironolactone plus finasteride in the treatment of hirsutism. Eur J Endocrinol 2004;150:351-354.
53. Cumming DC. Use of spironolactone in treatment of hirsutism. Cleve Clin J Med 1990;57:285-287.
54. Couzinet B, Pholsena M, Young J, Schaison G. The impact of a pure anti-androgen (flutamide) on LH, FSH, androgens and clinical status in idiopathic hirsutism. Clin Endocrinol (Oxf) 1993;39:157-162.
55. Ciotta L, Cianci A, Marletta E, Pisana L, Aglianò A, Palumbo G. Treatment of hirsutism with flutamide and a low-dosage oral contraceptive in polycystic ovarian disease patients. Fertil Steril 1994;62:1129-1135.
56. Cusan L, Dupont A, Gomez JL, Tremblay RR, Labrie F. Comparison of flutamide and spironolactone in the treatment of hirsutism: a randomized controlled trial. Fertil Steril 1994;61:281-287.
57. Famularo G, De Simone C, Minisola G, Nicotra GC. Flutamide-associated acute liver failure. Ann Ital Med Int 2003;18:250-253.
58. García Cortés M, Andrade RJ, Lucena MI, Sánchez Martínez H, Fernández MC, Ferrer T, Martín-Vivaldi R, Peláez G, Suárez F, Romero-Gómez M, et al. Flutamide-induced hepatotoxicity: report of a case series. Rev Esp Enferm Dig 2001;93:423-432. (Pubitemid 32757636)
59. Andrade RJ, Lucena MI, Fernández MC, Suárez F, Montero JL, Fraga E, Hidalgo F. Fulminant liver failure associated with flutamide therapy for hirsutism. Lancet 1999;353:983.
60. Castelo-Branco c, del Pino M. Hepatotoxicity during lowdose flutamide treatment for hirsutism. Gynecol Endocrinol 2009;25:419-422.
61. Wysowski DK, Freiman JP, Tourtelot JB, Horton ML. Fatal and nonfatal hepatotoxicity associated with flutamide. Ann Intern Med 1993;118:860-864.
62. Martin KA, Chang RJ, Ehrmann DA, Ibanez L, Lobo RA, Rosenfield RL, Shapiro J, Montori VM, Swiglo BA. Evaluation and treatment of hirsutism in premenopausal women: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2008;93:1105-1120.
63. Calaf J, López E, Millet A, Alcañiz J, Fortuny A, Vidal O, Callejo J, Escobar-Jiménez F, Torres E, Espinó s JJ; Spanish Working Group for Hirsutism. Long-term efficacy and tolerability of flutamide combined with oral contraception in moderate to severe hirsutism: a 12-month, double-blind, parallel clinical trial. J Clin Endocrinol Metab 2007;92:3446-3452.
64. Taner C, Inal M, Ba ogul O, Onoglu A, Karanfil C, Tinar S, Ispahi C. Comparison of the clinical efficacy and safety of flutamide versus flutamide plus an oral contraceptive in the treatment of hirsutism. Gynecol Obstet Invest 2002;54: 105-108.
65. Devoto E, Aravena L. Effectiveness of flutamide alone or combined with oral contraceptives in thetreatment of hirsutism in women. Rev Med Chil 2004;132:845-852.
66. Mü derris II, Bayram F, Gü ven M. A prospective, randomized trial comparing flutamide (250 mg/d) and finasteride (5mg/d) in the treatment of hirsutism. Fertil Steril 2000;73:984-987.
67. Falsetti L, Gambera A. Comparison of finasteride and flutamide in the treatment of idiopathic hirsutism. Fertil Steril 1999;72:41-46. (Pubitemid 29300259)
68. Castelo-Branco C, Moyano D, Gómez O, Balasch J. Longterm safety and tolerability of flutamide for the treatment of hirsutism. Fertil Steril 2009;91:1183-1188.
69. Lakryc EM, Motta EL, Soares JM Jr, Haidar MA, de Lima GR, Baracat EC. The benefits of finasteride for hirsute women with polycystic ovary syndrome or idiopathic hirsutism. Gynecol Endocrinol 2003;17:57-63.
70. Wong IL, Morris RS, Chang L, Spahn MA, Stanczyk FZ, Lobo RA. A prospective randomized trial comparing finasteride to spironolactone in the treatment of hirsute women. J Clin Endocrinol Metab 1995;80:233-238.
71. Townsend KA, Marlowe KF. Relative safety and efficacy of finasteride for treatment of hirsutism. Ann Pharmacother 2004;38:1070-1073.
72. Beigi A, Sobhi A, Zarrinkoub F. Finasteride versus cyproterone acetate-estrogen regimens in the treatment of hirsutism. Int J Gynaecol Obstet 2004;87:29-33.
73. Faloia E, Filipponi S, Mancini V, Di Marco S, Mantero F. Effect of finasteride in idiopathic hirsutism. J Endocrinol Invest 1998;21:694-698.
74. Tartagni M, Schonauer MM, Cicinelli E, Petruzzelli F, De Pergola G, De Salvia MA, Loverro G. Intermittent low-dose finasteride is as effective as daily administration for the treatment of hirsute women. Fertil Steril 2004;82:752-755.
75. Bayram F, Mü derris I, Gü ven M, Ozçelik B, Kele timur F. Low-dose (2.5 mg/day) finasteride treatment in hirsutism. Gynecol Endocrinol 2003;17:419-422.
76. Bayram F, Mü derris II, Gü ven M, Kele timur F. Comparison of high-dose finasteride (5 mg/day) versus low-dose finasteride (2.5 mg/day) in the treatment of hirsutism. Eur J Endocrinol 2002;147:467-471.
77. Kele timur F, Everest H, Unlühizarci K, Bayram F, Sahin Y. A comparison between spironolactone and spironolactone plus finasteride in the treatment of hirsutism. Eur J Endocrinol 2004;150:351-354.
78. Moghetti P, Tosi F, Tosti A, Negri C, Misciali C, Perrone F, Caputo M, Muggeo M, Castello R. Comparison of spironolactone, flutamide, and finasteride efficacy in the treatment of hirsutism: a randomized, double blind, placebo-controlled trial. J Clin Endocrinol Metab 2000;85:89-94.
79. Lumachi F, Rondinone R. Use of cyproterone acetate, finasteride, and spironolactone to treat idiopathic hirsutism. Fertil Steril 2003;79:942-946.
80. Yilmaz M, KarakoçA, Törü ner FB, Cakir N, Tiras B, Ayvaz G, Arslan M. The effects of rosiglitazone and metformin on menstrual cyclicity and hirsutism in polycystic ovary syndrome. Gynecol Endocrinol 2005;21:154-160. (Pubitemid 41597556)
81. Costello MF, Shrestha B, Eden J, Johnson NP, Sjoblom P. Metformin versus oral contraceptive pill in polycystic ovary syndrome: a Cochrane review. Hum Reprod 2007;22:1200-1209.
82. Morin-Papunen LC, Vauhkonen I, Koivunen RM, Ruokonen A, Martikainen HK, Tapanainen JS. et al. Endocrine and metabolic effects of metformin versus ethinyl estradiol-cyproterone acetate in obese women with polycystic ovary syndrome: a randomized study. J Clin Endocrinol Metab 2000;85:3161-3168.
83. Ganie MA, Khurana ML, Eunice M, Gupta N, Gulati M, Dwivedi SN, Ammini AC Comparison of efficacy of spironolactone with metformin in the management of polycystic ovary syndrome: an open-labeled study. J Clin Endocrinol Metab 2004;89:2756-2762.
84. Yilmaz M, KarakoçA, Tö rü ner FB, Cakir N, Tiras B, Ayvaz G, Arslan M. The effects of rosiglitazone and metformin on menstrual cyclicity and hirsutism in polycystic ovary syndrome. Gynecol Endocrinol 2005;21:154-160. (Pubitemid 41597556)
85. Cosma M, Swiglo BA, Flynn DN, Kurtz DM, Labella ML, Mullan RJ, Elamin MB, Erwin PJ, Montori VM. Clinical review: Insulin sensitizers for the treatment of hirsutism: a systematic review and metaanalyses of randomized controlled trials. J Clin Endocrinol Metab 2008;93:1135-1142. (Pubitemid 351519697)
86. Castelo-Branco C, Martínez de, Osaba MJ, Martínez S, Fortuny A. Effects of a long-acting gonadotropinreleasing hormone analog on the pituitary-ovarian-adrenal axis in women with severe hirsutism. Metabolism 1996;45: 24-27.
87. Castelo-Branco C, Martínez de, Osaba MJ, Pons F, Fortuny A. Gonadotropin-releasing hormone analog plus an oral contraceptive containing desogestrel in women with severe hirsutism: effects on hair, bone, and hormone profile after 1-year use. Metabolism 1997;46:437-440.
88. Pazos F, Escobar-Morreale HF, Balsa J, Sancho JM, Varela C. Prospective randomized study comparing the long-acting gonadotropin-releasing hormone agonist triptorelin, flutamide, and cyproterone acetate, used in combination with an oral contraceptive, in the treatment of hirsutism. Fertil Steril 1999;71:122-128.
89. Board JA, Rosenberg SM, Smeltzer JS. Spironolactone and estrogen-progestin therapy for hirsutism. South Med J 1987;80:483-486.
90. Swiglo BA, Cosma M, Flynn DN, Kurtz DM, Labella ML, Mullan RJ, Erwin PJ, Montori VM. Clinical review: antiandrogens for the treatment of hirsutism: a systematic review and metaanalyses of randomized controlled trials. Clin Endocrinol Metab 2008;93:1153-1160. (Pubitemid 351519699)
91. Inal MM, Yildirim Y, Taner CE. Comparison of the clinical efficacy of flutamide and spironolactone plus Diane 35 in the treatment of idiopathic hirsutism: a randomized controlled study. Fertil Steril 2005;84:1693-1697.
92. Sahin Y, Dilber S, Kele timur F. Comparison of Diane 35 and Diane 35 plus finasteride in the treatment of hirsutism. Fertil Steril 2001;75:496-500.
93. Kele timur F, Everest H, Unlühizarci K, Bayram F, Sahin Y. A comparison between spironolactone and spironolactone plus finasteride in the treatment of hirsutism. Eur J Endocrinol 2004;150:351-354