{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T09:35:26Z","timestamp":1767864926956,"version":"3.49.0"},"reference-count":42,"publisher":"The Endocrine Society","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,4,1]]},"abstract":"<jats:p>Sixty-six hirsute women were randomized and treated with 1) flutamide (n = 15), 250 mg\/day; 2) finasteride (n = 15), 5 mg\/day; 3) ketoconazole (n = 16), 300 mg\/day; and 4) ethinyl estradiol (EE)-cyproterone acetate (CPA; n = 20), 0.01 mg EE\/day for the first week, 0.02 mg EE\/day for the second week, and 0.01 mg EE\/day for the third week, followed by a pause of 7 days, then 12.5 mg CPA\/day added during the first 10 days of every month for 12 months. Hirsutism was evaluated by the Ferriman-Gallwey score, and hair diameter and hair growth rate were determined by a special image analysis processor in basal conditions and after 90, 180, 270, and 360 days of treatment. All treatments produced a significant decrease in the hirsutism score, hair diameter, and daily hair growth rate: flutamide, \u221255 \u00b1 13%, \u221221 \u00b1 14%, and \u221237 \u00b1 18%; finasteride, \u221244 \u00b1 13%, \u221216 \u00b1 12%, and\u2212 27 \u00b1 14%; ketoconazole, \u221253 \u00b1 18%, \u221214 \u00b1 12%, and \u221230 \u00b1 21%; and EE-CPA, \u221260 \u00b1 18%, \u221220 \u00b1 11%, and \u221228 \u00b1 21%.<\/jats:p><jats:p>Some differences existed among treatments with regard to effectiveness; EE-CPA and flutamide seem to be the most efficacious in improving hirsutism. For the hirsutism score, a greater decrease was seen with EE-CPA (\u221260 \u00b1 18%) than with finasteride (\u221244 \u00b1 13%; P &amp;lt; 0.01) and a greater decrease was seen with flutamide (\u221258 \u00b1 18%) than with finasteride (\u221244 \u00b1 13%; P &amp;lt; 0.05). Flutamide is the fastest in decreasing hair diameter; EE-CPA is the fastest in slowing down hair growth, even though at the end of the treatment there was a significant difference between flutamide and finasteride only (\u221241 \u00b1 18% vs.\u2212 27 \u00b1 14%; P &amp;lt; 0.05).<\/jats:p><jats:p>Flutamide, ketoconazole, and EE-CPA induced a significant decrease in total and free testosterone, 5\u03b1-dihydrotestosterone, dehydroepiandrosterone, dehydroepiandrosterone sulfate, and androstenedione plasma levels. During the EE-CPA treatment, gonadotropins were suppressed, and the sex hormone-binding globulin level increased. Finasteride induced a decrease in dehydroepiandrosterone sulfate and 5\u03b1-dihydrotestosterone and an increase in testosterone levels.<\/jats:p><jats:p>Very few side-effects were observed during treatment with low doses of flutamide, EE-CPA, and particularly finasteride. Flutamide induced a decrease whereas EE-CPA induced an increase in triglycerides and cholesterol, showing higher values within the normal range. Ketoconazole induced several side-effects and complications, and several people dropped out of the study.<\/jats:p><jats:p>Despite different modalities of action and significantly different effects on androgen levels, low doses of flutamide, finasteride, and EE-CPA constitute very satisfactory alternative therapeutic regimens in the treatment of hirsutism.<\/jats:p>","DOI":"10.1210\/jcem.84.4.5591","type":"journal-article","created":{"date-parts":[[2014,1,8]],"date-time":"2014-01-08T17:04:05Z","timestamp":1389200645000},"page":"1304-1310","source":"Crossref","is-referenced-by-count":86,"title":["A Prospective Randomized Trial Comparing Low Dose Flutamide, Finasteride, Ketoconazole, and Cyproterone Acetate-Estrogen Regimens in the Treatment of Hirsutism"],"prefix":"10.1210","volume":"84","author":[{"given":"S.","family":"Venturoli","sequence":"first","affiliation":[{"name":"Reproductive Medicine Unit, Institute of Obstetrics and Gynecology, and the Department of Evolutionary-Experimental Biology (O.M.), University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Marescalchi","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Unit, Institute of Obstetrics and Gynecology, and the Department of Evolutionary-Experimental Biology (O.M.), University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. M.","family":"Colombo","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Unit, Institute of Obstetrics and Gynecology, and the Department of Evolutionary-Experimental Biology (O.M.), University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Macrelli","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Unit, Institute of Obstetrics and Gynecology, and the Department of Evolutionary-Experimental Biology (O.M.), University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Ravaioli","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Unit, Institute of Obstetrics and Gynecology, and the Department of Evolutionary-Experimental Biology (O.M.), University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Bagnoli","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Unit, Institute of Obstetrics and Gynecology, and the Department of Evolutionary-Experimental Biology (O.M.), University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Paradisi","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Unit, Institute of Obstetrics and Gynecology, and the Department of Evolutionary-Experimental Biology (O.M.), University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Flamigni","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Unit, Institute of Obstetrics and Gynecology, and the Department of Evolutionary-Experimental Biology (O.M.), University of Bologna, Bologna, 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