Hirsutism - Excess Body hair in women-  Causes - investigation and Treatment

What is cyproterone acetate?

Cyproterone acetate is an anti-androgen; it competes at the receptor sites (hormones) with androgens and reduces their effects. Dianette (Schering) is a special combined oral contraceptive pill that contains 2mg cyproterone acetate.

Higher dose cyproterone acetate may be considered. It is prescribed in a 'reverse-sequential dose regimen' when there is an inadequate response to previous medication. Usually, progestogens are taken in the latter half of cyclical oestrogen therapy, in HRT for example (HRT and progestogen). Cyproterone acetate is stored in the fat tissues and when it is administered late in the cycle there is a tendency for the period to be delayed. Cyproterone acetate 50mg or 100mg is, therefore, given on the first 10 days of each course of the pill. When cyproterone acetate is given in combination with the pill, it is likely to reduce hair growth, lighten the hair colour, and decrease the hair thickness in hirsute areas. Your doctor may re quest blood tests from time to time to check hormone levels and to ensure that your chemistry is not being affected adversely. Until recently, it was believed that cyproterone pills (Dianette) carried a greater risk of being associated with thromboembolism. This no longer appears valid.^2007-01

Medical treatments for hirsutism are not rapidly effective, overnight remedies. New hair follicles are developing all the time and each lasts for about three years. In one study of hirsute patients, 10-20% of patients were improving after six months and 90% were happy after 36 months. These treatments only work whilst they are being taken. They do not cure the underlying abnormality so that when treatment is discontinued the hirsutism may recur.

Related Medical Abstracts - Click on the paper title:-

• Cyproterone acetate/ethinyl estradiol for acne and hirsutism: time to revise prescribing policy. (2007-01)
• Rosiglitazone and ethinyl estradiol/cyproterone acetate as single and combined treatment of overweight women with polycystic ovary syndrome and insulin resistance. (2006-01)
• Comparison of the clinical efficacy of flutamide and spironolactone plus Diane 35 in the treatment of idiopathic hirsutism: a randomized controlled study. (2005-01)
• Finasteride versus cyproterone acetate-estrogen regimens in the treatment of hirsutism. (2004-01)
• Comparison of the efficiency of anti-androgenic regimens consisting of spironolactone, Diane 35, and cyproterone acetate in hirsutism. (2003-01)
• Use of cyproterone acetate, finasteride, and spironolactone to treat idiopathic hirsutism. (2003-02)
• The risk of venous thromboembolism in women prescribed cyproterone acetate in combination with ethinyl estradiol: a nested cohort analysis and case-control study. (2003-03)
• Efficacy of the combination ethinyl oestradiol and cyproterone acetate on endocrine, clinical and ultrasonographic profile in polycystic ovarian syndrome. (2001-01)

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

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