Treatment of Hirsutism by Adrenal and Ovarian Suppression

Abstract

Adrenal suppression has been used in the treatment of 30 patients with hirsutism and ovarian suppression by cyclic administration of tablets of mestranol plus norethynodrel4 in 15 patients. In 17 of the patients the response has been monitored by weighing the hair grown on selected areas of the face, thighs, and forearms, in 6 serial estimations of plasma testosterone concentration have been made. Prednisone therapy resulted in reduction of hair growth in 5 out of 30 patients, restored menstrual regularity in 10 out of 17 and corrected infertility in 6 out of 9 patients. The reduction of hair growth was slow, and often took 12 months to become apparent. Ovarian suppression reduced hair growth in 10 out of 15 patients treated; the response could be detected within a few months and was apparently produced by the estrogenic component of the tablets. In the patients on whom serial estimations were made, pretreatment plasma testosterone concentrations were within the normal female range. It was reduced by adrenal suppression in 3 patients who responded to this form of treatment, and also in 2 patients responding to ovarian suppression. In 1 patient who failed to respond to ovarian suppression, the plasma testosterone was unaltered.