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Cyproterone Acetate (Androgenetic Alopcia (AGA) Female Pattern)

posted by HairSite Admin, 07.02.2009, 13:30

Cyproterone Acetate

Cyproterone acetate blocks DHT-androgen receptor binding and, given its steroid structure, has progestogen and antigonadotropic properties. In women of child-bearing potential, estrogens are usually given with cyproterone acetate to reinforce the latter effect and to ensure regular menses. Two combinations of cyproterone acetate with 50 μg ethinyl estradiol are utilized
for their antiandrogen effect in premenopausal women: (1) 100 mg along with estrogen on days 5–15 and estrogen alone on days 16–25 (cyclical antiandrogen therapy or CAT) for hirsutism or (2) 2 mg in combination with
estrogen on days 5–25 (Diane®). In postmenopausal women, 50 mg of cyproterone acetate daily may be used alone. Potential side-effects are dose related and include menstrual irregularity, weight gain, breast tenderness,
decreased libido, depression, and nausea.

There have been few controlled clinical trials of cyproterone acetate in FPHL. In one study 20 female patients with AGA were treated for 1 year with daily 50 μg ethinyl estradiol and 2 mg cyproterone acetate (Diane®)
plus an additional 20 mg cyproterone acetate on days 5–20 of the menses and were compared to 10 untreated control patients with AGA for 1 year . Trichogram results as well as hair diameter on the fronto-cranial and
temporal scalp were assessed. There was a statistically significant increase in the anagen/telogen ratio but no decrease in vellus hairs on the fronto-cranial scalp in the cyproterone acetate group compared to controls. In
another study, 40 patients with FPHL were treated with cyproterone acetate for 12 months, 22 postmenopausal women with 50 mg cyproterone acetate daily, and 18 premenopausal women with 100 mg cyproterone acetate daily for 10 days each month along with a combination oral contraceptive pill [89]. Of 40 women, 17 (42.5%) had a positive response documented photographically.
These results were almost identical to the comparative group of 40 patients treated with spironolactone.

A 48-week trial conducted by Vexiau et al. included equal numbers of women (33 each group) with female AGA treated with 52 mg per day of cyproterone acetate plus ethinyl estradiol 35 μg for 20 of every 28 days or 2% topical
minoxidil solution 1 ml bid plus combined oral contraceptive use [105]. Between baseline and 12 months, there was no significant difference in the mean number of target area hairs in the cyproterone group but an increase in the minoxidil group. There was no difference in the results with cyproterone acetate and FPHL with the presence or absence of other signs of hirsutism.
Dawber et al. has suggested that there is a minimally effective dose of cyproterone acetate, as 24 out of 29 women had improvement in FPHL when treated with 50 μg ethinyl estradiol and 200 mg cyproterone acetate
daily but 14 of 17 who remained on Diane® (2 mg cyproterone acetate) failed to maintain that response.


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Complete thread:

• Antiandrogens - HairSite Admin, 26.01.2009, 07:21 (Androgenetic Alopcia (AGA) Female Pattern)
  • Spironolactone - HairSite Admin, 27.01.2009, 12:54
  • Flutamide - HairSite Admin, 28.01.2009, 13:25
  • Antiandrogens - Jessie, 30.01.2009, 01:51
    • Antiandrogens - Nutmeg, 06.02.2009, 19:10
  • Cyproterone Acetate - HairSite Admin, 07.02.2009, 13:30