Treatment of hirsutism with a gonadotropin-releasing hormone agonist and estrogen replacement therapy.

OBJECTIVE

To determine the efficacy of treatment of significant hirsutism with a GnRH agonist (GnRH-a) and estrogen and progestin replacement therapy.

DESIGN

Clinical series.

SETTING

Ambulatory gynecology clinic in a community hospital.

PATIENTS: Ten women with significant hirsutism caused by polycystic ovarian disease.

INTERVENTIONS: The patients were treated with leuprolide acetate 20 micrograms/kg per day in combination with E2 (2 mg) and medroxyprogesterone acetate (5 mg) for 6 months.

MAIN OUTCOME MEASURE: Hirsutism scores and hair growth rates determined before and upon completion of treatment protocol.

RESULTS

Hirsutism scores and hair growth rates significantly decreased by 23% and 26%, respectively. The duration of hirsutism was the only significant covariate for hirsutism scores and hair growth rates. Only two patients had minimal, irregular bleeding that was corrected by increasing the estrogen dose.

CONCLUSION

The combination of a GnRH-a and estrogen replacement therapy was an effective and well-tolerated treatment in a small group of women with significant hirsutism caused by PCOD.