Medroxyprogesterone acetate therapy in hirsutism

Abstract

In a pilot study, 26 hirsute females were treated with medroxyprogesterone acetate (MPA). We used an ointment containing 0.2% MPA in 13 patients, subcutaneous injection of MPA into the hairy areas of the face in five patients and intramuscular injection of low doses of MPA in 13 patients, each for an average duration of 16 weeks. The best clinical result was achieved by subcutaneous injection, the next most successful was the intramuscular injection, and the least successful was the topical application. Hair diameter measurements, carried out in 12 patients, were found to be reduced by 33% on average. Serum androgen levels, measured monthly, remained unaffected by topical treatment, but were decreased by intralesional and intramuscular injection. The clinical improvement with topical therapy despite the lack of effect on serum androgen levels supports the idea that MPA works partly at the cellular level. The intralesional and systemic injection of MPA may exert an effect both by systemic androgen suppression and a local action.

The Effect of Drugs on Hair

“…Despite the clinical effectiveness of systemic anti-androgen therapy and limited reports of the efficacy of intradermally injected medroxyprogesterone acetate (SCHMIDT et al 1985), topical application of anti-androgens has been without clinical benefit (see Chap. 36).…”