Efficacy of low-dose GnRH analogue (Buserelin) in the treatment of hirsutism

The aim of the present study was to evaluate the effect of low dose GnRH analogue (Buserelin) on gonadal steroid secretion and hair growth in hirsute women. The drug was administered as a nasal spray (200 micrograms tid) to reduce gonadal steroid secretion. Eight hirsute women were treated for six month with the gonadotropin-releasing hormone analog. All had subclinical polycystic ovary syndromes on the basis of ultrasound or hormonal data, together with ovary dysfunctions and irregular menses. None had adrenal or pituitary dysfunction. The score of hirsutism was evaluated according to Ferriman and Gallway; pituitary function was evaluated measuring the FSH and LH response to GnRH stimulation and gonadal steroid secretion by measuring estradiol, progesterone, total plasma testosterone, androstenedione and androstanediol. Sex hormone binding globulin, insulin, prolactin and DHEA-S were also measured. The suppression of ovarian steroid secretion was confirmed by reductions in total plasma testosterone, and rostenedione and androstanediol that were detectable after one month of treatment. FSH and LH responses to GnRH stimulation were inhibited consistent with pituitary desensitization. No significant side effects were observed and all patients completed the trial. The score of hirsutism was 24 +/- 5 before, 19.6 +/- 6 by the 3rd month and 16.8 +/- 5.1 by the 6th month of treatment (p < 0.001); the effect was still evident 1 and 6 months after the withdrawal of the therapy (14.8 +/- and 15.8 +/- 5 respectively; p < 0.001). Our findings indicate that Buserelin is useful in the treatment of non adrenal hirsutism when other forms of therapy are contraindicated or poorly tolerated by the patient.