Medications for Hirsutism

bandanna · 09-23-2002, 01:16 AM

hi everyone,

i have an appointment to see my endocrinologist this week and would really appreciate your input re: medication for hirsutism.

i am currently on aldactone but am open to other meds as i am concerned about the steroids in aldactone. i would be interested in hearing about both synthetic and alternative meds.

i am listing my concerns below. please let me know if you have noticed the same yourself:
- upper arms and calves muscles development (though not really grossly large but large enough in the absence of weight lifting)
- more hair (i am not sure if it is because i already have the condition and that i am just noticing it more or it is because of aldactone)

i was reading that the steroids in aldactone may in fact, cause more androgenic side effects such as more excess hair, voice deepening etc. i'm glad many women on this board have found success with aldactone but i'm just concerened that it is not working out for me. i'm on 50mgs. my testosterone level is only slightly above the norm in one blood test and was normal in another. my fsh:lh ratio was 1:4. i believe mine is more idiopathic hirsutism. but i will get more blood test done again this week as the last blood test was done a few months ago.

i also read in another post that taking anti-androgen may in fact elevate testosterone levels as it works to block the effects of testosterone and may trigger the pituitary glands to produce more thinking that the body does not have enough. if any of you have heard anything about this, please share.

if you have any other questions that you can recommend asking my doctor, please feel free to pass it along as well.

thank you so much for your replies. i'd really appreciate your input so that i am prepared when i see my doctor on wednesday. if you are reading this post after wednesday, i would still appreciate your input.

thanks,
bandanna

Maureen77 · 09-23-2002, 02:16 AM

Re: your testost. levels.
What some dr.'s say are "normal" are really not normal. Did you know that all lab normal ranges are taken from the population that uses that particular lab. And if 10% women have PCOS like some statistics say, then their numbers are skewing the results of EVERY lab higher? Interesting to think about. Even so, any number 50 or above is elevated according to the INCIID site.

And, it's the FREE TESTOSTERONE level that is most important, the active form. Sometimes your total blood testosterone level is normal and the free is high. The total level is the amount bound to proteins in the blood, and is essentially meaningless according to some specialists, since it is the Free version that is active in the body.

Re: the FSH/LH level
If it is 1:4 then it is not idiopathic hirsuitism (which means there is no cause), you have a classic sign of PCOS and the hair is due to that. If the endo does not agree you have PCOS, you need a new endo. The ratio is 1:1 in "normal" women, since it is not, you have something that needs to be diagnosed and pronto.

How's your insulin?

Good luck, I'll be thinking of you! and be sure to report back!

P.S. this is an excellent article from the American Assoc. of Clinical Endocrinologists http://www.aace.com/clin/guidelines/...genism2001.pdf

Melynnez · 09-26-2002, 06:24 AM

I was on Spironolactone for about 5 months and it worked great for me. My body hair started to take longer to grow back and seemed to not be so thick. It also helped the hair on my head to grow back! I am currently not taking it because of TTC ...but I would gladly go back on it again.

Mathisk · 09-26-2002, 10:40 AM

I took aldactone for about 6 years. I do beleive it gave me more hair. It cleared me of breakouts and made the hair finer and more manageable so I stayed on it. I think you are on to something there. I don't know of another drug that will help however. Im currently on nothing but antibiotics for the monthly breakouts. I am getting laser and perhaps that will help. I have only had it once, a week ago.

bandanna · 09-27-2002, 04:24 PM

hi,

thank you for getting back to me.

i saw my endocrinologist on wednesday. we took some blood tests including my free testosterone in june so i finally know what the results were. my free testosterone is showing to be below 1 (i'm in canada) so my endocrinologist think that i'm okay since it is showing to be even below. however, my free testosterone has always been normal, it was my total testosterone that was just slightly elevated in the past. i understand maureen's point about "normal" is really defined by the lab where a person is tested. however, i was tested at 3 different labs (twice in april (i saw two doctors to get second opinion) and once in june). the only time my total testosterone was showing to be "abnormal" was in one of blood test.

since it's really the free testosterone that's causing the hair growth and mine appears to be "normal", i am wondering if i should continue with aldactone. i am not really noticing any difference (granted that i am only on 50mgs) and am not comfortable after reading that it might actually promote more hair growth. i also am noticing other things happening on my skin that i am not sure if it is related to taking aldactone. my facial pores are getting bigger - could it be due to sodium and potassium retention caused by aldactone? plus, i am getting more really visible veins on my hands, uppper arms and feet which i read another cyster wrote about in the past.

i am wondering if my excess hair is more genetics than pcos. i know that i have pcos because of my fsh:lh ratio but apart from the heavy periods and the hair, i don't really have any other symptoms. i am wondering if the excess hair growth is caused by something else and not pcos-related.

i would really appreciate your input.

thank you once again for replying.

Maureen77 · 09-28-2002, 10:31 AM

Yes, I do believe it is the DHT (active form of testosterone) receptors in the skin that is inherited. For example, why some men go bald and some do not -- when clearly the men who keep their hair well into old age have massive amounts of testosterone!

It's how your body processes it. Whether your skin and hair follicles have the enzymes to allow conversion of the hormones to their active forms.

This is not to say that Aldactone won't work for you. It certainly should. Much like Propecia and the like are used for balding men to reduce DHT activity. (although I still recommend saw palmetto instead!)

Aldactone has been used for many years to prevent hormonal acne, hair growth and loss. There are many success stories here on the websie as well. I do not at all understand why Aldactone was labeled it would promote hair growth - except hair growth on your head. If it was listed as a side effect of the med - what percentage of patients trying it? Have you read Dr. Geoffrey Redmond's website? www.hormonehelpny.com

Large pores would be similar, the skin reacting to androgens and producing more oil, I doubt it would be potassium related.

Serena · 10-05-2002, 10:32 PM

Hi Bandanna,

I went looking for this post because I had a flash in the middle of the night! The reason your veins are sticking out more is most likely because Aldactone is a mild diuretic, so there's no bloating to cover the veins. Make sense?

Good luck!