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Study Objective: Hirsutism has negative impact on adolescent psychosocial development for both cosmetic and endocrine reasons. This study evaluated the effectiveness of a new intermittent, low-dose finasteride regimen consisting of 2.5 mg of drug given every 3 days (1 day of treatment, 2 days of drug withdrawal) for 6 months in girls with hirsutism by polycystic ovarian syndrome (PCOS) or idiopathic hirsutism (IH)., Design and Participants: Twenty-eight girls (15-19 y old) with hirsutism were randomly assigned to 2 treatment groups and treated for 6 months. Fourteen patients (7 with IH, 7 with PCOS) received finasteride; fourteen patients (7 with IH, 7 with PCOS) received placebo. Hirsutism score (HS), clinical, and hormonal effects were compared between the 2 groups., Results: In patients treated with finasteride, the HS value at 6 months was 52.9% lower than that observed at baseline in girls with IH, and 52.8% lower in girls with PCOS (P < .0001 for both). Similarly, the 3α-17 β-androstenediol glucuronide serum levels were decreased by 34.8% in patients with IH, and by 47.5% in patients with PCOS (P < .0001, respectively). Finasteride treatment was well tolerated and did not alter values of BMI, serum levels of sexual hormones, metabolic parameters related to liver and kidney function as well as glycemic and lipidic asset., Conclusions: A low-dose of finasteride, given every 3 days, reduces the HS in young patients affected by PCOS or IH. Compared with conventional continuous finasteride administration, the intermittent low-dose regimen has similar efficacy with the advantage to be safer and less expensive., (Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

The sulphoconjugates of delta 5-C19O2 steroids were determined in 32 women with idiopathic hirsutism (IH). The plasma and urinary levels of 5-androsten-3 beta, 17 beta-diol (delta 5, 3 beta-diol) were 82 +/- 24 ng/ml and 169 +/- 170 micrograms/24 h respectively for the monosulphate ester and 193 +/- 101 ng/ml and 180 +/- 108 micrograms/24 h for the disulphate ester. These levels are statistically higher (p less than 0,001) as compared with the levels observed in women without IH (30 +/- 20 ng/ml and 23 +/- 13 micrograms/24 h for the monosulphate, 78 +/- 40 ng/ml and 48,0 +/- 23,7 micrograms/24 h for the disulphate). There is a correlation between the urinary levels of the monosulphate of delta 5, 3 beta-diol (y) and of the dehydroepiandrosterone sulphate (S-DHA) (x) : y (microgram/24 h) = 0,124x + 16,8; r = 0,93 (p less than 0,01) and n = 32. The plasma levels of S-DHA ranged form 1,250 ng/ml to 7,000 ng/ml in the abnormal population and from 1,000 ng/ml to 2,400 ng/ml in the normal population. A concomitant determination of plasma free androgens showed that 60 % of the dehydroepiandrosterone values were above the upper limits of normal values. Conversely, the testosterone and androstenedione levels were only higher in 20 % and 27 % of cases respectively. These results suggest that the possible importance of the sulphoconjugates of delta 5-C19O2 steroids in the IH pathogeny should not be overlooked.