A randomized cross-over study was done to compare the therapeutic efficacy of
cyproterone acetate (CPA) and a
depot preparation of the
LHRH superagonist (DTrp6-LHRH) in 10 patients with polycystic
ovarian disease (PCO). All patients were treated with both agents (50 mg/day CPA, orally and (3 mg DTrp6-
LHRH, im, approximately once a month) for 3 months, the 2 treatment periods being separated by 6 months. Both treatments resulted in marked clinical improvement, with diminished
acne and seborrhoea and normalization of ovarian size by ultrasonographic criteria. In response to CPA treatment, basal plasma
gonadotropin levels decreased, but the response to a
LHRH test was not completely suppressed. Plasma
estradiol,
estrone,
testosterone, and
androstenedione levels significantly decreased, but urinary 3 alpha-androstanediol and plasma
dehydroepiandrosterone sulfate levels did not change significantly. In contrast to CPA treatment, both basal and stimulated
gonadotropin levels were completely suppressed after 3 weeks of treatment with DTrp6-
LHRH. After a slight initial evaluation on day 2, plasma
estrogen and
androgen levels, with the exception of
dehydroepiandrosterone sulfate fell into the castrate range urinary 3 alpha-androstanediol excretion decreased significantly. Thus, in patients with PCO,
LHRH-A induced more complete
gonadotropin inhibition than did CPA. After cessation of either
therapy, the disease rapidly recurred.