This has been marketed for the treatment of male hypersexuality and prostatic cancer and has been combined with ethinyloestradiol for the treatment of female hirsutism and acne. Unfortunately, prolonged use at high doses is associated with an increased risk of potentially severe hepatoxicity. The result is a reduction in cyclical follicle-stimulating hormone output and, therefore, the absence of gonadal androgen production. The disadvantage of these drugs is that they cannot be given orally and are still relatively expensive. In some cases, it may be appropriate to bring forward surgical intervention if these compounds are prescribed.
Side effects are relatively minor, but include nasal irritation, headaches and nervous response.
A periodic review of the clinical progress with respect to the desired effects of these drugs is based principally on the patient's subjective impressions. Even semiquantitative assessments, such as frequency of shaving or electrolysis, are dependent upon accurate information from the user. Measuring of breast and hip size and assessing each stage of nipple development are more objective, but they distress and embarrass some patients. Clinical assessments are usually conducted on a three-monthly basis, as are blood assays of oestradiol and testosterone. Where synthetic ethinyloestradiol is being used, it is important to appreciate that it will be undetectable by most assays for oestradiol.