Durmuşoğlu, F., & Erenus, M. (1997). Efficacy and safety of finasteride? Fertility and Sterility, 67(3), 589-590. https://doi.org/10.1016/s0015-0282(97)80100-8
Durmuşoğlu F, Erenus M. Efficacy and safety of finasteride? Fertil Steril. 1997;67(3):589-590. doi:10.1016/s0015-0282(97)80100-8
Durmuşoğlu, Fatih, and Mithat Erenus. "Efficacy and safety of finasteride?" Fertility and Sterility, vol. 67, no. 3, 1997, pp. 589-590.
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Doctors Debate How PCOS Was Diagnosed in a Finasteride Study
This letter to the editor records a debate between two groups of doctors over how an earlier study diagnosed polycystic ovary syndrome (PCOS, now also called PMOS). The earlier study tested finasteride for hirsutism, or extra hair growth. The original authors defended their method in a published reply.
Key Findings
Critics said the earlier study judged ovary enlargement by pelvic exam, which has no universally accepted criteria. They said selection should rest on ultrasound with a set standard, like ovarian volume.
Critics noted three other studies found finasteride raised testosterone levels, unlike the original study. Those studies reported hirsutism score changes of 10%, 30%, and 47%.
Critics said their own earlier study found hirsutism scores fell 46%, 52%, and 46% with flutamide, cyproterone acetate, and spironolactone, challenging a claim that other treatments work poorly.
In their reply, the original authors said it appears that at least 20% of women with a clinical PCOS diagnosis show no specific findings on ovarian imaging, citing established diagnostic criteria.
The original authors said it appears that two hormone levels did not change with finasteride, matching results from earlier studies.
Interpretation
This exchange puts two diagnostic traditions side by side. The critics wanted ultrasound measurements of the ovaries. They pointed to bigger hirsutism score gains with drugs already in use for PCOS. The original authors said they combined blood tests, ultrasound, and clinical signs together. They said many women with PCOS show no single specific finding on ovarian imaging alone. The debate supports continued work toward standard PCOS diagnostic criteria in future research.
RRM Context
This exchange reflects a core RRM principle. Diagnosis should rest on clear, repeatable testing. A single exam finding on its own is not enough. Finasteride and the other drugs named here block a hormone pathway. They do not ask why androgen levels rise in the first place. RRM's restorative approach looks for that root cause.
Our editorial summary of this paper, not the article's abstract.
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