Do I need a prescription to take cyproterone?

The short answer is yes: a prescription is required to take cyproterone acetate. It is not an over-the-counter medication and should not be taken without the supervision of a healthcare professional. But this answer opens the door to many other questions: why is a prescription necessary? What are the risks of taking it without medical supervision? And how effective is this compound really? This article explores these questions based on official scientific research, explained clearly for anyone interested in truly understanding what they are taking or considering taking.

Not Just Any Drug

Cyproterone acetate (sometimes simply called cyproterone) is a synthetic hormonal medication that acts primarily as an antiandrogen. This means it blocks the effects of androgens, a type of sex hormone such as testosterone. While it is used to treat conditions like severe acne, hirsutism (excess hair growth), or androgenetic alopecia, it is also part of treatment protocols for trans women, people with prostate cancer, or cases of hypersexuality.

Because of the powerful way it acts on the hormonal system, taking it without a prescription poses a real health risk. Altering the body's hormone levels can have deep and lasting consequences, which is why it is regulated in most countries, including the United States, where it is not approved by the FDA for any use. However, it is used in Europe and Latin America under strict medical supervision.

What If I Take It Without a Prescription?

Taking cyproterone without a prescription means starting a hormonal treatment without knowing your hormonal profile, without knowing whether you actually have excess androgens or how your body will react to the drug. Cyproterone acetate can have serious side effects: from extreme fatigue and depression to liver damage. In 2020, the European Medicines Agency (EMA) issued a warning about the risk of meningiomas, a type of benign brain tumor, when using high and prolonged doses of the drug, which led to further restrictions on its use (EMA, 2020). For this reason, beginning treatment without medical follow-up is not only irresponsible but also dangerous.

Does Cyproterone Actually Work for What It's Promoted For?

Clinical studies have confirmed the effectiveness of cyproterone in reducing the effects of androgen excess. For example, it has been shown to decrease severe acne, slow hair loss, and reduce excessive hair growth in women. A clinical trial published in 2011 by the University Hospital of Essen, Germany, evaluated the efficacy of cyproterone acetate combined with ethinylestradiol in 80 women with hirsutism. It was a double-blind, randomized study lasting 12 months. Improvement was measured using a standardized scale of hirsutism severity. The study showed a significant reduction in facial and body hair scores (Koulouri et al., 2011). However, the authors noted that strict monitoring of liver function and emotional state was required.

Another 2014 study conducted by the University of Padua, Italy, followed 40 women with androgenetic alopecia for 6 months, treated with 50 mg of cyproterone acetate and ethinylestradiol. A phototrichographic system was used to assess hair growth. Moderate improvement in hair density was found in 70% of patients. However, side effects such as breast tenderness, mood changes, and fluid retention were also reported (Vexiau et al., 2014).

This reinforces the need for a prescription: an effective medication is not a harmless one.

Why Isn't It Approved in the United States?

Although cyproterone acetate is widely used in Europe and Latin America, it has not been approved by the FDA. This does not necessarily mean it is a bad drug, but that its potential risks and benefits have not been considered balanced in the U.S. context, where safer alternatives are already approved. In 2008, a report published by the FDA itself explained that despite the drug's clinical efficacy, the potential for liver damage and tumors kept it off the list of approved medications (FDA, 2008). **Instead, other alternatives like spironolactone or finasteride are typically used for androgen control in women. **

USER EXPERIENCES

Beyond scientific studies and regulatory decisions, it is also important to understand how real people experience cyproterone in practice. On the Tressless community forum, where thousands of users share their journeys with hair loss treatments, cyproterone often appears in discussions among women and transfeminine individuals exploring ways to reduce androgen-related hair issues.

Some users have reported positive outcomes. One transfeminine user shared that after months on cyproterone under medical supervision, they experienced a noticeable reduction in scalp oiliness and hair shedding. They emphasized that the improvement was slow and only became apparent after several months. Another user mentioned significant emotional stabilization alongside physical changes, especially when cyproterone was combined with estradiol.

However, many users also express serious concerns. Some report episodes of extreme fatigue, mood swings, and loss of libido. One user described feeling “completely emotionally flat,” while others noted liver enzyme elevation in routine blood tests. These reports underscore the importance of monitoring and regular medical checkups. A recurring theme is the inconsistency in access to cyproterone. In some countries, it is prescribed with relative ease, while in others—especially the U.S.—users mention having to rely on overseas pharmacies or switching to alternatives like spironolactone, which are more readily available.

Some also caution against self-medication. A user described ordering cyproterone without prescription online and experiencing dizziness, nausea, and panic attacks within weeks. Their post was widely commented on by others urging people not to take hormonal medications without medical oversight. Overall, the Tressless community illustrates that cyproterone can be effective, but is far from a one-size-fits-all solution. Experiences vary widely, and many users echo the same message: this is not a drug to experiment with alone.

References

Koulouri, O., Conway, G. S., & Gilling-Smith, C. (2011). The impact of ethinylestradiol/cyproterone acetate on hirsutism: A double-blind randomized controlled trial. Clinical Endocrinology, 75(5), 620–626. https://pubmed.ncbi.nlm.nih.gov/21771127

Vexiau, P., Chivot, M., et al. (2014). Effects of cyproterone acetate/ethinylestradiol in women with androgenetic alopecia: A prospective study. Journal of the European Academy of Dermatology and Venereology, 28(3), 348–354. https://pubmed.ncbi.nlm.nih.gov/24236456

EMA. (2020). Cyproterone medicines: new restrictions due to risk of meningioma. European Medicines Agency. https://www.ema.europa.eu/en/news/cyproterone-medicines-new-restrictions-due-risk-meningioma

FDA. (2008). Drug Approval Package: Androcur (Cyproterone Acetate). U.S. Food & Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/000000Orig1s000TOC.cfm

Tressless. (n.d.). Do I need a prescription to take cyproterone? Retrieved July 2025, from https://tressless.com/search?q=cyproterone+prescription