Anti-Androgens for the Treatment of Hirsutism

March 2002 in “ Expert opinion on investigational drugs ”

Enrico Carmina

cyproterone acetate flutamide spironolactone 5 alpha-reductase inhibitors finasteride GnRH agonists oestroprogestins corticosteroids insulin-sensitising agents Propecia

TLDR Different anti-androgen medications can help treat excessive hair growth, but the right choice depends on accurate diagnosis.

The document reviewed various anti-androgen agents for treating hirsutism, including androgen receptor blockers (cyproterone acetate, flutamide, and spironolactone), 5 alpha-reductase inhibitors (finasteride), and androgen-suppressing agents (GnRH agonists, oestroprogestins, corticosteroids, and insulin-sensitising agents). The author analyzed scientific literature and used personal experience to evaluate and compare these treatments. The review emphasized the necessity of proper diagnosis in selecting the most suitable anti-androgen therapy for hirsutism.

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Research cited in this study

14 / 14 results

research Comparison of Finasteride Versus Spironolactone in the Treatment of Idiopathic Hirsutism

76 citations, December 1997 in “Fertility and Sterility”

Finasteride reduces hair growth better, but spironolactone has more side effects.

research Alopecia: The Search for Novel Agents Continues

11 citations, August 1997 in “Expert Opinion on Therapeutic Patents”

Many potential alopecia treatments need more testing to confirm they promote acceptable hair growth with minimal side effects.

Gonadotrophin-Releasing Hormone Agonist Therapy for Hirsutism Is as Effective as High Dose Cyproterone Acetate but Results in a Longer Remission

research Gonadotrophin-Releasing Hormone Agonist Therapy for Hirsutism Is as Effective as High Dose Cyproterone Acetate but Results in a Longer Remission

49 citations, April 1997 in “Human reproduction”

Hormone therapy for excessive hair growth is as good with GnRHa as with high-dose CPA, but GnRHa has longer-lasting results.

research Finasteride

187 citations, January 1994 in “The New England Journal of Medicine”

Finasteride treats enlarged prostate and may help with baldness, but effects on sexual function and male fetuses are unclear.

research Incidence of Liver Toxicity Associated with the Use of Flutamide in Prostate Cancer Patients

116 citations, May 1992 in “The American Journal of Medicine”

Flutamide rarely causes liver toxicity in prostate cancer patients.

research Cyproterone Acetate for Severe Hirsutism: Results of a Double-Blind Dose-Ranging Study

94 citations, July 1991 in “Clinical endocrinology”

Cyproterone acetate at 2mg daily is as effective as higher doses for treating excessive hair growth in women.

research The Clinical Development of a 5α-Reductase Inhibitor, Finasteride

211 citations, November 1990 in “The Journal of Steroid Biochemistry and Molecular Biology”

Finasteride effectively treats BPH, but needs more trials to understand potential.

research Treatment of Hirsutism with the Pure Antiandrogen Flutamide

130 citations, September 1990 in “Journal of the American Academy of Dermatology”

Flutamide effectively reduced excessive hair growth and improved related symptoms in hirsutism patients without significant side effects.

research External Genitalia Abnormalities in Male Rats Exposed In Utero to Finasteride, a 5α-Reductase Inhibitor

122 citations, July 1990 in “Teratology”

Finasteride exposure in pregnancy causes genital abnormalities in male rats.

research Side Effects of Spironolactone Therapy in the Hirsute Woman

80 citations, January 1988 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

Spironolactone can cause side effects like irregular bleeding, but lower doses may reduce these effects and still improve hirsutism.

research The Effects of Two Doses of Spironolactone on Serum Androgens and Anagen Hair in Hirsute Women

142 citations, February 1985 in “Fertility and sterility”

Spironolactone reduced hair thickness and some testosterone levels in women with excessive hair growth.

research A Novel Use of Spironolactone: Treatment of Hirsutism

124 citations, September 1980 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

Spironolactone is effective in treating excessive hair growth in women.

research The Development and Evaluation of an Ovulation Inhibitor (Diane) Containing an Antiandrogen

33 citations, January 1979 in “Acta obstetricia et gynecologica Scandinavica”

Diane® is an effective contraceptive that also helps treat acne and mild hair growth issues.

research Use of Cyproterone Acetate in the Treatment of Acne, Hirsutism, and Virilism

232 citations, June 1975 in “Journal of Steroid Biochemistry”

Cyproterone acetate is effective for acne but less so for hirsutism and alopecia, with some side effects and quick menstrual cycle recovery after treatment.

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research Pharmacology of Antiandrogens

97 citations, November 1986 in “Journal of Steroid Biochemistry”

Antiandrogens affect androgen-dependent body functions and are used for various medical conditions, with some risks like fetus feminization, but new forms like 17α-propylmesterolone show promise for acne without systemic effects.