Efficacy and Safety of Anti-Androgens in the Management of Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

    August 2023 in “ EClinicalMedicine ”
    Simon Alesi, Maria Forslund, Johanna Melin, Daniela Romualdi, Alexia S Peña, Chau Thien Tay, Selma F. Witchel, Helena Teede, Aya Mousa
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    TLDR Anti-androgens can help manage some PCOS symptoms better than metformin but are not more effective than placebos or birth control pills for other symptoms.
    This systematic review and meta-analysis examined the efficacy and safety of anti-androgens in managing polycystic ovary syndrome (PCOS), pooling data from 13 studies involving 961 participants. The anti-androgens used were finasteride, flutamide, spironolactone, and bicalutamide. The results showed that anti-androgens combined with lifestyle changes were superior to metformin combined with lifestyle changes for treating hirsutism and other symptoms. However, they were not superior to a placebo combined with lifestyle changes. Daily use of anti-androgens was more effective for hirsutism than use every three days. Combining anti-androgens with COCP resulted in poorer lipid profiles compared with COCP ± placebo. The study concluded that current evidence does not support the use of anti-androgens preferentially to COCPs to treat hyperandrogenism in PCOS. Anti-androgens could be considered to treat hirsutism in PCOS, where COCPs are contraindicated, poorly tolerated, or present a sub-optimal response after a minimum 6-month period. The study also highlighted the need for more research on adolescents with PCOS, as only two studies in this review included this demographic.
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      community Spironolactone for 11 years, finasteride for almost 5 years, started oral minoxidil in November 😢 ended oral contraceptive in Dec.

      in Progress Pictures  224 upvotes 1 year ago
      A user shared their 11-year experience with spironolactone and nearly 5 years with finasteride for hair loss, recently adding oral minoxidil and stopping birth control. Various treatments were discussed, including organic options, checking for underlying health issues, considering dutasteride, and the potential role of progesterone in hair loss.

      community C’est terrible - at my wits end

      in Female  450 upvotes 2 years ago
      A 29-year-old woman is experiencing gradual hair thinning since age 15, suspects Androgenic Alopecia, and has tried 5% minoxidil with little success. She has purchased various hair loss treatments including minoxidil, dutasteride, finasteride, and spironolactone, but is cautious about starting them due to potential interactions with her ADHD medication.

      community Female, 30, PCOS diagnosis, MPB Norwood 2. Endo refuses to give anything other than Spironolactone. Feel like I’m at my wit’s end here.

      in Female  55 upvotes 2 years ago
      A 30-year-old female with PCOS and male pattern baldness is frustrated with her endocrinologist's recommendation of only Spironolactone and minoxidil, feeling that dutasteride, finasteride, and progesterone would be more effective. Other users suggest various online sources for treatments, warn against self-medicating due to potential risks, and recommend seeking a specialized endocrinologist or considering additional treatments like Inositol, Berberine, and dermaneedling.

      community About microneedling for hair.For AGA,Is dermastamp better?

      in Microneedling  7 upvotes 8 months ago
      A 22-year-old female with AGA due to PCOS is using 5% minoxidil foam and 2mg finasteride daily, and is seeking advice on microneedling frequency and safety. Concerns about finasteride dosage and its effects on PCOS were discussed, with emphasis on trusting the prescribed treatment plan.

      community My boy Saul Goodman was on Minoxidil tabs too

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      Saul Goodman was humorously depicted using high doses of minoxidil, finasteride, and spironolactone for hair loss. The conversation jokes about the unrealistic dosages and their potential side effects.

      community Dutasteride is amazing even for women with FAGA!

      in Female  151 upvotes 6 months ago
      Dutasteride significantly improved hair health and reduced shedding for a woman with PCOS and hyperandrogenism, without causing depression or anxiety, unlike finasteride. Dutasteride also helped with PMDD symptoms and had no side effects, though it changed hair texture.

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