Antiandrogen Drugs Lower Serum Prostate-Specific Antigen Levels in Hirsute Subjects: Evidence That Serum PSA Is a Marker of Androgen Action in Women
TLDR Antiandrogen drugs can reduce PSA levels in women with excess hair, suggesting PSA is a sign of male hormone activity in women.
In a study from 2000, 40 hirsute women were examined to determine if serum prostate-specific antigen (PSA) could serve as a biochemical marker of androgen action in females. The study was a double-blind, placebo-controlled, 6-month trial where participants were treated with one of three antiandrogen drugs: spironolactone, flutamide, or finasteride. At the start, hirsute subjects had higher PSA levels compared to 19 nonhirsute controls (12.9±1.5 vs. 4.9±0.7 pg/mL, P = 0.03), and these levels were significantly correlated with serum free testosterone. After treatment, the 29 hirsute subjects who received active drugs experienced a significant reduction in serum PSA levels (7.2±1.4 vs. 14.7±3.0 pg/mL, P = 0.002), while no change was observed in the placebo group. The study concluded that serum PSA is elevated in many hirsute women and that antiandrogen treatments can reduce PSA levels, supporting the use of serum PSA as a marker of androgen action in women.
