Antiandrogen Treatment of Polycystic Ovary Syndrome

The 1999 document reviews the effectiveness of antiandrogen treatments for hirsutism and androgenetic alopecia in women with polycystic ovary syndrome (PCOS). It highlights that antiandrogens, particularly when combined with oral contraceptives to suppress ovarian androgen secretion, can be effective. The antiandrogens discussed include spironolactone, cyproterone acetate (not available in the U.S.), flutamide, and finasteride. Spironolactone is recommended at a starting dose of 50 mg twice daily, with potential dose increases if no improvement is observed within 6 months. Flutamide is less favored due to cost and liver toxicity concerns. Cyproterone acetate is noted for its use in hirsutism treatment outside the U.S., and finasteride is effective but not approved for women due to pregnancy risks. The document also states that while antiandrogens can prevent the progression of hirsutism and improve symptoms, complete resolution is not always possible, and ongoing treatment may be necessary unless the underlying PCOS is corrected.