Antiandrogens for the Treatment of Hirsutism: A Systematic Review and Meta-Analyses of Randomized Controlled Trials
TLDR Antiandrogens are somewhat effective in reducing excessive hair growth in women.
In a systematic review and meta-analysis of 12 randomized controlled trials (RCTs) with low methodological quality, antiandrogens were found to be mildly effective in treating hirsutism. The review, which included 18 comparisons and used studies up to May 2006, showed that antiandrogens reduced Ferriman-Gallwey scores by 3.9 compared to placebo, with no inconsistency in results (I(2) = 0%). Spironolactone and flutamide were more effective than metformin, reducing hirsutism scores by 1.3 and 5.0, respectively. Combination therapies, such as spironolactone or finasteride with contraceptives, and flutamide with metformin, were superior to monotherapy with contraceptives and metformin. The number needed to treat (NNT) ranged from two to five women for one to notice improvement. However, only three RCTs included patient self-assessments, indicating a need for more patient-centered research.
