Comparison of flutamide and spironolactone in the treatment of hirsutism: a randomized controlled trial

In a study from 30 years ago involving 53 premenopausal women with moderate to severe hirsutism, flutamide was found to be significantly more effective than spironolactone when used in combination with a triphasic oral contraceptive pill. Over a treatment period of 9 months and a 6-month follow-up, flutamide achieved a 50% reduction in hirsutism scores at 6 months and an 80% decrease in total acne, seborrhea, and hair loss score at 3 months, while spironolactone only achieved a 30% reduction in hirsutism and a 50% reduction in the other symptoms, with no significant effect on hair loss. Flutamide also had a lower rate of adverse side effects, with only one patient discontinuing due to dry skin, compared to four discontinuations in the spironolactone group due to various side effects. The study concluded that flutamide is a more effective and preferable treatment for hirsutism and related androgen-dependent symptoms than spironolactone.