Cyproterone acetate for hirsutism

November 2025 in “ Cochrane Database of Systematic Reviews ”

Mushi J Matjila, Paul Andre Le Roux, Zephne M. van der Spuy

The document discusses the use of cyproterone acetate (CPA) for treating hirsutism and compares its clinical outcomes with spironolactone, flutamide, and finasteride. It notes some differences in outcomes between these treatments, but no significant differences were found between CPA and other medical therapies, likely due to small study sizes and lack of standardized assessments. The document highlights insufficient data on adverse effects and calls for larger, well-designed studies to better compare the efficacy and safety of these treatment options.

View this study on cochranelibrary.com →

Discuss this study in the Community →

Research cited in this study

40 / 40 results

Recommendations From The 2023 International Evidence-Based Guideline For The Assessment And Management Of Polycystic Ovary Syndrome

research Recommendations From The 2023 International Evidence-Based Guideline For The Assessment And Management Of Polycystic Ovary Syndrome

2 citations , August 2023 in “Human Reproduction”

The document provides updated advice on how to diagnose and treat polycystic ovary syndrome.

The Efficacy of Oral Isotretinoin Versus Cyproterone Compound in Female Patients With Acne and the Triad of Cutaneous Hyperandrogenism: A Randomized Clinical Trial

research The Efficacy of Oral Isotretinoin Versus Cyproterone Compound in Female Patients With Acne and the Triad of Cutaneous Hyperandrogenism: A Randomized Clinical Trial

2 citations , January 2014 in “Advanced Biomedical Research”

Oral isotretinoin and cyproterone compound are equally effective for treating acne in women with cutaneous hyperandrogenism.

research An Approach to the Patient with Hirsutism

49 citations , September 2012 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

The document concludes with guidance for doctors on diagnosing and treating hirsutism effectively and safely.

research The Investigation and Management of Hirsutism

26 citations , July 2012 in “Journal of family planning and reproductive health care”

The document says that hirsutism in women usually needs hair removal and hormone treatment to manage symptoms and improve well-being.

Epidemiology, Diagnosis, and Management of Hirsutism: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome Society

research Epidemiology, Diagnosis, and Management of Hirsutism: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome Society

378 citations , November 2011 in “Human reproduction update”

Experts recommend using evidence-based methods to diagnose and treat hirsutism, focusing on symptoms and underlying causes.

Polycystic Ovary Syndrome: A Complex Condition with Psychological, Reproductive, and Metabolic Manifestations That Impacts Health Across the Lifespan

research Polycystic Ovary Syndrome: A Complex Condition with Psychological, Reproductive, and Metabolic Manifestations That Impacts Health Across the Lifespan

926 citations , June 2010 in “BMC Medicine”

Polycystic ovary syndrome is a complex condition that affects women's mental, reproductive, and metabolic health throughout their lives.

research Spironolactone Versus Placebo or in Combination with Steroids for Hirsutism and/or Acne

112 citations , April 2009 in “Cochrane library”

Spironolactone may reduce excessive hair growth in women but its effectiveness for acne is not supported.

research Antiandrogens for the Treatment of Hirsutism: A Systematic Review and Meta-Analyses of Randomized Controlled Trials

150 citations , February 2008 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

Antiandrogens are somewhat effective in reducing excessive hair growth in women.

research A Systematic Review of Commonly Used Medical Treatments for Hirsutism in Women

75 citations , November 2007 in “Clinical endocrinology”

Certain medications including flutamide, spironolactone, and others effectively reduce excessive hair growth in women, especially when combined with lifestyle changes.

Current Recommendations for the Diagnostic Evaluation and Follow-Up of Patients Presenting with Symptomatic Polycystic Ovary Syndrome

research Current Recommendations for the Diagnostic Evaluation and Follow-Up of Patients Presenting with Symptomatic Polycystic Ovary Syndrome

19 citations , October 2004 in “Best Practice & Research in Clinical Obstetrics & Gynaecology”

The diagnosis of polycystic ovary syndrome (PCOS) requires a detailed patient history, ultrasound scanning, hormone level checks, and assessments of ovulation, obesity, and insulin resistance. It's a variable condition that needs individualized management and is a significant risk factor for type 2 diabetes.

research Finasteride Versus Cyproterone Acetate-Estrogen Regimens in the Treatment of Hirsutism

39 citations , August 2004 in “International journal of gynaecology and obstetrics”

Finasteride and CPA-EE2 equally reduce hirsutism, but affect hormone levels differently.

research Revised 2003 Consensus on Diagnostic Criteria and Long-Term Health Risks Related to Polycystic Ovary Syndrome (PCOS)

4025 citations , December 2003 in “Human Reproduction”

The 2003 consensus updated PCOS diagnosis criteria and linked PCOS to higher risks of diabetes and heart problems, recommending lifestyle changes to lower these risks.

research Cyproterone Acetate for Hirsutism

78 citations , October 2003 in “Cochrane library”

Cyproterone acetate with estradiol may subjectively improve excessive hair growth in women, but it's not clinically better than other treatments.

research Metformin or Antiandrogen in the Treatment of Hirsutism in Polycystic Ovary Syndrome

192 citations , September 2003 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

Metformin is effective for treating excessive hair growth in women with PCOS and may work better than the standard treatment in some ways.

research Use of Cyproterone Acetate, Finasteride, and Spironolactone to Treat Idiopathic Hirsutism

56 citations , April 2003 in “Fertility and Sterility”

All three treatments reduce hirsutism, but spironolactone works best long-term.

research Update and Future of Hormonal Therapy in Acne

78 citations , January 2003 in “Dermatology”

Hormonal therapy is becoming a promising treatment for acne.

research Comparison of Diane 35 and Diane 35 Plus Finasteride in the Treatment of Hirsutism

63 citations , March 2001 in “Fertility and Sterility”

Diane 35 plus finasteride is more effective for treating hirsutism.

research A Prospective, Randomized Trial Comparing Flutamide (250 mg/d) and Finasteride (5 mg/d) in the Treatment of Hirsutism

50 citations , May 2000 in “Fertility and Sterility”

Flutamide reduces hair growth better but has more side effects.

research Comparison of Diane 35 and Diane 35 Plus Finasteride in the Treatment of Hirsutism

50 citations , April 2000 in “Fertility and Sterility”

Diane 35 plus finasteride is more effective in reducing hair growth and androgen levels, but may decrease libido.

research Antiandrogen Treatment of Polycystic Ovary Syndrome

52 citations , June 1999 in “Endocrinology and Metabolism Clinics of North America”

Antiandrogen treatments combined with oral contraceptives can help manage hair growth and hair loss in women with PCOS.

A Prospective Randomized Trial Comparing Low Dose Flutamide, Finasteride, Ketoconazole, and Cyproterone Acetate-Estrogen Regimens in the Treatment of Hirsutism

research A Prospective Randomized Trial Comparing Low Dose Flutamide, Finasteride, Ketoconazole, and Cyproterone Acetate-Estrogen Regimens in the Treatment of Hirsutism

113 citations , April 1999 in “The Journal of Clinical Endocrinology and Metabolism”

Cyproterone acetate-estrogen most effective for hirsutism, but consider side effects and patient needs.

research Treatment of Hirsutism: Comparisons Between Different Antiandrogens with Central and Peripheral Effects

75 citations , March 1999 in “Fertility and sterility”

Finasteride, CPA, and flutamide are all equally effective in reducing excessive hair growth in women.

research Hirsutism II: Treatment

15 citations , August 1998 in “Australasian journal of dermatology”

The document concludes that various cosmetic and drug treatments are available for hirsutism, and some new drugs show promise.

research Comparison of Cyproterone Acetate Plus Ethinyl Estradiol and Finasteride in the Treatment of Hirsutism

49 citations , June 1998 in “Journal of Endocrinological Investigation”

Cyproterone acetate plus ethinyl estradiol is generally more effective in treating hirsutism, but consider side effects and patient characteristics.

research Oral Contraceptives and Cyproterone Acetate in Female Acne Treatment

30 citations , January 1998 in “Dermatology”

Birth control pills and cyproterone acetate can help treat acne in women, especially when linked to hormonal issues.

research Treatment of Androgen Excess in Females: Yesterday, Today, and Tomorrow

9 citations , January 1997 in “Gynecological Endocrinology”

The document concludes that treating androgen excess needs patience, managing expectations is important, and many drugs used are not officially approved, suggesting cosmetic options for mild cases.

research An Open Randomized Comparative Study of an Oral Contraceptive Containing Ethinyl Estradiol and Cyproterone Acetate with and without the GnRH Analogue Goserelin in the Long-Term Treatment of Hirsutism

18 citations , January 1996 in “Gynecologic and obstetric investigation”

The oral contraceptive alone is the preferred treatment for hirsutism, as adding the GnRH analog showed no significant benefit.

research Cyproterone Acetate for Severe Hirsutism: Results of a Double-Blind Dose-Ranging Study

94 citations , July 1991 in “Clinical endocrinology”

Cyproterone acetate at 2mg daily is as effective as higher doses for treating excessive hair growth in women.

research Comparison of Sequential Cyproterone Acetate/Estrogen Versus Spironolactone/Oral Contraceptive in the Treatment of Hirsutism

68 citations , May 1991 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

Both cyproterone acetate and spironolactone effectively reduce hair growth in women with hirsutism.

research Hirsutography: Photographic Measurement of Linear Hair Growth in Hirsute Women During Comparison of Anti-Androgen Treatments

4 citations , January 1991 in “Journal of obstetrics and gynaecology”

The photographic method accurately measures hair growth and both treatments effectively reduced hair growth in hirsute women.

research Ketoconazole Therapy for Women with Acne and/or Hirsutism

46 citations , August 1990 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

Ketoconazole reduced hair growth and improved acne in women, but caused side effects needing careful monitoring.

research Anti-Androgens in Gynecological Practice

7 citations , September 1988 in “Baillière's clinical obstetrics and gynaecology”

Cyproterone acetate is effective for treating hirsutism and acne in women by blocking androgens in the skin and also works as a contraceptive.

research Parenteral and Oral Cyproterone Acetate Treatment in Severe Hirsutism

5 citations , January 1987 in “Gynecologic and obstetric investigation”

Cyproterone acetate implants were more effective at reducing facial hair and improving skin in severe hirsutism than oral treatment.

research The Hair Cycle on the Human Thigh and Upper Arm

67 citations , July 1985 in “British journal of dermatology/British journal of dermatology, Supplement”

Men's thigh hair grows longer and has a longer growth cycle than women's, but arm hair growth is similar between genders.

Female Hirsutism: Pathophysiological Considerations and Therapeutic Implications