Cyproterone Acetate for Hirsutism

This updated Cochrane review assessed the effectiveness and safety of cyproterone acetate (CPA), alone or with ethinylestradiol, in treating hirsutism in women. The review included 23 studies with 1,557 women, but most studies were small, limiting the strength of the conclusions. CPA, especially when combined with ethinylestradiol, showed no significant difference in reducing hair growth or hormone levels compared to other treatments like spironolactone, finasteride, and flutamide. However, CPA was likely more effective than spironolactone at 6 months and finasteride at 24 months. The evidence was insufficient to compare adverse effects across treatments, highlighting the need for larger, well-designed studies. The current evidence suggests CPA or spironolactone, ideally combined with ethinylestradiol, as effective treatments for unwanted hair growth.