TLDR Oral contraceptives and antiandrogens are effective for treating hirsutism, with antiandrogens being the most effective.
The systematic review and network meta-analysis conducted by the Mayo Clinic evaluated 43 randomized controlled trials to assess treatment options for hirsutism in women. The study found that estrogen-progestin oral contraceptive pills (OCPs), antiandrogens, and insulin sensitizers were more effective than placebo, with antiandrogens showing the greatest efficacy. Combinations of OCPs with antiandrogens or insulin sensitizers were more effective than monotherapy. Individual antiandrogens like flutamide, finasteride, and spironolactone were effective and comparable. The study highlighted moderate certainty in comparisons with placebo but low certainty in head-to-head comparisons due to methodological limitations. The analysis suggested OCPs as first-line therapy, especially when contraception is needed, and noted the teratogenic potential of antiandrogens.
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.
198 citations,
July 2011 in “Cochrane library” Lifestyle changes can improve body composition, excess male hormone levels, and insulin resistance in women with PCOS.
112 citations,
April 2009 in “Cochrane library” Spironolactone may reduce excessive hair growth in women but its effectiveness for acne is not supported.
121 citations,
April 2008 in “The Journal of Clinical Endocrinology & Metabolism” Insulin sensitizers may slightly reduce hirsutism but are less effective than other treatments.
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.
271 citations,
December 2005 in “New England journal of medicine/The New England journal of medicine” The document likely offers guidance on treating a woman's excessive hair growth, considering her symptoms and obesity.
633 citations,
September 1998 in “The Journal of Clinical Endocrinology and Metabolism” PCOS affects a similar percentage of Black and White women in the Southeastern United States.
378 citations,
September 1998 in “The Journal of Clinical Endocrinology and Metabolism” PCOS affects about 4% of women in the southeastern U.S. equally across Black and White populations.
97 citations,
November 1986 in “Journal of Steroid Biochemistry” Antiandrogens affect androgen-dependent body functions and are used for various medical conditions, with some risks like fetus feminization, but new forms like 17α-propylmesterolone show promise for acne without systemic effects.
33 citations,
January 1979 in “Acta obstetricia et gynecologica Scandinavica” Diane® is an effective contraceptive that also helps treat acne and mild hair growth issues.
