Treatment of Hirsutism with 5α-Reductase Inhibitors

Studies have indicated that 5α-reduced androgens play a significant role in hirsutism, but until recently, there was no effective 5α-reductase inhibitor available to test this theory in treatment. However, a class of compounds known as 4-azasteroids has been discovered to have strong 5α-reductase inhibitory activity both in vitro and in vivo. These compounds have shown to have little affinity for androgen receptors, reduce the growth effect of testosterone (T) on rat prostate, decrease dihydrotestosterone (DHT) concentration in rats and dogs, and reduce prostate size with chronic treatment. It is anticipated that these inhibitors will soon be clinically tested as a treatment for hirsutism, and the outcomes of these tests are highly anticipated to improve the understanding and management of the condition.