The Investigation and Management of the Hirsute Woman

July 2006 in “ Reviews in gynaecological and perinatal practice ”

Nadia Soliman, Peter G. Wardle

hirsutism androgen polycystic ovary syndrome PCOS combined oral contraceptive pill OCP finasteride cyproterone acetate spironolactone insulin sensitisers metformin Vaniqa Dianette birth control pill Propecia

TLDR The document concludes that hirsutism in women, often caused by PCOS, requires systematic evaluation and can be treated with medications, mechanical removal, or cosmetic methods, with weight loss also being beneficial.

Hirsutism in women, characterized by male-pattern coarse hair growth, significantly impacts psychological well-being and quality of life. Affecting 5%-15% of women, it is often underdiagnosed. The most common cause is polycystic ovary syndrome (PCOS), accounting for nearly 90% of cases. Effective management involves understanding hair growth physiology and androgen metabolism, with treatments typically combining androgen suppression, antiandrogens, and mechanical hair removal. Long-term psychological support may be necessary for some patients. Antiandrogens like finasteride, combined with oral contraceptives, have shown good control in most cases.

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research Intermittent Low-Dose Finasteride Is as Effective as Daily Administration for the Treatment of Hirsute Women

29 citations , September 2004 in “Fertility and Sterility”

Intermittent low-dose finasteride works as well as daily use for treating excessive hair growth in women.

research A Comparison Between Spironolactone and Spironolactone Plus Finasteride in the Treatment of Hirsutism

47 citations , March 2004 in “European journal of endocrinology”

Spironolactone plus finasteride reduces hirsutism more effectively.

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

32 citations , October 2003

Spironolactone is better than placebo for reducing excessive hair growth in women, but its effectiveness for acne is unclear due to small study sizes.

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 The Evaluation and Management of Hirsutism

195 citations , May 2003 in “Obstetrics and gynecology (New York. 1953. Online)/Obstetrics and gynecology”

Most women with excess hair growth have an underlying hormonal issue, often treated with medication and hair removal methods.

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 The Benefits of Finasteride for Hirsute Women with Polycystic Ovary Syndrome or Idiopathic Hirsutism

7 citations , February 2003 in “Gynecological Endocrinology”

Finasteride effectively reduces excess hair in women with certain conditions.

research Low-Dose (2.5 mg/Day) Finasteride Treatment in Hirsutism

18 citations , January 2003 in “Gynecological Endocrinology”

Low-dose finasteride effectively reduces hirsutism without serious side-effects.

research The Effect of Metformin on Hirsutism in Polycystic Ovary Syndrome

90 citations , August 2002 in “European journal of endocrinology”

Metformin improves hair growth and menstrual frequency in women with PCOS and hirsutism.

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 Comparison of Spironolactone, Flutamide, and Finasteride Efficacy in the Treatment of Hirsutism: A Randomized, Double-Blind, Placebo-Controlled Trial

46 citations , January 2000 in “The Journal of Clinical Endocrinology and Metabolism”

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 Comparison of Finasteride Versus Spironolactone in the Treatment of Idiopathic Hirsutism

76 citations , December 1997 in “Fertility and Sterility”

Finasteride reduces hair growth better, but spironolactone has more side effects.

research Diagnosis and Therapy of Hyperandrogenism

23 citations , June 1997 in “Baillière's clinical obstetrics and gynaecology”

Most women with too much androgens have PCOS, which can be managed with birth control pills, medication for hair growth, and fertility treatments, and losing weight helps too.

research Finasteride in the Treatment of Hirsutism: New Therapeutic Perspectives

50 citations , July 1996 in “Fertility and Sterility”

Finasteride effectively treats hirsutism in women, but more research needed for long-term results.

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.

Related Research

1 / 1 results

research Pharmacology of Antiandrogens

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.