Management of Hirsutism

    March 2000 in “ American journal of clinical dermatology ”
    L. Falsetti, Alessandro Gambera, C. Platto, Laura Legrenzi
    TLDR Antiandrogens, particularly flutamide and CPA, are most effective for treating hirsutism, with long-term use needed for best results.
    The document from 2000 reviews the management of hirsutism, with a focus on pharmacological treatments for women with PCOS and idiopathic hirsutism. It evaluates the effectiveness of GnRH agonists, COCs, and antiandrogens such as flutamide, CPA, spironolactone, and finasteride. The review highlights that antiandrogens, especially flutamide and CPA, are the most effective, with flutamide showing a Ferriman-Gallwey score reduction of up to 56.7% in PCOS and 50.9% in idiopathic hirsutism at 12 months. COCs are beneficial over the long term, particularly for mild to moderate hirsutism. The document also emphasizes the importance of managing obesity, insulin resistance, and hyperinsulinemia in hirsutism treatment. Adverse effects of these treatments are noted, including hepatotoxicity and teratogenicity. The authors' experience with 310 hirsute women shows the necessity of long-term and continuous use of antiandrogens and COCs for treating mild to moderate hirsutism, with electrolysis recommended for severe cases. The preferred management approach at the time was using CPA and flutamide in specific dosages and regimens, often in combination with COCs.
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      community DHT levels after 4 weeks of Fina and 8 weeks of Fina + 4 weeks of Duta

      in Update  35 upvotes 5 years ago
      The user reported early stage diffuse hair thinning and increased DHT levels after 4 weeks on Finasteride and 8 weeks on Finasteride plus 4 weeks on Dutasteride, despite the medications being authentic and stored properly. They are considering increasing their Dutasteride dosage due to the lack of side effects and are unsure if the treatment is helping their hair.

      community AA and Hirsutism but T levels are normal

      in Female  8 upvotes 3 years ago
      27-year-old female experiences aggressive hair thinning and hirsutism despite normal testosterone levels. Spironolactone and 2% minoxidil were ineffective; high DHEA sulfate levels may be the cause.

      community Female, 30, PCOS diagnosis, MPB Norwood 2. Endo refuses to give anything other than Spironolactone. Feel like I’m at my wit’s end here.

      in Female  53 upvotes 1 year ago
      A 30-year-old female with PCOS and male pattern baldness is frustrated with her endocrinologist's recommendation of only Spironolactone and minoxidil, feeling that dutasteride, finasteride, and progesterone would be more effective. Other users suggest various online sources for treatments, warn against self-medicating due to potential risks, and recommend seeking a specialized endocrinologist or considering additional treatments like Inositol, Berberine, and dermaneedling.

      community No, Finasteride as a treatment for MPB was not an "accident"

      in Research/Science  105 upvotes 3 years ago
      Finasteride was intentionally developed to treat BPH and later approved for male pattern baldness (MPB) due to its 5AR inhibition effects. The delay in MPB approval was due to concerns about off-label use for female hirsutism and the prioritization of treating a more debilitating condition.

      community Any balding females? I need advice with coping :(

       16 upvotes 8 years ago
      A 27-year-old woman is struggling with hair loss, feeling self-conscious and seeking advice on coping. She mentions trying Minoxidil but is hesitant due to scalp issues and is looking for ways to regain confidence.

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