Pharmacological Basis for Clinical Use of Antiandrogens

Cyproterone acetate (CPA), discovered in the early 1960s, is an antiandrogen that affects all androgen target organs and functions. It inhibits accessory sexual gland function, spermatogenesis, libido, delays puberty and bone maturation, and reduces sebaceous gland activity and lipogenesis. CPA also acts as a progestogen, suppressing gonadotropin secretion, which is particularly relevant for treating dermatological conditions in women. While it has glucocorticoid-like effects in animals, in humans these are only observed at high doses in children with precocious puberty and not in adults. CPA is clinically indicated for the treatment of prostatic carcinoma, precocious puberty, hypersexuality and sexual deviations, and androgenization in women, including conditions like hirsutism, acne, seborrhea oleosa, and androgenic alopecia.