A Review of Hormonal Therapy for Female Pattern (Androgenic) Alopecia

In 2007, a review was conducted on the use of hormonal therapy for female pattern (androgenic) alopecia, a condition affecting up to 75% of women aged 65 or older. At the time, the only approved treatment was 2% topical minoxidil. The review suggested that anti-hormonal therapies such as cyproterone acetate and spironolactone might be beneficial for some women with normal hormone levels, but larger studies were needed to confirm this. Flutamide was found to be more effective than spironolactone or cyproterone in one study. Testosterone conversion inhibitors were tried in post-menopausal women with normal hormone levels, but no study showed that 1 mg of finasteride effectively treated female androgenetic alopecia. However, doses of 2.5 and 5 mg finasteride helped some women in a few open studies. The review concluded that finasteride 1mg was not useful for female alopecia in post-menopausal women, and the role of other hormonal treatments remained largely undefined, especially in pre-menopausal women. The review emphasized the need for more comprehensive studies to assess the value of these treatments.