A Systematic Review of Commonly Used Medical Treatments for Hirsutism in Women

    November 2007 in “ Clinical endocrinology ”
    Olympia Koulouri, Gerard S. Conway
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    TLDR Certain medications including flutamide, spironolactone, and others effectively reduce excessive hair growth in women, especially when combined with lifestyle changes.
    The systematic review analyzed randomized controlled trials (RCTs) to assess the efficacy of pharmaceutical treatments for hirsutism in women, specifically those with polycystic ovary syndrome or idiopathic hirsutism. Out of 79 RCTs identified, 28 were eligible for analysis. The study found that treatments with flutamide, spironolactone, cyproterone acetate combined with an oral contraceptive, thiazolidinediones, oral contraceptive pills (OCPs), finasteride, and metformin significantly reduced hirsutism as measured by the Ferriman–Gallwey (F–G) score after 6 months, while placebo did not. The reduction in F–G score was negatively correlated with body mass index (BMI), indicating that higher BMI may reduce the effectiveness of these treatments. The conclusion suggests that these seven drug groups can improve hirsutism and should be considered in treatment plans, but also emphasizes the importance of lifestyle advice to enhance treatment success, especially in the context of obesity.
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