Spironolactone Is an Effective and Well-Tolerated Systemic Antiandrogen Therapy for Hirsute Women

    Julian H. Barth, C.A. Cherry, Fenella Wojnarowska, R.P.R. Dawber
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    TLDR Spironolactone effectively reduces hair growth in women with hirsutism and is generally well-tolerated.
    In 1989, a study involving 22 hirsute women, of which 18 completed the study, found that daily treatment with 200 mg of spironolactone significantly reduced hair growth on various body parts, with mean daily linear growth rates and hair shaft diameters showing reductions ranging from 15% to 66% after 12 months. The treatment also decreased daily hair volume production by 34% to 60%. While six women experienced midcycle vaginal bleeding and three saw a regulation of previously irregular menstrual cycles, only one participant discontinued treatment due to suspected hyperkalemia. Overall, the study concluded that spironolactone is an effective and well-tolerated systemic antiandrogen therapy for hirsutism in women, despite the occurrence of menstrual irregularities in 67% of the participants. No serious adverse effects were reported.
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