A Prospective Randomized Trial Comparing Finasteride to Spironolactone in the Treatment of Hirsute Women

A 20-year-old female is using finasteride 5mg and spironolactone 100mg for severe hirsutism and is experiencing minor side effects like water weight loss and irregular periods. She is concerned about potential future side effects and hair regrowth on her scalp.

The conversation is about managing hair loss while on hormone replacement therapy (HRT) with estrogen and spironolactone. The user considers adding finasteride but decides to wait and see the effects of the current treatment.

Spironolactone and finasteride are not recommended for women planning pregnancy due to birth defect risks. Both need to be stopped months before conception, and finasteride is generally not advised for women.

Using both finasteride and spironolactone together is more effective for hair loss in females, as they have different mechanisms and complement each other. It's important to avoid these medications during pregnancy and choose birth control with anti-androgenic activity.

A dermatologist prescribed oral minoxidil, finasteride, and spironolactone, suggesting minoxidil and finasteride as the most effective combination, but with potential side effects. Another user recommended minoxidil (both topical and oral) and spironolactone for female hair loss, advising against finasteride.

Spironolactone is more potent and lowers testosterone and DHT, while dutasteride only impacts DHT. For female hair loss, checking hormones and considering treatments like oral minoxidil, spironolactone, or topical minoxidil is recommended.