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      learn Pyrilutamide

      highly targeted anti-androgen that might have minimal systemic effects

      learn Cyproterone

      a synthetic anti-androgen and weak progestogen that inhibits DHT binding to androgen receptor
      • Is cyproterone only for women, or can men use it too? Cyproterone acetate is not a women-only drug — published reports describe use in men for prostate cancer, paraphilic disorders and gender-affirming therapy — but it is not FDA-approved for any indication, and European regulators restricted higher doses over a dose-related meningioma risk.
      • Is cyproterone safe to use during gender transition? Regulators and a large French cohort study link higher-dose, long-term cyproterone acetate to meningioma, and its label also lists liver-enzyme and mood effects — so it is not a drug anyone should call safe in the abstract, and its use in gender-affirming care is a prescriber's decision with monitoring.
      • Do I need a prescription to take cyproterone? Cyproterone acetate is a prescription-only medicine in every country that licenses it, and it has no FDA approval in the United States — regulators require a prescriber because the drug needs hormonal and liver monitoring and carries a dose-related meningioma risk flagged by the EMA in 2020.

      learn Bicalutamide

      a nonsteroidal anti-androgen, most commonly used orally for women

      learn Dutasteride

      Heavy duty finasteride that comes with higher risks

      learn RU58841

      a potent but unapproved and potentially problematic topical anti-androgen