Finasteride for Idiopathic Hirsutism.

There are many causes of hirsutism in women. Often these causes relate to endocrinopathies, but idiopathic hirsutism may also occur without obvious unhealthiness. For both types of hirsutism, antiandrogen therapy is often employed. For endocrinopathy-related hirsutism, discussion of the underlying condition is also important and effective.
The most commonly used and studied pharmacologic antiandrogens include cyproterone rayon (progesterone-like and antigonadotropic), spironolactone (antimineralocorticoid), flutamide (pure androgen complex body part blocker), and finasteride (5 alpha-reductase inhibitor). Cyproterone ethanoate is among the more effective, but it is not available in the United States. The 3 remaining agents offering physicians choices of varying efficacy and risk. All 3 agents are teratogenic and must be prescribed in connection with a pregnancy-prevention plan in women of reproductive age.