Unwanted Hair Growth from PCOS - Are Drugs a Good Choice?

If you have PCOS and excessive hair growth, are you wondering if drugs might help?

Researchers at the University College London Hospital in the U.K. recently examined 28 medical studies of medical treatments for hirsutism (excessive hair growth) in women with polycystic ovary syndrome. They did not examine "alternative" treatments.

Birth control pills

They report that seven groups of drugs showed a "significant reduction in hirsutism" The seven drug groups were flutamide, spironolactone, cyproterone acetate combined with an oral contraceptive, thiazolidinediones, oral contraceptive pills, finasteride and metformin.

If you are interested in a medical approach for excessive hair growth, ask your doctor about using one or more of these medications.

However, they also found that "obesity has a negative impact on the efficacy of treatments for hirsutism, thus appropriate lifestyle advice is necessary for a successful treatment program."

In other words, the more overweight you are, the less effective are the various drugs. Actually, weight loss itself is an excellent way to cause a reduction in hirsutism.

What Are the Types of Drugs for Hirsutism?

Drugs to retard PCOS-related hirsutism fall into three broad categories:

  • Androgen receptor blockers: Cyproterone, flutamide (Eulexin), and spironolactone (Aldactone).
  • Androgen-suppressing agents: GnRH agonists (Lupron), estroprogestins (birth control pills), corticosteroids, and insulin-sensitizing agents (metformin/Glucophage).
  • 5 alpha-reductase inhibitors: Finasteride (Proscar), eflornithine hydrochloride (Vaniqa).

Advantages and Disadvantages of Hirsutism Drugs for PCOS

All of these drugs work to some extent. They have helped some women see measurable reductions in androgen levels and unwanted hair growth. Most have side effects.

All are recommended in conjunction with birth control pills, partly to control the side effects of these medications.

These synthetic drugs are designed to either suppress testosterone production or inhibit its effect so that new hair growth is reduced. Existing hair is not affected; it falls out on its own, like all hair eventually does.

You can expect to take these medications for at least six months before seeing significant results. It's advisable to defer electrolysis or laser therapy until the drug treatment has had at least six months to suppress new growth. Then, your doctor may recommend electrolysis or laser treatment to remove existing hair.

Impaired liver function is a potentially serious side effect as you metabolize and eliminate these synthetic drugs. Research also suggests that most of these drugs work best when used along with some other drug, so choosing medicine for hirsutism usually involves multiple medicines. The health consequences of using these drugs for more than about two years has not been studied.

For some women, the reduction of unwanted hair (hirsutism) is well worth the expense and potential health risks of these drugs. Others are concerned about side effects and long term consequences of using drug treatments. Some feel strongly about avoiding drugs of all kinds.

If you're not into taking multiple medications, then improving your diet, losing weight and taking selected nutritional supplements may help you get the results you're looking for.

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Source: Koulouri O et al, A systematic review of commonly used medical treatments for hirsutism in women, Clin Endocrinol (Oxf). 2008 May;68(5):800-5.


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