Spironolactone is an Effective and Well Tolerated Systemic Antiandrogen Therapy for Hirsute Women*

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Abstract
We treated 22 hirsute women with spironolactone in an open trial to determine whether it caused objective changes in hair growth. Among them, 18 women completed 12 months therapy with 200 mg spironolactone daily. During this period, the mean daily linear growth rates of hair on the face, abdomen, and thigh were reduced to 66% (P < 0.001), 75% (P < 0.01), and 72% (P < 0.001) of their pretreatment values. The mean hair shaft diameters were reduced to 83% (P < 0.01) on the face, 88% (P < 0.001) on the arm, 74% (P < 0.01) on the abdomen, and 80% (P < 0.001) on the thigh. Daily hair volume production was calculated from the diameter and daily growth rate; it was reduced to 60% (P < 0.01) on the face, 52% (P < 0.01) on the arm, 34% (P < 0.001) on the abdomen, and 48% (P < 0.001) on the thigh. Six of the 18 women who completed the study developed midcycle vaginal bleeding, and 3 women had previously irregular menstrual cycles regulated. We conclude that spironolactone is effective and well tolerated for hirsute women.

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