pcos and unwanted hair
Drugs that curb androgen levels are another common treatment used for PCOS, although they are not officially FDA-approved for PCOS treatment. By lowering androgen levels, many patients have significant improvements in androgen-related symptoms such excess hair. Spironolactone is the anti-androgen drug most often used.
To curb hirsutism (excess hair), Dr. Andrea Dunaif from Northwestern University typically starts patients with spironolactone. A 6 month trial is needed to show effects on unwanted hair, and she usually starts women at a higher dose. The unwanted hair doesn’t disappear, but grows in finer and lighter. Improvement of acne generally comes more quickly. Unfortunately, this drug is unlikely to help with androgen-related hair loss (aka androgenic alopecia) which is more difficult to treat.
Two important things to note are that the long term safety effects of use are not known (but the drug has been in use for decades already) and spironolactone IS NOT SAFE in pregnancy, so it is commonly used in conjunction with birth control pills. This use of birth control pills also protects against abnormal growth of the lining of the uterus. Some women cannot take birth control pills, in which case it is important to use other means of birth control if you are sexually active while taking spironolactone.
Treatments targeting the skin or hair more directly are also available to help with hair problems. These include the prescription cream eflornithine hydrochloride (Vaniqa), acne products, and cosmetic treatments such as laser therapy and electrolysis.