Which regimen is used to treat hirsutism in premenopausal women?

Which regimen is used to treat hirsutism in premenopausal women?

• A. Metformin
• B. Spironolactone plus oral contraceptives
• C. Finasteride
• D. Eflornithine cream

Answer: (B)

Hirsutism in premenopausal women is driven by excess androgens, so effective treatment targets both reducing androgen production and blocking its effects on hair follicles. Using an estrogen-containing oral contraceptive lowers ovarian androgen production and increases sex hormone-binding globulin, which decreases the amount of free testosterone available. Adding spironolactone provides antiandrogen effects by blocking androgen receptors and further reducing androgen activity. This combination addresses both the source and action of androgens, making it the most effective regimen for improving hirsutism in this population. Topical eflornithine cream can slow hair growth in treated areas, but it doesn’t fix the underlying androgen excess, so it’s not sufficient as a stand-alone regimen. Metformin helps with insulin resistance in conditions like PCOS and can have indirect effects on androgen levels, but it isn’t the primary treatment for hirsutism. Finasteride lowers DHT but carries teratogenic risks and is not typically used as first-line therapy for premenopausal women without concurrent contraception.

Hirsutism in premenopausal women is driven by excess androgens, so effective treatment targets both reducing androgen production and blocking its effects on hair follicles. Using an estrogen-containing oral contraceptive lowers ovarian androgen production and increases sex hormone-binding globulin, which decreases the amount of free testosterone available. Adding spironolactone provides antiandrogen effects by blocking androgen receptors and further reducing androgen activity. This combination addresses both the source and action of androgens, making it the most effective regimen for improving hirsutism in this population.

Topical eflornithine cream can slow hair growth in treated areas, but it doesn’t fix the underlying androgen excess, so it’s not sufficient as a stand-alone regimen. Metformin helps with insulin resistance in conditions like PCOS and can have indirect effects on androgen levels, but it isn’t the primary treatment for hirsutism. Finasteride lowers DHT but carries teratogenic risks and is not typically used as first-line therapy for premenopausal women without concurrent contraception.