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A Guide to Anti-Androgens

by Paresh Bramhane
A Guide to Anti-Androgens

Did you know that hormones are the culprit behind the hair loss of about half of men in their 50s? In these men, hormones known as androgens cause androgenetic alopecia. You may know this type of hair loss by its more common term, male pattern baldness.

Pattern baldness also occurs in women and is also due to androgens.

Fortunately, substances called anti-androgens can help control androgens and their effects. We’ll give you the basic facts on these drugs and what they can help with, so be sure to read on.

What Are Anti-Androgens?

Anti-androgens are medications that counter or reduce the effects of androgens. Their other names include testosterone blockers, androgen receptor (AR) antagonists, or AR blockers.

Doctors prescribe anti-androgens to patients who have high levels of androgens. Androgens, in turn, are male sex hormones, including dihydrotestosterone (DHT) and testosterone (T).

How Can Having Too Much Androgen Be a Bad Thing?

Everyone, including those born with female sex characteristics, has androgens. However, their levels are higher in those born with male sex characteristics. For instance, the female body produces only about 1/10 to 1/20 of the testosterone produced by the male body.

So, if the female body produces far more than that, it can develop male sex characteristics. For example, it can lead to an increase in body hair that mimics that of males. Breast size reduction, a lack of menstrual period, acne, and oily skin can also occur.

In the male body, high levels of androgen can cause problems like androgenetic acne. Blood pressure changes can also be signs of excessive androgens.

How Then Do Anti-Androgens Work?

Anti-androgens work by interfering with androgen receptors. ARs are proteins that androgens need to bind with to exert their activities on the body.

For example, the anti-androgens bicalutamide, flutamide, spironolactone, and RU58841 are AR antagonists. This means they bind directly to ARs so that androgens can’t.

Other anti-androgens work by preventing the synthesis of androgens. One good example is ketoconazole. It blocks the activity of enzymes needed to convert cholesterol to the T hormone.

What Common Conditions Do Anti-Androgens Help Treat?

Anti-androgens can help treat pattern baldness, which occurs with high DHT levels. In such cases, doctors may prescribe the anti-androgen known as finasteride. Studies suggest that finasteride can help by lowering the amount of DHT in scalp tissues.

Hormonal acne is another condition that anti-androgens may help treat. That’s because such type of acne often occurs due to high levels of testosterone and DHT. These two seem to stimulate the sebaceous glands, leading to more skin oil production. 

Spironolactone is also a common anti-androgen for acne in women. However, in 2020, the FDA approved Winlevi (clascoterone), a topical anti-androgen. What’s more, the FDA gave it the green light for use in both men and women aged 12 or older.

Should You Use Anti-Androgens Then?

While anti-androgens are effective, they’re not for everyone. That’s why your best bet is to see a doctor first to undergo hormonal tests. This way, the doc can confirm if you do have excessive androgens.

From there, your physician can determine if prescription anti-androgens could benefit you.

Have more questions about health, lifestyle, or even tech and business? Then ask away and get the answers by reading our other blog posts!

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