It decreases adrenal gland production of testosterone and, as the medication is broken down by the body, one of its break down products also interferes with DHT binding at hormone receptor sites on hair follicle cells. It has been used as a hair loss treatment in tablet form and as a topical lotion for women with elevated androgen levels and a genetic predisposition to androgenetic alopecia. Spironolactone may cause irregular menstruation, mood swings, and may feminized a male fetus in pregnant women. Cyproterone acetate also interferes with DHT binding at hormone receptor sites on hair follicle cells. When used to treat androgenetic hair loss in women, it is combined with a powerful estrogen hormone called ethinyl estradiol.
Estrogens are a class of hormones that are prescription anti-androgens.
Estrogens counterbalance and help regulate androgens. Estrogens compete with androgens at hormone receptor sites on hair follicle cells, but do not trigger hair loss. Women generally have higher proportions of estrogens than androgens when compared to men. The high levels of estrogen hormones in women usually protects those women who have a genetic predisposition for androgenetic hair loss from losing their hair. When women with a genetic predisposition to androgenetic hair loss produce reduced amounts of estrogens, or increased levels of androgens, they may experience pattern hair loss.