This leads to lower levels of free testosterone. Medical therapy is slow and requires at least 6 months for a visible effect - shaving, waxing, etc., can be used in the meantime. This is the enzyme that converts testosterone to the active hormone dihydrotestosterone. There are usually few side effects. But sometimes women complain of increased urination in the first few days of use, fatigue, or problems with their menstrual periods.
Spironolactone works best when used in conjunction with oral contraceptives.
This also controls the menstrual cycle to avoid problems with dysfunctional bleeding. A nonsteroidal antiandrogen that can be used at a dose of 250 mg three times daily for hirsutism. Its use seems to be relatively free of side effects. However, it should be used in conjunction with a method of contraception.