Spironolactone
Spironolactone is a diuretic with possible selective anti-androgen properties. In women who suffer from FPHL, the level of their sex hormones might be normal, but their follicles are genetically more sensitive to androgens. Spironolactone essentially blocks androgen receptors and prevents miniaturization of the follicle. The treatment usually is given for six months, showing very good results with women with polycystic ovarian syndrome (PCOS) with signs of acne and hirsutism. However, spironolactone may have some side effects such as breast tenderness and diminution or disappearance of the normal menstrual cycle, therefore it is suggested the dosage be gradually increased over a four to six week period. During the course of treatment, potassium blood levels must be monitored. Women who are pregnant or intend to become pregnant cannot use the medication due to its teratogenic effects.
Birth control pills
As a routine part of the lab testing done on women who suffer from hair loss, hormone levels must be evaluated as it is critical to have them in a normal range. Many women who suffer from a hormonal imbalance can effectively be treated with birth control pills (BCPs). Certain BCPs contain both estradiol and drospirenone and those seem to be the most effective due to an anti-androgen effect. Flutamide is another anti-androgen that has the same mechanism of action as spironolactone with even higher anti-androgen activity. While used in women with good results, there is a concern about the hepatotoxicity of this medicine. Women planning to become pregnant should not use spironolactone, flutamide or finasteride- however BCPs can be safely used under physician supervision.
Bimatoprost
Bimatoprost (Latisse) belongs to a group of medications called prostaglandin analogs. This medicine was used to treat glaucoma, and had as a side effect the growth of longer and thicker eyelashes, now making it a treatment for women seeking fuller eyelashes. It also is used as a treatment of hair loss of the scalp, where it is thought to lengthen the anagen phase (active phase) of hair growth. Further testing and studies are required to assess the efficacy of these prostaglandin analogs in scalp hair loss.
