12 Common medicines treatment hair loss in women - 4
9. Oral contraceptive pills for female
Oral contraceptive pills can be used in the treatment of female pattern hair loss.
Although testosterone is considered to be a male hormone, it also occurs naturally in women. The exact roles of androgen over-production, activity, and androgen receptors in androgenetic alopecia in women are still unclear. Approximately 30 percent of a woman's testosterone is produced in the ovaries; the other 70 percent is derived from the transformation of adrenal androgen precursors such as dehydro epiandrosterone (DHEA) and androstenedione, both of which decline inevitably with age.
Considering the involvement of androgen receptors and 5 alpha - reductase in androgenetic alopecia, blocking them would be a logical approach to treatment. Over the years, several agents that target these mechanisms have been used, with varying success rates in men and women.
Side effects of oral contraceptive pills
Some authors indicate that oral contraceptive pills are generally well tolerated, the main adverse effects being nonspecific. Some women complain of headache, breast tenderness and nausea, but these drugs have no clinically relevant effects on metabolic or liver functions or on bodyweight. Effects on mood and libido are rare. Whether or not oral contraceptive pills increase the risk for the development of breast cancer is still a controversial issue.
Some authors are of the opinion that combination oral contraceptive pills appear to have potential serious side effects. These include an increased risk of venous thromboembolism (occlusion of a blood vessel due to a fibrinous clot), stroke, and myocardial infarction (heart attack). The higher the dose of ethinyl estradiol, the higher is the risks of venous thromboembolism, ischemic stroke, and myocardial infarction. The risks of stroke and myocardial infarction are also more likely in individuals with hypertension, diabetes, and migraine headaches and in individuals who smoke cigarettes.
Conclusion
Combined oral contraceptives containing antiandrogenic progestogens are likely to be particularly useful in treating women who have pre-existing androgen-related disorders and require contraception. However, similar to other agents, progress of hair growth in androgenetic alopecia takes a long time with oral contraceptive pills. This lower responsiveness may reflect the natural length of the hair growth cycle, and the fact that androgenetic alopecia has multifactorial etiologies involving genetic, metabolic, environmental and nutritional factors as well as androgen production.
10. Systemic spironolactone for female
Some women use systemic spironolactone to treat female pattern baldness.
Spironolactone therapy may reduce shedding of hair in those individuals without hyperandrogenism and may promote some hair growth in those with hyperandrogenism (an excessive production of male hormones). In some women with hirsutism the drug decreases the growth rate and mean diameter of facial hair.
Side effects of spironolactone
One of the potential side effects of spironolactone in both men and women is acute intoxication of potassium, a condition called hyperkalemia. Decreased libido, impotence, and worse still, gynecomastia (excessive development of the male breasts) can occur in men treated with spironolactone, thus confining the systemic use to women. In women, breast tenderness, irregular menses, and mood swings are not uncommon side effects. Women of childbearing age who are treated with spironolactone should use effective contraception, preferably a concomitant oral contraceptive pill. If pregnancy occurs while they are on spironolactone, there is a possible risk of feminization of the male fetus.
Conclusion
No dermatologic indications for spironolactone have been approved by the FDA. It is only approved as a diuretic, for the treatment of primary hyperaldosteronism, idiopathic hyperaldosteronism, edematous conditions of congestive heart failure, cirrhosis with ascites, nephrotic syndrome, essential hypertension, or hypokalemia. Spironolactone is perceived to be somewhat effective in preventing hair loss in androgenetic alopecia in women at doses of 200 mg per day, but hair re-growth is limited. Laboratory monitoring every 3 to 4 months is recommended to assist in following androgen suppression if a condition of androgen excess is found.
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