Anti-androgen

Anti-androgens block or reduce the effect of male hormones (androgens). That sounds technical, but in practice these drugs help treat very different problems: male pattern hair loss, acne and hirsutism in women, prostate cancer, and part of hormone therapy for trans women. Which drug you use depends on the problem — they’re not interchangeable.

Common drugs and what to expect

Finasteride and dutasteride are 5-alpha-reductase inhibitors. They lower DHT, the hormone that shrinks hair follicles. For male pattern hair loss, finasteride taken daily often stabilizes hair loss and helps regrow some hair after a few months. Side effects can include reduced libido, erectile issues, and rarely mood changes; these usually improve if you stop the drug, but discuss risks with your doctor.

Spironolactone is an older medicine originally for blood pressure and fluid balance. At low-to-moderate doses it blocks androgen receptors and is widely used for acne and unwanted facial/body hair in people assigned female at birth. Expect some breast tenderness, irregular periods, dizziness, and a risk of high potassium — so your clinician will check blood tests.

Anti-androgen receptor drugs like bicalutamide or flutamide are used mainly in prostate cancer. They block the androgen receptor directly. Flutamide can cause liver injury, so doctors prefer drugs with a safer liver profile when possible. These are strong medications and need oncology or urology oversight.

Practical safety tips

Before starting any anti-androgen, answer two simple questions with your prescriber: what outcome are we aiming for, and how will we watch for side effects? That directs the drug choice and follow-up plan. Basic checks often include liver tests (if using flutamide or similar), kidney and potassium monitoring (if using spironolactone), and a discussion about sexual side effects and fertility. If you’re pregnant or could become pregnant, avoid finasteride and similar drugs — they can harm a developing male fetus.

Buying medications online is common, but be careful: use licensed pharmacies, keep prescriptions, and check return policies. Don’t alter doses on your own; starting low and adjusting under supervision reduces surprises. If you notice jaundice, severe fatigue, muscle weakness, or sudden mood shifts, contact your provider right away.

Topical options exist (some topical anti-androgens or compounded finasteride) and can lower systemic exposure, but discuss expectations — topical treatments may be less well studied and vary in how much they help.

Want to try an anti-androgen? Talk to a clinician who knows your reason for treatment. Be clear about goals, ask which side effects are common and which are rare, and agree a simple monitoring plan. That keeps you safer and helps the medicine actually work for you.