Which anti-androgen used for hirsutism in PCOS is teratogenic and must be used with concurrent OCPs?

Which anti-androgen used for hirsutism in PCOS is teratogenic and must be used with concurrent OCPs?

• A. Flutamide.
• B. Leuprolide.
• C. Spironolactone.
• D. Finasteride.

Answer: (C)

Blocking androgen effects in hair follicles is the key approach for hirsutism in PCOS. Spironolactone serves as a steroidal antiandrogen, binding to androgen receptors and reducing the hair-growth response to circulating androgens. Because it can cause birth defects, it is teratogenic, so it must be used only with reliable contraception. In practice, it’s paired with a combined oral contraceptive to prevent pregnancy while the drug works. Other antiandrogens carry safety concerns or aren’t the standard first-line choice for PCOS-related hirsutism, making spironolactone the best fit for this scenario.

Blocking androgen effects in hair follicles is the key approach for hirsutism in PCOS. Spironolactone serves as a steroidal antiandrogen, binding to androgen receptors and reducing the hair-growth response to circulating androgens. Because it can cause birth defects, it is teratogenic, so it must be used only with reliable contraception. In practice, it’s paired with a combined oral contraceptive to prevent pregnancy while the drug works. Other antiandrogens carry safety concerns or aren’t the standard first-line choice for PCOS-related hirsutism, making spironolactone the best fit for this scenario.