Antiandrogens drugs for women against acne

Androgens are special hormones that are responsible for the functioning of the genital organs in the male body. It is these substances that determine the timbre of the voice and the appearance of the stronger sex. However, due to a number of factors, androgens can also accumulate in the female body. Moreover, the effect they have on girls and women can be extremely unpleasant. If the amount of male hormones in the female body is off the charts, you have to take special antiandrogenic drugs and agents.

What is the function of androgens?

Androgens are responsible for the normal functioning of the genital organs. In addition, these substances help strengthen bone tissue and are also responsible for the production of other hormones. It is androgens that control the normal functioning of the sebaceous glands. It is no coincidence that hormones and antiandrogen drugs are used in the treatment of acne and severe acne. If the amount of sex hormones in the female body is normal, the menstrual cycle is not disrupted. If any problems arise with the genitourinary system in representatives of the fairer sex, the gynecologist conducts tests to make sure there are no hormonal imbalances.

Causes and consequences of increased androgen levels in women

Most of the visitors to beauty salons are women with elevated levels of the male sex hormone. First of all, the functions of the sebaceous glands are disrupted. Girls already in adolescence begin to suffer from a serious form of acne. After 30 years of age, women begin to grow a lot of facial hair. Many people make the mistake of removing unwanted hair mechanically. But it is necessary to take antiandrogen drugs for women. In most cases, hair appears above the upper lip. Less commonly, they can be seen on the chin, thighs, back and abdomen.

Antiandrogen drugs for women can be prescribed if the normal functioning of the adrenal glands is disrupted. In addition, patients may have an enlarged thyroid gland and ovaries. Treatment must be comprehensive and can only take place under the supervision of a doctor.

How do plant antiandrogens work?

Regardless of the reason for the increased amount of androgens in a woman’s body, in most cases special suppressive drugs are used. Medicines can be taken independently or as part of complex therapy. Medicines control the production of male hormones and also prevent them from affecting internal organs.

All synthetic or plant antiandrogens are divided into steroidal and non-steroidal. The latter help reduce male hormones by affecting the pituitary gland of the brain. Therefore, taking such drugs should only be done under the supervision of a specialist. It is not recommended to abruptly discontinue therapy. The dosage of antiandrogenic drugs is gradually reduced only when the doctor sees positive dynamics. Below we will present the most popular drugs with an antiandrogenic effect today.

"Androcur"

A popular antiandrogenic drug, produced in the form of tablets and powder for injection. The main active ingredient is cyproterone acetate. Additionally, the drug contains corn starch, colloidal silicon dioxide, lactose monohydrate, and magnesium stearate. Most often, the medication is prescribed in the form of tablets. The drug is suitable in cases where an increase in the male hormone leads to consequences such as severe acne or seborrhea, hair loss in women. Treatment (antiandrogens) in such cases is selected very carefully. After all, these drugs have many contraindications.

When choosing antiandrogen drugs and medications, descriptions and instructions must be studied first. Particular attention should be paid to contraindications. The drug "Androkur" is contraindicated for liver diseases. If there were previously tumors in this area, but were removed, the medication should be taken with caution. Androkur tablets are not prescribed to patients with jaundice, Rotor syndrome, diabetes mellitus and chronic alcoholism. Use of the product by nursing and pregnant women is strictly prohibited.

When using the drug, side effects that are reversible are often observed. They manifest themselves in the form of sudden changes in mood, depression, tearfulness, fatigue and apathy. If such symptoms appear, the drug continues to be taken. But if hypersensitivity to the active substance occurs, the Androkur medication should be discontinued.

"Visanne"

The drug belongs to the group of non-steroidal drugs and has antitumor activity. The drug is available in tablet form. The main active ingredient is bicalutamide. Additionally, the medication contains potato starch, lactose, colloidal silicon dioxide, and magnesium stearate. The drug is most often used to treat endometriosis, as well as disorders in the female genitourinary system. The drug has quite a lot of contraindications. Therefore, it should be taken strictly under the supervision of a specialist.

Visanne tablets are not prescribed for bleeding, severe liver damage, or malignant tumors that are hormonal in nature. Contraindications are lactose deficiency, diabetes mellitus, and chronic alcohol dependence. Androgens and antiandrogens are not taken during pregnancy. Drugs from this group are also not prescribed to minors.

For treatment to give good results, it is very important to follow the correct dosage. The tablets are taken once a day. It is advisable to take the appointment at the same time every day. The course of treatment should not be interrupted under any circumstances. Most often, Visanne tablets are prescribed for at least 6 months. The decision to continue therapy can only be made by a doctor.

"Marvelon"

An oral contraceptive that belongs to the group of antiandrogenic drugs. The main active ingredient is desogestrel. Additionally, the drug contains lactose monohydrate, potato starch, colloidal silicon dioxide, and stearic acid. In most cases, Marvelon tablets are used to protect against unwanted pregnancy. Quite often, antiandrogenic contraceptives can also be used to solve cosmetic problems, such as an increased amount of facial hair and severe forms of acne. At the same time, Marvelon tablets are included only as part of complex therapy.

The tablets are taken for a 28-day menstrual cycle. Starting from day 7, the girl needs to take one tablet daily for three weeks. Then a break is taken for 7 days. During this period, menstrual bleeding should occur.

"Janine"

Another popular contraceptive with an antiandrogenic effect. Like many other herbal antiandrogens, Janine is available in pill form. The medicine is based on dienogest. Additionally, lactose monohydrate, gelatin, magnesium stearate, and potato starch are used. Dragee "Janine" is primarily used as protection against unwanted pregnancy. In addition, the product helps solve facial skin problems caused by increased levels of male sex hormones in the blood. If menstrual irregularities occur, medication may also be prescribed.

Antiandrogen drugs should be taken with caution. Modern therapy for acne in women is carried out only under the supervision of a specialist. This is due to the fact that contraceptives with an antiandrogenic effect have many contraindications. First of all, this is the presence of thrombosis, diabetes mellitus, serious liver diseases, and vaginal bleeding of unknown origin. “Janine” tablets are not prescribed during pregnancy and lactation. The components can cause serious developmental disorders of the fetus. Before the gynecologist prescribes the drug to a woman, he will ask her to take a pregnancy test.

"Logest"

A good oral contraceptive that successfully relieves androgen-dependent skin syndromes in women. The main active ingredient is gestodene. The drug is available in the form of dragees and tablets. The product can be used not only for contraception. It successfully eliminates the symptoms of increased levels of male hormone in the female body. Logest tablets are prescribed for the treatment of acne, as well as menstrual irregularities.

Contraindications to the use of the drug are thrombophlebitis, diabetes mellitus, vaginal bleeding of unknown origin, neurological migraines, and liver failure. The drug "Logest" is not prescribed to girls under 15 years of age, as well as to women during pregnancy and lactation. In very rare cases, the drug can be prescribed to patients who have entered menopause.

"Spironolactone"

This antiandrogen drug is most often used to treat severe forms of acne. The active ingredient is a magnesium-sparing diuretic that controls the functioning of the sebaceous glands. The medication is available in tablet form. It can also be used in the second half of pregnancy if severe swelling of the limbs occurs. The drug "Spinorolactone" is indicated for women with menstrual irregularities, as well as polycystic ovary syndrome.

Spinoronolactone tablets cannot be prescribed to women with diabetes mellitus, renal and liver failure. In the first trimester of pregnancy, the medication is also contraindicated. Patients with thrombophlebitis and chronic alcoholism should take the drug with caution. In any case, treatment should be carried out under the supervision of a doctor. It is very important to follow the dosage. Treatment can continue for 2-3 weeks. You should take one tablet 3 times a day. Only a doctor can adjust the dosage and duration of treatment.

Antiandrogen drugs for women. Reviews and prices

Despite the fact that drugs with an antiandrogenic effect usually have a high price, only the most positive reviews can be heard about them. You can especially hear a lot of good words from girls with severe acne. In just a few courses you can stop the inflammatory process and normalize the functioning of the sebaceous glands. Most often, contraceptive antiandrogen drugs for women are used for these purposes. Their prices range from 700 to 2000 rubles. The cost is really not that small. But the positive reviews speak for themselves.

Under no circumstances should you choose an antiandrogenic drug based only on the positive experience of friends and relatives. Any medication can only be prescribed by a doctor.

Antiandrogen drugs help reduce the amount of androgens (hormones responsible for the functioning of the genital organs in the male body) in the blood. It is this hormone that helps change the tone of voice or appearance of men and makes them more masculine. At the same time, accumulating in the female body, a similar effect occurs, which is not very pleasant for women. In addition, a large amount of androgens in the blood leads to the appearance of acne, which can only be removed with drugs that reduce their amount in the body; all other drugs can improve the situation, but only temporarily.

Consequences of increasing the amount of androgens in the body

The body has an enzyme called 5α-reductase, which converts testosterone into an active androgen called 5-dihydrotestosterone. When the amount of testosterone exceeds the norm, that is, a state of hyperandrogenism occurs, the functioning of the entire body is disrupted, and 5α-reductase, accordingly, converts more testosterone into active androgen. In women this is expressed as follows:

1. hair loss, both on the face and body - for example, eyebrows disappear;
2. there is an increased function of the sebaceous glands, which gives rise to acne;
3. excess body hair of the male type;
4. ovarian hyperfunction develops;
5. infertility;
6. the risk of developing various diseases, such as endometriosis and uterine fibroids, increases.

To reduce the amount of active androgens, it is necessary to initiate the mechanism of inhibition of 5α-reductase to leave testosterone in a free state without further conversion, for which antiandrogen drugs are prescribed.

Principle of treatment with antiandrogens

Antiandrogen drugs relieve acne due to their effect on the presence of free testosterone in the blood serum by reducing sebum production. As a rule, such drugs belong to combined oral contraceptives (COCs). You need to know that antiandrogens are not prescribed exclusively for acne; they are indicated only if there are additional indications, which include:

1. need for contraception;
2. juvenile bleeding;
3. ovarian tumors;
4. primary dysmenorrhea;
5. hyperandrogenism;
6. menstrual irregularities.

Such drugs are not used to treat men. It has been noted that in women, when using antiandrogen therapy, sebum production is significantly reduced, such a decrease varies in the range from 13 to 65%. This can significantly reduce the number of acne, as well as the speed of their further appearance.

Despite the fact that since 1997 the use of combined oral contraceptives by adolescents has been allowed, it is not recommended to do this unless absolutely necessary - their hormonal surge is caused not by the presence of disorders, but by the formation and restructuring of the body. This permission is prescribed in legislation for the reason that the latest generations of COCs are the most gentle and low-dose.

Mechanism of action of antiandrogenic combined oral contraceptives

Today there are several combined oral contraceptives. Their composition is characterized by two components - estrogens and gestagens. All drugs contain ethinyl estradiol, which is the main estrogen. Its dosage in various preparations varies from 15 to 50 mcg. Modern COCs contain gestogens: gestodene, desogestrel or norgestimate, which are third-generation gestagens, which makes it possible to create low-dose oral contraceptives.

While taking combined oral contraceptives, the testosterone suppression mechanism begins to work, which is expressed as follows:

1. Thanks to estrogens, the synthesis of globulin, which binds sex hormones, increases in the liver. As a result, there is a decrease in the content of free testosterone in the blood;
2. the joint work of estrogens and gestagens makes it possible to reduce the secretion of androgens in the ovaries, acting to suppress the secretion of gonadotropic hormones;
3. gestagens inhibit 5α-reductase to reduce the conversion of testosterone to the active form.

It is worth noting that a good result of estrogen treatment is observed with long-term use, which should be at least 5 menstrual cycles. And evidence that anti-androgen medications help with acne can be seen towards the end of the second or third menstrual cycle.

Review of antiandrogen drugs

In modern medical practice, several of the most popular and effective combined oral contraceptives are used:

Sometimes, in order to obtain the greatest effect, treatment is prescribed using two drugs at once - for example, Androcur and Diane-35, prescribing the drugs according to a certain schedule alternately.

All oral contraceptives require individual selection depending on the characteristics of the body. When selecting, both the results of the tests obtained and the general condition of the patient, as well as the external manifestations of hyperandrogia, including an assessment of the severity of the rash, are taken into account. For convenience, they were classified into 4 degrees:

1. I degree – there are black spots and no more than 10 rashes in the form of dense nodules on the skin (papules);
2. II degree – there are black spots, no more than 5 pustules (pustules);
3. III degree – a pronounced rash, there are black spots and pustules;
4. IV degree – the deep layers of the skin are affected, there are many painful pimples and cysts.

If rashes appear only in the second half of the menstrual cycle, it is worth starting treatment with a drug such as Yarina. In the presence of stage II, the use of “Zhannine” is indicated, but if the disease has progressed to stage III, then the drug “Diane-35” is recommended.

It is necessary to understand that when deciding to take combined oral contraceptives, you should undergo a laboratory examination, which will show the level of hormones responsible for regulating the menstrual cycle. These are the following hormones:

1. FSH (follicle stimulating hormone);
2. prolactin;
3. LH (luteinizing hormone);
4. testosterone;
5. estradiol;
6. DEA sulfate;
7. progesterone.

In addition, consultation with specialists is necessary, among whom there must be not only a gynecologist, but also an endocrinologist. Do not forget that laboratory examinations must be carried out regularly throughout the entire period of treatment with oral contraceptives - it is not recommended to joke with hormonal levels.

If after 3 menstrual cycles there is no improvement, then you should not postpone a visit to the doctor - this can cause great harm to the body. The consequences of uncontrolled use of antiandrogen drugs will have to be treated additionally. The same applies to the occurrence of various undesirable side effects.

Taking antiandrogen medications, prescribed to reduce hyperandrogenism or as contraception, may help clear up acne. However, this statement is true only if the rash occurs as a result of a hormonal imbalance in the body; a different etymology for the appearance of acne suggests other treatment methods.

Antiandrogens are a group of drugs and compounds that reduce the level or activity of the male androgen hormones in the body. Androgen antagonists can broadly be defined as any compound that has the biological effect of blocking or suppressing the action of male sex hormones such as testosterone in the human body.

Antiandrogen therapy in women may work through:

1. Blocking androgen receptors/reducing their sensitivity.
2. Reducing the production of androgens by the adrenal glands or ovaries.
3. Reduced production of the “lactation hormone” prolactin by the pituitary gland.
4. Inhibition (suppression) of 5-alpha reductase, thereby reducing dihydroxytestosterone, or DHT.
5. Reducing insulin resistance.

The list of diseases for which women are prescribed these medications includes:

1. polycystic ovary syndrome,
2. hirsutism (“hairiness”),
3. hair loss (alopecia),
4. blackheads (acne),
5. seborrhea,
6. hidradenitis suppurativa,
7. endocrine disorders and pathologies.

Women with excess androgens usually seek medical help to treat primary symptoms such as hirsutism, acne, and menstrual irregularities.

Hirsutism is best treated by combining mechanical and chemical methods. Mechanical methods immediately remove hair, while chemical methods prevent further transition of vellus (vellus, thin) into final hair (dark, thick).

PCOS associated with insulin resistance is most often treated with metformin and/or OCs with or without the addition of an antiandrogen (spironolactone). For polycystic disease not associated with insulin resistance, COCs are prescribed with or without the addition of spironolactone.

Treatment of acne and pimples is aimed at reducing flaking and excessive keratinization of the skin using topical and systemic medications. Suppressing androgen production reduces sebum production and reduces acne.

ANTIANDROGENS FOR WOMEN: DRUGS, TABLETS FOR HAIR AND ACNE

1. Cyproterone acetate

Cyproterone acetate is a synthetic steroid that acts as a powerful antiandrogen. It also has progestogenic properties and can be used in the complex treatment of infertility in women.

Tablets with cyproterone acetate (Androcur - Androcur, Procur, Siterone) 50-200 mg can be purchased with a doctor's prescription. This potent antiandrogen is usually taken from days 1 to 10 of the menstrual cycle (i.e., the first day of your period).

Oral contraceptives (birth control pills) containing ethinyl estradiol (estrogen) and the antiandrogen progesterone are also prescribed to reduce male hormones in the body. These include cyproterone acetate (Diane-35, Estelle 35, Ginet-84), drospirenone - Drospirenone (Yasmin, Jess - Yaz) or dienogest (Valette). Other low-dose combined oral contraceptives have minimal antiandrogenic effect. They contain ethinyl estradiol and desorgestrel, gestodene or norgestimate.

Spironolactone is a synthetic corticosteroid commonly used as a competitive aldosterone antagonist and acts as a potassium-sparing diuretic. It is used to treat hypokalemia, Conn's syndrome and hypertension due to low renin hormone, but also has antiandrogenic effects and weakly inhibits 5-alpha reductase.

Spironolactone is usually prescribed to women over 30 years of age at 25–200 mg daily (Aldactone, Spirotone, Spiractin).

1. Flutamide / Nilutamide / Bicalutamide

These are non-steroidal, pure antiandrogens. Bicalutamide is a relatively new drug that has fewer side effects.

Flutamide is prescribed at 250–500 mg/day and is commonly used as a hormonal anticancer agent in men with prostate cancer. This remedy can cause serious liver damage and should not be used to treat skin conditions.

Ketoconazole is an imidazole derivative that is used as a broad-spectrum antifungal agent. It reduces the formation of androgens in the adrenal glands in women. It is a relatively weak antiandrogen, but has a good effect in patients with Cushing's syndrome.

Preparations with ketoconazole can be used externally for hair loss and seborrhea. In this case, they have virtually no side effects.

1. Finasteride

Finasteride and Dutasteride are inhibitors of 5-alpha reductase, an enzyme that is responsible for converting testosterone into the active form of dihydrotestosterone (DHT). They are specific antiandrogens because they only counteract the effects of testosterone and not other androgens. Finasteride does not reduce sebum production and is not effective in treating acne.

5-alpha reductase inhibitors also include zinc, azelaic acid and some plant-derived antiandrogens. Isotretinoin reduces the amount of sebum in part by reducing the production of dihydrotestosterone in the sebaceous gland.

1. Bromocriptine, cabergoline and quinagolide

These drugs help reduce excessively high prolactin, which also reduces testosterone.

Prescribed for type 2 diabetes mellitus, obesity, metabolic syndrome. Helps reduce manifestations of insulin resistance. Reducing elevated insulin levels in women can also reduce signs of hyperandrogenism. Metformin is safe at dosages of 250 mg to 2 g daily, but may cause diarrhea, so it should be taken after meals and gradually increased in dose. Rosiglitazone and pioglitazone, prescribed for insulin resistance, are more harmful and can be toxic to the heart and liver.

PLANT ANTIANDROGENS FOR WOMEN

In recent decades, Western experts have begun to pay more attention to the so-called herbal antiandrogens for women, obtained from natural remedies. Antiandrogen chemicals in plants, herbs and foods are an alternative to modern synthetic pharmaceuticals and are believed to have far fewer side effects.

1. Licorice, Licorice (Glycyrrhiza glabra)

Licorice is an aromatic substance that is several tens of times sweeter than sugar. Liquorice is traditionally used not only for food, but also for medicinal purposes (for example, for coughs). Licorice may also lower testosterone levels in women. This is thought to be due to glycyrrhizic acid, which has a weak antiandrogenic effect.

The results of different studies vary. The decrease in testosterone appears to be short-lived and dose dependent. Small doses of licorice (100 g licorice as a food product) do not reduce androgen levels. The therapeutic effect begins to appear when taken from 500 mg, however, these same doses can cause side effects: hypertension, an increase in DHEA and cortisol. It is not recommended to use licorice and additives with it for a long time and in high doses.

1. White Peony (Paeonia lactiflora)

Chinese peony is a common ornamental plant that is used in traditional Chinese medicine and has been shown to influence human androgen levels in vitro. A 1991 study described the effects of peloniflorin, a compound found in white peony, that inhibited testosterone production and promoted the activity of aromatase, which converts testosterone to estrogen. To date, there is no evidence that white peony will be as effective in reducing androgens in a woman’s body.

1. Flax seeds (lignans, flaxseeds)

According to experiments, flax reduces total and free testosterone, as well as FSH in women, but does not affect estradiol levels. The course of treatment is usually 12 weeks, 40 grams of seeds per day.

1. Peppermint (Mentha spicata)

Mint and tea with this herb are widely used by women in the Middle Eastern regions as an herbal remedy against hirsutism. The antiandrogenic properties of this plant reduce the level of free testosterone in the blood, leaving total testosterone and DHEA (DHEAS) unchanged. A cup of peppermint tea taken twice a day for 5 days during the follicular phase helps reduce the symptoms of hirsutism in women. In addition to these hormonal effects, mint increases LH, FSH and estradiol.

Another study found that drinking peppermint tea twice daily for 30 days significantly reduced plasma androgen levels in patients with hirsutism and polycystic ovary syndrome. At the same time, there was no objective change on the Ferriman-Gallwey scale in the subjects.

Vitex is traditionally used to restore hormonal balance. Clinical studies have demonstrated the effectiveness of drugs obtained from the plant extract in the treatment of PMS and mastodynia. The mechanism of action is believed to be dopaminergic effects (increased dopamine) leading to changes in prolactin production in the anterior pituitary gland. At low doses, it blocks the activation of D2 receptors in the brain by binding, which causes a slight increase in prolactin release. At higher concentrations, binding activity is sufficient to reduce prolactin release.

A decrease in prolactin affects FSH and estrogen levels in women, and testosterone can also normalize.

This pseudovitamin improves insulin sensitivity, and if the increase in testosterone is due to insulin resistance, myo-inositol may help reduce it. According to studies, it also lowers LH, increases SHBG and progesterone.

1. Cinnamon (Ceylon cinnamon, Cinnamomum verum)

Cinnamon also helps in the fight against testosterone, which is increased due to insulin. It is almost as effective as metformin (Siofor, Glucophage). Used as a supplement or as a seasoning for food (from 1 gram together with carbohydrate foods).

Remedies such as saw palmetto and green tea (EGCG) have not yet proven effective in reducing testosterone and DHT in women. Research, however, shows that green tea catechins can reduce insulin secretion and improve skin quality, and palmetto is sometimes added to topical hair loss medications.