<unk>  is used as a progestin and antiandrogen in hormonal birth control and in the treatment of androgen-dependent conditions. Specifically,<unk>  is used in combined birth control pills, in the treatment of androgen-dependent skin and hair conditions such as acne, seborrhea, excessive hair growth, and scalp hair loss, high androgen levels, in transgender hormone therapy, to treat prostate<unk> ncer, to reduce sex drive in sex offenders or men with paraphilias or hypersexuality, to treat early puberty, and for other uses. It is used both at low doses and at higher doses. In the United States, where<unk>  is not available, other medications with antiandrogenic effects are used to treat androgen-dependent conditions instead. Examples of such medications include gonadotropin-releasing hormone modulators (GnRH modulators) like leuprorelin and degarelix, nonsteroidal antiandrogens like flutamide and bicalutamide, the diuretic and steroidal antiandrogen spironolactone, the progestin medroxyprogesterone<unk> , and the 5α-reductase inhibitors finasteride and dutasteride. The steroidal antiandrogen and progestin chlormadinone<unk>  is used as an alternative to<unk>  in Japan, South Korea, and a few other countries. Birth control<unk>  is used with ethinylestradiol as a combined birth control pill to prevent pregnancy. This birth control combination has been available since 1978. The formulation is taken once daily for 21 days, followed by a 7-day free interval.<unk>  has also been available in combination with estradiol valerate (brand name Femilar) as a combined birth control pill in Finland since 1993. High-dose<unk>  tablets have a contraceptive effect and<unk> n be used as a form of birth control, although they are not specifically licensed as such. Skin and hair conditions Females<unk>  is used as an antiandrogen to treat androgen-dependent skin and hair conditions such as acne, seborrhea, hirsutism (excessive hair growth), scalp hair loss, and hidradenitis suppurativa in women. These conditions are worsened by the presence of androgens, and by suppressing androgen levels and blocking their actions,<unk>  improves the symptoms of these conditions.<unk>  is used to treat such conditions both at low doses as a birth control pill and on its own at higher doses. A birth control pill containing low-dose<unk>  in combination with ethinylestradiol to treat acne has been found to result in overall improvement in 75 to 90% of women, with responses approaching 100% improvement. High-dose<unk>  alone likewise has been found to improve symptoms of acne by 75 to 90% in women. Discontinuation of<unk>  has been found to result in marked recurrence of symptoms in up to 70% of women.<unk>  is one of the most commonly used medications in the treatment of hirsutism, hyperandrogenism, and polycystic ovary syndrome in women throughout the world. Higher dosages of<unk>  are used in combination with an estrogen specifically at doses of 25 to 100 mg/day cyclically in the treatment of hirsutism in women. The efficacy of such dosages of<unk>  in the treatment of hirsutism in women appear to be similar to that of spironolactone, flutamide, and finasteride. Randomized controlled trials have found that higher dosages of<unk>  (e.g., 20 mg/day or 100 mg/day) added cyclically to a birth control pill containing ethinylestradiol and 2 mg/day<unk>  were no more effective or only marginally more effective in the treatment of severe hirsutism in women than the birth control pill alone. Maintenance therapy with lower doses of<unk> , such as 25 mg/day, has been found to be effective in preventing relapse of symptoms of hirsutism.<unk>  has typically been combined with ethinylestradiol, but it<unk> n alternatively be used in combination with hormone replacement therapy dosages of estradiol instead.<unk>  at a dosage of 50 mg/day in combination with 100 μg/day transdermal estradiol patches has been found to be effective in the treatment of hirsutism similarly to the combination of<unk>  with ethinylestradiol. The efficacy of the combination of an estrogen and<unk>  in the treatment of hirsutism in women appears to be due to marked suppression of total and free androgen levels as well as additional blockade of the androgen receptor. Males<unk>  has been found to be effective in the treatment of acne in males, with marked improvement in symptoms observed at dosages of 25, 50, and 100 mg/day in different studies. It<unk> n also halt further progression of scalp hair loss in men. Increased head hair and decreased body hair has been observed with<unk>  in men with scalp hair loss. However, its side effects in men, such as demasculinization, gynecomastia, sexual dysfunction, bone density loss, and reversible infertility, make the use of<unk>  in males impractical in most<unk> ses. In addition, lower dosages of<unk> , such as 25 mg/day, have been found to be better-tolerated in men. But such doses also show lower effectiveness in the treatment of acne in men. High androgen levels<unk>  is used as an antiandrogen to treat high androgen levels and associated symptoms such as masculinization due to conditions like polycystic ovary syndrome (PCOS) and congenital adrenal hyperplasia <unk> H) in women. It is almost always combined with an estrogen, such as ethinylestradiol, when it is used in the treatment of PCOS in women. Hormone therapy Menopausal hormone therapy<unk>  is used at low doses in menopausal hormone therapy in combination with an estrogen to provide endometrial protection and treat menopausal symptoms. It is used in menopausal hormone therapy under the brand name Climen, which is a sequential preparation that contains 2 mg estradiol valerate and 1 mg<unk> . Climen was the first product for use in menopausal hormone therapy containing<unk>  to be marketed. It is available in more than 40 countries. Transgender hormone therapy<unk>  is widely used as an antiandrogen and progestogen in feminizing hormone therapy for transgender women. It is used orally at a dosage of 10 to 100 mg/day and by intramuscular injection at a dosage of 300 mg once every 4 weeks. Studies have found that 10, 25, and 50 mg/day<unk>  in combination with estrogen all result in equivalent and full testosterone suppression in transgender women. In light of risks of<unk>  such as fatigue, blood clots, benign brain tumors, and liver damage, the use of lower dosages of the medication may help to minimize such risks. The side effects of<unk>  are more acceptable for transgender women than for (cis) men.<unk>  has also been used as a puberty blocker and hence as an antiandrogen and antiestrogen to suppress puberty in transgender youth, although GnRH modulators are primarily used for this purpose. Prostate<unk> ncer<unk>  is used as an antiandrogen monotherapy and means of androgen deprivation therapy in the palliative treatment of prostate<unk> ncer in men. It is used at very high doses by mouth or by intramuscular injection to treat this disease. Antiandrogens do not cure prostate<unk> ncer, but<unk> n significantly extend life in men with the disease.<unk>  has similar effectiveness to GnRH modulators and surgical<unk> stration, high-dose estrogen therapy (e.g., with diethylstilbestrol), and high-dose nonsteroidal antiandrogen monotherapy (e.g., with bicalutamide), but has significantly inferior effectiveness to combined androgen blockade with a GnRH modulator and a nonsteroidal antiandrogen (e.g., with bicalutamide or enzalutamide). In addition, the combination of<unk>  with a GnRH modulator or surgical<unk> stration has not been found to improve outcomes relative to a GnRH modulator or surgical<unk> stration alone, in contrast to nonsteroidal antiandrogens. Due to its inferior effectiveness, tolerability, and safety,<unk>  is rarely used in the treatment of prostate<unk> ncer today, having largely been superseded by GnRH modulators and nonsteroidal antiandrogens.<unk>  is the only steroidal antiandrogen that continues to be used in the treatment of prostate<unk> ncer. Dose-ranging studies of<unk>  for prostate<unk> ncer were not performed, and the optimal dosage of<unk>  for the treatment of the condition has not been established. A dosage range of oral<unk>  of 100 to 300 mg/day is used in the treatment of prostate<unk> ncer, but generally 150 to 200 mg/day oral<unk>  is used. Schröder (1993, 2009) reviewed the issue of<unk>  dosage and recommended a dosage of 200 to 300 mg/day for<unk>  as a monotherapy and a dosage of 100 to 200 mg/day for<unk>  in combined androgen blockade (that is,<unk>  in combination with surgical or medical<unk> stration). However, the combination of<unk>  with<unk> stration for prostate<unk> ncer has been found to significantly decrease overall survival compared to<unk> stration alone. Hence, the use<unk>  as the antiandrogen component in combined androgen blockade would appear not to be advisable. When used by intramuscular injection to treat prostate<unk> ncer,<unk>  is used at a dosage of 300 mg once a week. The combination of<unk>  with an estrogen such as ethinylestradiol sulfonate or low-dose diethylstilbestrol has been used as a form of combined androgen blockade and as an alternative to the combination of<unk>  with surgical or medical<unk> stration. Sexual deviance<unk>  is used as an antiandrogen and form of chemical<unk> stration in the treatment of paraphilias and hypersexuality in men. It is used to treat sex offenders. The medication is approved in more than 20 countries for this indication and is predominantly employed in<unk> nada, Europe, and the
Cyproterone acetate
Desoxymethyltestosterone
15β-Hydroxycyproterone acetate
Oxandrolone
Acetothiolutamide
Goserelin
Darolutamide
Bisoctrizole