-Excessive growth of hair in women. This hair is usually in a male pattern.
-Presence of abnormal androgen action → Excessive hairiness.
Treatment
–Oral contraceptives are the first-line drug for treatment of hirsutism in women not trying to conceive.
–Antiandrogens (e.g. spironolactone) are another option for premenopausal women
Metformin works only for PCOS. There is no evidence it works in primary hirsutism.
Glucocorticoids are indicated for CAH (congenital adrenal hyperplasia)
Leuprolide works but is expensive and has many side effects like hot flashes, atrophic vaginitis, bone density loss
NB: Spironolactone is teratogenic and so women should not get pregnant on it.
Spironolactone is an anti-androgen. It antagonizes aldosterone-specific mineralocorticoid receptors mainly in the distal convoluted tubule, decreasing sodium and water reabsorption and increasing potassium retention.
J Clin Endocrinol Metab. 2008 Apr;93(4):1105-20. Evaluation and treatment of hirsutism in premenopausal women: an endocrine society clinical practice guideline. https://www.ncbi.nlm.nih.gov/pubmed/18252793
Am Fam Physician. 2012 Feb 15;85(4):373-380. Hirsutism in Women. https://www.aafp.org/afp/2012/0215/p373.html