Antiandrogens

Finasteride

• Mechanism 
  • 5α-reductase inhibitor
    • ↓ conversion of testosterone to dihydrotestosterone
• Indications
  • BPH
  • male-pattern baldness
• both hairloss and prostate hyperplasia are DHT driven processes 

Flutamide

• Mechanism
  • testosterone receptor blocker 
• Indications
• prostate carcinoma

Ketoconazole

• Mechanism
  • steroid synthesis inhibitor
    • inhibits desmolase 
  • used at higher doses than as an anti-fungal
• Indications
  • PCOS
    • specifically the symptoms of hirsutism
  • androgen receptor-positive prostate cancer
• Toxicity
• gynecomastia, amenorrhea

Spironolactone

• Mechanism
  • inhibits steroid binding
• Indications
  • PCOS
    • specifically the symptoms of hirsutism
  • K-sparing diuretic
• Toxicity
  • gynecomastia, amenorrhea