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Spironolactone can be used in the treatment of female-pattern hair loss (pattern scalp hair loss in women). [68] There is tentative low quality evidence supporting its use for this indication. [ 69 ] Although apparently effective, not all cases of female-pattern hair loss are dependent on androgens.
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Spironolactone is a prodrug with a short terminal half-life of 1.4 hours. [5] [6] [7] The active metabolites of spironolactone have extended terminal half-lives of 13.8 hours for 7α-TMS, 15.0 hours for 6β-OH-7α-TMS, and 16.5 hours for canrenone, and accordingly, these metabolites are responsible for the therapeutic effects of the drug. [5] [6]
Androgen receptor antagonistic potency of spironolactone, cyproterone acetate, and flutamide in castrated male rats treated with exogenous testosterone (as measured by inhibition of androgen-dependent ventral prostate weight). [27] Spironolactone is an antagonist of the AR, the biological target of androgens like testosterone and DHT.