Editing Antiandrogen (section)

==Medical uses==
Antiandrogens are used in the treatment of an assortment of [[androgen-dependent condition]]s in both males and females.<ref name="pmid31712062" /><ref name="pmid2147859">{{cite journal | vauthors = Sciarra F, Toscano V, Concolino G, Di Silverio F | title = Antiandrogens: clinical applications | journal = The Journal of Steroid Biochemistry and Molecular Biology | volume = 37 | issue = 3 | pages = 349–362 | date = November 1990 | pmid = 2147859 | doi = 10.1016/0960-0760(90)90484-3 | s2cid = 20274398 }}</ref> They are used to treat men with [[prostate cancer]], [[benign prostatic hyperplasia]], [[pattern hair loss]], [[hypersexuality]], [[paraphilia]]s, and [[priapism]], as well as boys with [[precocious puberty]].<ref name="pmid2147859" /><ref name="pmid20092449">{{cite journal | vauthors = Broderick GA, Kadioglu A, Bivalacqua TJ, Ghanem H, Nehra A, Shamloul R | title = Priapism: pathogenesis, epidemiology, and management | journal = The Journal of Sexual Medicine | volume = 7 | issue = 1 Pt 2 | pages = 476–500 | date = January 2010 | pmid = 20092449 | doi = 10.1111/j.1743-6109.2009.01625.x }}</ref><ref name="SteinbergForget2009">{{cite book| vauthors = Steinberg MH, Forget BG, Higgs DR, Weatherall DJ |title=Disorders of Hemoglobin: Genetics, Pathophysiology, and Clinical Management|url=https://books.google.com/books?id=5UcgAwAAQBAJ&pg=PA476|date=17 August 2009|publisher=Cambridge University Press|isbn=978-1-139-48080-2|pages=476–}}</ref> In women and girls, antiandrogens are used to treat [[acne vulgaris|acne]], [[seborrhea]], [[hidradenitis suppurativa]], [[hirsutism]], and [[hyperandrogenism]].<ref name="pmid2147859" /><ref name="pmid16828411">{{cite journal | vauthors = Essah PA, Wickham EP, Nunley JR, Nestler JE | title = Dermatology of androgen-related disorders | journal = Clinics in Dermatology | volume = 24 | issue = 4 | pages = 289–298 | year = 2006 | pmid = 16828411 | doi = 10.1016/j.clindermatol.2006.04.004 }}</ref><ref name="RabeGrunwald2009">{{cite journal| vauthors = Rabe T, Grunwald K, Feldmann K, Runnebaum B |title=Treatment of hyperandrogenism in women|journal=Gynecological Endocrinology|volume=10|issue=sup3|year=2009|pages=1–44|issn=0951-3590|doi=10.3109/09513599609045658}}</ref> Antiandrogens are also used in [[transgender women]] as a component of [[feminizing hormone therapy]] and as [[puberty blocker]]s in [[transgender youth|transgender girl]]s.<ref name="pmid21714669" /><ref name="pmid25404716" />

===Men and boys===

====Prostate cancer====
{{See also|Management of prostate cancer#Hormonal therapy|Androgen deprivation therapy}}

Androgens like testosterone and particularly DHT are importantly involved in the development and progression of prostate cancer.<ref name="pmid27019626">{{cite journal | vauthors = Wadosky KM, Koochekpour S | title = Therapeutic Rationales, Progresses, Failures, and Future Directions for Advanced Prostate Cancer | journal = Int. J. Biol. Sci. | volume = 12 | issue = 4 | pages = 409–26 | year = 2016 | pmid = 27019626 | pmc = 4807161 | doi = 10.7150/ijbs.14090 }}</ref> They act as [[growth factor]]s in the [[prostate gland]], stimulating [[cell division]] and [[tissue growth]].<ref name="pmid27019626" /> In accordance, therapeutic modalities that reduce androgen signaling in the prostate gland, referred to collectively as [[androgen deprivation therapy]], are able to significantly slow the course of prostate cancer and extend life in men with the disease.<ref name="pmid27019626" /> Although antiandrogens are effective in slowing the progression of prostate cancer, they are not generally curative, and with time, the disease adapts and androgen deprivation therapy eventually becomes ineffective.<ref name="pmid21680543">{{cite journal | vauthors = Massard C, Fizazi K | title = Targeting continued androgen receptor signaling in prostate cancer | journal = Clin. Cancer Res. | volume = 17 | issue = 12 | pages = 3876–83 | year = 2011 | pmid = 21680543 | doi = 10.1158/1078-0432.CCR-10-2815 | doi-access = free }}</ref> When this occurs, other treatment approaches, such as [[chemotherapy]], may be considered.<ref name="pmid21680543" />

The most common methods of androgen deprivation therapy currently employed to treat prostate cancer are [[castration]] (with a GnRH modulator or [[orchiectomy]]), nonsteroidal antiandrogens, and the androgen synthesis inhibitor [[abiraterone acetate]].<ref name="pmid27019626" /> Castration may be used alone or in combination with one of the other two treatments.<ref name="pmid27019626" /><ref name="pmid17604502">{{cite journal | vauthors = Msaouel P, Diamanti E, Tzanela M, Koutsilieris M | title = Luteinising hormone-releasing hormone antagonists in prostate cancer therapy | journal = Expert Opin Emerg Drugs | volume = 12 | issue = 2 | pages = 285–99 | year = 2007 | pmid = 17604502 | doi = 10.1517/14728214.12.2.285 | s2cid = 41988320 }}</ref> When castration is combined with a nonsteroidal antiandrogen like [[bicalutamide]], this strategy is referred to as [[combined androgen blockade]] (also known as complete or maximal androgen blockade).<ref name="pmid27019626" /><ref name="pmid21091846">{{Cite journal | vauthors = Akaza H | title = Combined androgen blockade for prostate cancer: review of efficacy, safety, and cost-effectiveness | journal = Cancer Science | volume = 102 | pages = 51–6 |date=Jan 2011 | pmid = 21091846 | doi = 10.1111/j.1349-7006.2010.01774.x | issue = 1| s2cid = 38486547 | doi-access = free }}</ref> [[Enzalutamide]], [[apalutamide]], and abiraterone acetate are specifically approved for use in combination with castration to treat castration-resistant prostate cancer.<ref name="pmid27019626" /><ref name="pmid24390422">{{cite journal | vauthors = Mateo J, Smith A, Ong M, de Bono JS | title = Novel drugs targeting the androgen receptor pathway in prostate cancer | journal = Cancer Metastasis Rev. | volume = 33 | issue = 2–3 | pages = 567–79 | year = 2014 | pmid = 24390422 | doi = 10.1007/s10555-013-9472-2 | s2cid = 13980764 }}</ref> Monotherapy with the nonsteroidal antiandrogen bicalutamide is also used in the treatment of prostate cancer as an alternative to castration with comparable effectiveness but with a different and potentially advantageous side effect profile.<ref name="pmid27019626" /><ref name="pmid11121992" /><ref name="pmid11502439">{{cite journal |vauthors=Kolvenbag GJ, Iversen P, Newling DW | title = Antiandrogen monotherapy: a new form of treatment for patients with prostate cancer | journal = Urology | volume = 58 | issue = 2 Suppl 1 | pages = 16–23 |date=August 2001 | pmid = 11502439 | doi = 10.1016/s0090-4295(01)01237-7}}</ref>

[[High-dose estrogen]] was the first functional antiandrogen used to treat prostate cancer. It was widely used, but has largely been abandoned for this indication in favor of newer agents with improved safety profiles and fewer feminizing side effects.<ref name="pmid12667881">{{cite journal | vauthors = Mcleod DG | title = Hormonal therapy: historical perspective to future directions | journal = Urology | volume = 61 | issue = 2 Suppl 1 | pages = 3–7 | year = 2003 | pmid = 12667881 | doi = 10.1016/s0090-4295(02)02393-2 }}</ref> [[Cyproterone acetate]] was developed subsequently to high-dose estrogen and is the only steroidal antiandrogen that has been widely used in the treatment of prostate cancer,<ref name="SmithWilliams2005">{{cite book | vauthors = Smith HJ, Williams H | title = Smith and Williams' Introduction to the Principles of Drug Design and Action, Fourth Edition |url=https://books.google.com/books?id=P2W6B9FQRKsC&pg=PA489 |date=10 October 2005 |publisher=CRC Press |isbn=978-0-203-30415-0 |pages=489–}}</ref> but it has largely been replaced by nonsteroidal antiandrogens, which are newer and have greater effectiveness, tolerability, and safety.<ref name="ChabnerLongo2010">{{cite book|vauthors=Chabner BA, Longo DL|title=Cancer Chemotherapy and Biotherapy: Principles and Practice|url=https://books.google.com/books?id=WL4arNFsQa8C&pg=PA680|date=8 November 2010|publisher=Lippincott Williams & Wilkins|isbn=978-1-60547-431-1|pages=679–680|quote=From a structural standpoint, antiandrogens are classified as steroidal, including cyproterone [acetate] (Androcur) and megestrol [acetate], or nonsteroidal, including flutamide (Eulexin, others), bicalutamide (Casodex), and nilutamide (Nilandron). The steroidal antiandrogens are rarely used.|access-date=27 December 2016|archive-date=10 January 2023|archive-url=https://web.archive.org/web/20230110224032/https://books.google.com/books?id=WL4arNFsQa8C&pg=PA680|url-status=live}}</ref><ref name="KaliksDel Giglio2008">{{cite journal | vauthors = Kaliks RA, Del Giglio A | title = Management of advanced prostate cancer | journal = Revista da Associação Médica Brasileira | volume = 54 | issue = 2 | pages = 178–82 | year = 2008 | pmid = 18506331 | doi = 10.1590/S0104-42302008000200025 | url = http://www.scielo.br/pdf/ramb/v54n2/a25v54n2.pdf | doi-access = free | access-date = 2016-12-27 | archive-date = 2017-05-10 | archive-url = https://web.archive.org/web/20170510112152/http://www.scielo.br/pdf/ramb/v54n2/a25v54n2.pdf | url-status = live }}</ref> Bicalutamide, as well as enzalutamide, have largely replaced the earlier nonsteroidal antiandrogens [[flutamide]] and [[nilutamide]], which are now little used.<ref name="pmid21091846" /><ref name="HHS2010">{{citation | title = Bicalutamide BPCA Drug Use Review in the Pediatric Population | vauthors = Chang S | publisher = [[United States Department of Health and Human Services|U.S. Department of Health and Human Service]] | date = 10 March 2010 | access-date = 20 July 2016 | url = https://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/PediatricAdvisoryCommittee/UCM214400.pdf | archive-date = 24 October 2016 | archive-url = https://web.archive.org/web/20161024181831/https://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/PediatricAdvisoryCommittee/UCM214400.pdf | url-status = live }}</ref><ref name="Gulley2011">{{cite book | vauthors = Gulley JL |title=Prostate Cancer |url=https://books.google.com/books?id=WJkjgbRJe3EC&pg=PT81 |year=2011 |publisher=Demos Medical Publishing |isbn=978-1-935281-91-7 |pages=81–}}</ref><ref name="Moser2008">{{cite book |vauthors=Lutz M |title=Controversies in the Treatment of Prostate Cancer |url=https://books.google.com/books?id=4J4OCRyHWRYC&pg=PA41 |date=1 January 2008 |publisher=Karger Medical and Scientific Publishers |isbn=978-3-8055-8524-8 |pages=41–42 |access-date=27 December 2016 |archive-date=12 January 2023 |archive-url=https://web.archive.org/web/20230112173054/https://books.google.com/books?id=4J4OCRyHWRYC&pg=PA41 |url-status=live }}</ref><ref name="Demnos2011">{{cite book |title=Prostate Cancer |url=https://books.google.com/books?id=WJkjgbRJe3EC&pg=PA505 |date=20 December 2011 |publisher=Demos Medical Publishing |isbn=978-1-935281-91-7 |pages=505–}}</ref> The earlier androgen synthesis inhibitors [[aminoglutethimide]] and [[ketoconazole]] have only limitedly been used in the treatment of prostate cancer due to [[toxicity]] concerns and have been replaced by abiraterone acetate.<ref name="FiggChau2010" />

In addition to active treatment of prostate cancer, antiandrogens are effective as [[prophylaxis]] (preventatives) in reducing the risk of ever developing prostate cancer.<ref name="pmid21604953">{{cite journal | vauthors = Rittmaster RS | title = Chemoprevention of prostate cancer | journal = Acta Oncol | volume = 50 | issue = Suppl 1 | pages = 127–36 | year = 2011 | pmid = 21604953 | doi = 10.3109/0284186X.2010.527367 | doi-access = free }}</ref> Antiandrogens have only limitedly been assessed for this purpose, but the 5α-reductase inhibitors [[finasteride]] and [[dutasteride]] and the steroidal AR antagonist [[spironolactone]] have been associated with significantly reduced risk of prostate cancer.<ref name="pmid21604953" /><ref name="pmid27735065">{{cite journal | vauthors = Mackenzie IS, Morant SV, Wei L, Thompson AM, MacDonald TM | title = Spironolactone use and risk of incident cancers: a retrospective, matched cohort study | journal = Br J Clin Pharmacol | volume = 83| issue = 3| pages = 653–663| year = 2016 | pmid = 27735065 | doi = 10.1111/bcp.13152 | pmc = 5306481 }}</ref> In addition, it is notable that prostate cancer is extremely rare in transgender women who have been on feminizing hormone therapy for an extended period of time.<ref name="pmid19509099">{{cite journal | vauthors = Hembree WC, Cohen-Kettenis P, Delemarre-van de Waal HA, Gooren LJ, Meyer WJ, Spack NP, Tangpricha V, Montori VM | title = Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline | journal = J. Clin. Endocrinol. Metab. | volume = 94 | issue = 9 | pages = 3132–54 | year = 2009 | pmid = 19509099 | doi = 10.1210/jc.2009-0345 | doi-access = free }}</ref><ref name="pmid24329588">{{cite journal | vauthors = Gooren L, Morgentaler A | title = Prostate cancer incidence in orchidectomised male-to-female transsexual persons treated with oestrogens | journal = Andrologia | volume = 46 | issue = 10 | pages = 1156–60 | year = 2014 | pmid = 24329588 | doi = 10.1111/and.12208 | s2cid = 1445627 | doi-access = free }}</ref><ref name="pmid24032068">{{cite journal | vauthors = Turo R, Jallad S, Prescott S, Cross WR | title = Metastatic prostate cancer in transsexual diagnosed after three decades of estrogen therapy | journal = Can Urol Assoc J | volume = 7 | issue = 7–8 | pages = E544–6 | year = 2013 | pmid = 24032068 | pmc = 3758950 | doi = 10.5489/cuaj.175 }}</ref>

====Enlarged prostate====
{{See also|Benign prostatic hyperplasia#5α-Reductase inhibitors}}

The 5α-reductase inhibitors [[finasteride]] and [[dutasteride]] are used to treat benign prostatic hyperplasia, a condition in which the prostate becomes enlarged and this results in urinary obstruction and discomfort.<ref name="pmid19030020">{{cite journal | vauthors = Dörsam J, Altwein J | title = 5alpha-Reductase inhibitor treatment of prostatic diseases: background and practical implications | journal = Prostate Cancer Prostatic Dis. | volume = 12 | issue = 2 | pages = 130–6 | year = 2009 | pmid = 19030020 | doi = 10.1038/pcan.2008.56 | doi-access = free }}</ref> They are effective because androgens act as growth factors in the prostate gland.<ref name="pmid19030020" /> The antiandrogens [[chlormadinone acetate]] and [[oxendolone]] and the functional antiandrogens [[allylestrenol]] and [[gestonorone caproate]] are also approved in some countries for the treatment of benign prostatic hyperplasia.<ref name="pmid12534901">{{cite journal | vauthors = Ishizuka O, Nishizawa O, Hirao Y, Ohshima S | title = Evidence-based meta-analysis of pharmacotherapy for benign prostatic hypertrophy | journal = Int. J. Urol. | volume = 9 | issue = 11 | pages = 607–12 | year = 2002 | pmid = 12534901 | doi = 10.1046/j.1442-2042.2002.00539.x| s2cid = 8249363 | doi-access = free }}</ref><ref name="RaspéBrosig2013">{{cite book| vauthors = Raspé G, Brosig W |title=International Symposium on the Treatment of Carcinoma of the Prostate, Berlin, November 13 to 15, 1969: Life Science Monographs|url=https://books.google.com/books?id=8RjLBAAAQBAJ&pg=PA165|date=22 October 2013|publisher=Elsevier|isbn=978-1-4831-8711-2|pages=165–}}</ref>

====Scalp hair loss====
{{See also|Management of hair loss#Antiandrogens}}

5α-Reductase inhibitors like finasteride, dutasteride, and [[alfatradiol]] and the [[topical]] nonsteroidal AR antagonist [[topilutamide]] (fluridil) are approved for the treatment of pattern hair loss, also known as scalp hair loss or baldness.<ref name="TrüebLee2014">{{cite book| vauthors = Trüeb RM, Lee WS |title=Male Alopecia: Guide to Successful Management|url=https://books.google.com/books?id=0ue5BAAAQBAJ&pg=PA93|date=13 February 2014|publisher=Springer Science & Business Media|isbn=978-3-319-03233-7|pages=91–93}}</ref> This condition is generally caused by androgens, so antiandrogens can slow or halt its progression.<ref name="BologniaJorizzo">{{cite book| vauthors = Bolognia JL, Jorizzo JL, Rapini RP |title=Dermatology|year=2003 |url=https://books.google.com/books?id=f2IwYiyh3YUC&pg=PT1072|publisher=Gulf Professional Publishing|isbn=9789997638991|pages=1072–}}</ref> Systemic antiandrogens besides 5α-reductase inhibitors are not generally used to treat scalp hair loss in males due to risks like feminization (e.g., gynecomastia) and sexual dysfunction.<ref name="Simpson1989">{{cite book| vauthors = Simpson NB |title=Pharmacology of the Skin II|volume=87 / 2|year=1989|pages=495–508|issn=0171-2004|doi=10.1007/978-3-642-74054-1_37|series=Handbook of Experimental Pharmacology|isbn=978-3-642-74056-5|chapter=The Effect of Drugs on Hair|publisher=Springer }}</ref><ref name="Unger1995">{{cite book| vauthors = Unger WP |chapter=Androgenetic alopecia and its treatment. A historical overview|pages=1–33|title=Hair Transplantation | edition =Third |url=https://books.google.com/books?id=_KxsAAAAMAAJ|date=1 February 1995|publisher=Taylor & Francis|isbn=978-0-8247-9363-0}}</ref><ref name="Rasmusson1986" /><ref name="Cormanevan der Meeren1981" /><ref name="pmid19297634">{{cite journal | vauthors = Giltay EJ, Gooren LJ | title = Potential side effects of androgen deprivation treatment in sex offenders | journal = The Journal of the American Academy of Psychiatry and the Law | volume = 37 | issue = 1 | pages = 53–58 | date = 2009 | pmid = 19297634 }}</ref><ref name="LamHempstead2012">{{cite book| vauthors = Lam SM, Hempstead BR, Williams EF |title=Aesthetic Medicine|chapter=Medical Management Options for Hair Loss|year=2012|pages=529–535|publisher=Springer |doi=10.1007/978-3-642-20113-4_41|isbn=978-3-642-20112-7}}</ref><ref name="Neumann1996" /> However, they have been assessed and reported to be effective for this indication.<ref name="Simpson1989"/><ref name="Unger1995"/><ref name="Coskey1984">{{cite journal | vauthors = Coskey RJ | title = Dermatologic therapy: December, 1982, through November, 1983 | journal = Journal of the American Academy of Dermatology | volume = 11 | issue = 1 | pages = 25–52 | date = July 1984 | pmid = 6376557 | doi = 10.1016/S0190-9622(84)80163-2 }}</ref>

====Acne====
Systemic antiandrogens are generally not used to treat acne in males due to their high risk of feminization (e.g., gynecomastia) and sexual dysfunction.<ref name="PlewigKligman2012">{{cite book| vauthors = Plewig G, Kligman AM |title= ACNE and ROSACEA|url=https://books.google.com/books?id=0cD-CAAAQBAJ&pg=PA687|date=6 December 2012|publisher=Springer Science & Business Media|isbn=978-3-642-59715-2|pages=687–}}</ref><ref name="AlldredgeCorelli2012">{{cite book| vauthors = Alldredge BK, Corelli RL, Ernst ME |title=Koda-Kimble and Young's Applied Therapeutics: The Clinical Use of Drugs|url=https://books.google.com/books?id=qcVpuHngXK0C&pg=PA952|date=1 February 2012|publisher=Lippincott Williams & Wilkins|isbn=978-1-60913-713-7|pages=952–}}</ref> However, they have been studied for acne in males and found to be effective.<ref name="WardBrogden1984">{{cite journal | vauthors = Ward A, Brogden RN, Heel RC, Speight TM, Avery GS | title = Isotretinoin. A review of its pharmacological properties and therapeutic efficacy in acne and other skin disorders | journal = Drugs | volume = 28 | issue = 1 | pages = 6–37 | date = July 1984 | pmid = 6235105 | doi = 10.2165/00003495-198428010-00002 }}</ref><ref name="Rasmusson1986">{{cite book| vauthors = Rasmusson GH |title= Chapter 18. Chemical Control of Androgen Action|volume=21|year=1986|pages=179–188|issn=0065-7743|doi=10.1016/S0065-7743(08)61128-8|series=Annual Reports in Medicinal Chemistry|publisher= Academic Press|isbn=9780120405213}}</ref><ref name="Cormanevan der Meeren1981">{{cite journal| vauthors = Cormane RH, van der Meeren HL |title=Cyproteronacetate in the management of severe acne in males|journal=Archives of Dermatological Research |volume=271 |issue=2 |year=1981 |pages=183–187 |issn=0340-3696|doi=10.1007/BF00412545|s2cid=12153042}}</ref><ref name="pmid2945742">{{cite journal | vauthors = Misch KJ, Dolman WF, Neild V, Rhodes EL | title = Response of male acne to antiandrogen therapy with cyproterone acetate | journal = Dermatologica | volume = 173 | issue = 3 | pages = 139–142 | date = 1986 | pmid = 2945742 | doi = 10.1159/000249236 }}</ref> [[Clascoterone]], a topical antiandrogen, is effective for acne in males, albeit modestly,<ref name="BasendwhAlharbiBukhamsin2024" /> and has been approved by the FDA in August 2020.<ref name="pmid31487336">{{cite journal | vauthors = Kircik LH | title = What's new in the management of acne vulgaris | journal = Cutis | volume = 104 | issue = 1 | pages = 48–52 | date = July 2019 | pmid = 31487336 | url = https://www.mdedge.com/dermatology/article/204308/acne/whats-new-management-acne-vulgaris | access-date = 2020-03-30 | archive-date = 2020-10-26 | archive-url = https://web.archive.org/web/20201026050003/https://www.mdedge.com/dermatology/article/204308/acne/whats-new-management-acne-vulgaris | url-status = live }}</ref><ref name="pmid27416311">{{cite journal | vauthors = Hassoun LA, Chahal DS, Sivamani RK, Larsen LN | title = The use of hormonal agents in the treatment of acne | journal = Seminars in Cutaneous Medicine and Surgery | volume = 35 | issue = 2 | pages = 68–73 | date = June 2016 | pmid = 27416311 | doi = 10.12788/j.sder.2016.027 | doi-broken-date = 1 November 2024 }}</ref><ref>{{Cite web |date=2020-08-28 |title=Cassiopea Receives FDA Approval for Winlevi® (clascoterone cream 1%), First-in-Class Topical Acne Treatment Targeting the Androgen Receptor - Cassiopea |url=https://www.cassiopea.com/2020/08/27/cassiopea-receives-fda-approval-for-winlevi-clascoterone-cream-1-first-in-class-topical-acne-treatment-targeting-the-androgen-receptor/ |access-date=2024-04-15 |archive-url=https://web.archive.org/web/20200828021558/https://www.cassiopea.com/2020/08/27/cassiopea-receives-fda-approval-for-winlevi-clascoterone-cream-1-first-in-class-topical-acne-treatment-targeting-the-androgen-receptor/ |archive-date=2020-08-28 }}</ref><ref>{{Cite web |title=Drugs@FDA: FDA-Approved Drugs |url=https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=213433 |access-date=2024-04-15 |website=www.accessdata.fda.gov |language=en}}</ref>

====Paraphilias====
{{See also|Paraphilia#Antiandrogens|Chemical castration#Treatment for sex offenders}}

Androgens increase [[sex drive]],<ref name="JonesLopez2013">{{cite book| vauthors = Jones RE, Lopez KH |title=Human Reproductive Biology|url=https://books.google.com/books?id=M4kEdSnS-pkC&pg=PA77|date=28 September 2013|publisher=Academic Press|isbn=978-0-12-382185-0|pages=77–}}</ref> and for this reason, antiandrogens are able to reduce sex drive in men.<ref name="pmid11221487">{{cite journal | vauthors = Bradford JM | title = The neurobiology, neuropharmacology, and pharmacological treatment of the paraphilias and compulsive sexual behaviour | journal = Can J Psychiatry | volume = 46 | issue = 1 | pages = 26–34 | year = 2001 | pmid = 11221487 | doi = 10.1177/070674370104600104| doi-access = free }}</ref><ref name="pmid19243704">{{cite journal | vauthors = Guay DR | title = Drug treatment of paraphilic and nonparaphilic sexual disorders | journal = Clin Ther | volume = 31 | issue = 1 | pages = 1–31 | year = 2009 | pmid = 19243704 | doi = 10.1016/j.clinthera.2009.01.009 }}</ref> In accordance, antiandrogens are used in the treatment of conditions such as [[hypersexuality]] (excessively high sex drive) and [[paraphilia]]s (atypical and sometimes societally unacceptable sexual interests) like [[pedophilia]] (sexual attraction to children).<ref name="pmid11221487" /><ref name="pmid19243704" /> They have been used to decrease sex drive in [[sex offender]]s so as to reduce the likelihood of [[recidivism]] (repeat offenses).<ref name="MarshallLaws2013">{{cite book| vauthors = Marshall WL, Laws DR, Barbaree HE |title=Handbook of Sexual Assault: Issues, Theories, and Treatment of the Offender|url=https://books.google.com/books?id=lkf2BwAAQBAJ&pg=PA297|date=21 November 2013|publisher=Springer Science & Business Media|isbn=978-1-4899-0915-2|pages=297–}}</ref> Antiandrogens used for these indications include [[cyproterone acetate]], [[medroxyprogesterone acetate]], and GnRH modulators.<ref name="StunkardBaum1989">{{cite book| vauthors = Stunkard AJ, Baum A |title=Eating, Sleeping, and Sex|url=https://books.google.com/books?id=bf-dRU-Ie9EC&pg=PA209 |year=1989|publisher=Psychology Press|isbn=978-0-8058-0280-1|pages=209–}}</ref><ref name="PhenixHoberman2015">{{cite book| vauthors = Phenix A, Hoberman HM |title=Sexual Offending: Predisposing Antecedents, Assessments and Management|url=https://books.google.com/books?id=NhEpCwAAQBAJ&pg=PA759|date=7 December 2015|publisher=Springer|isbn=978-1-4939-2416-5|pages=759–}}</ref>

====Early puberty====
Antiandrogens are used to treat [[precocious puberty]] in boys.<ref name="pmid18345393">{{cite journal | vauthors = Brito VN, Latronico AC, Arnhold IJ, Mendonça BB | title = Update on the etiology, diagnosis and therapeutic management of sexual precocity | journal = Arq Bras Endocrinol Metabol | volume = 52 | issue = 1 | pages = 18–31 | date = February 2008 | pmid = 18345393 | doi = 10.1590/S0004-27302008000100005 | doi-access = free }}</ref><ref name="pmid6205409">{{cite journal | vauthors = Tindall DJ, Chang CH, Lobl TJ, Cunningham GR | title = Androgen antagonists in androgen target tissues | journal = Pharmacol. Ther. | volume = 24 | issue = 3 | pages = 367–400 | date = 1984 | pmid = 6205409 | doi = 10.1016/0163-7258(84)90010-x}}</ref><ref name="pmid2462132">{{cite journal | vauthors = Namer M | title = Clinical applications of antiandrogens | journal = J. Steroid Biochem. | volume = 31 | issue = 4B | pages = 719–29 | date = October 1988 | pmid = 2462132 | doi = 10.1016/0022-4731(88)90023-4}}</ref><ref name="pmid3109366">{{cite journal | vauthors = Fraser HM, Baird DT | title = Clinical applications of LHRH analogues | journal = Baillière's Clin. Endocrinol. Metab. | volume = 1 | issue = 1 | pages = 43–70 | date = February 1987 | pmid = 3109366 | doi = 10.1016/S0950-351X(87)80052-6}}</ref> They work by opposing the effects of androgens and delaying the development of [[secondary sexual characteristic]]s and onset of changes in [[sex drive]] and [[sexual function|function]] until a more appropriate age.<ref name="pmid18345393" /><ref name="pmid6205409" /> Antiandrogens that have been used for this purpose include [[cyproterone acetate]], [[medroxyprogesterone acetate]], GnRH modulators, [[spironolactone]], [[bicalutamide]], and [[ketoconazole]].<ref name="pmid18345393" /><ref name="pmid3109366" /><ref name="pmid10969925">{{cite journal | vauthors = Laron Z, Kauli R | title = Experience with cyproterone acetate in the treatment of precocious puberty | journal = J. Pediatr. Endocrinol. Metab. | volume = 13 | issue = Suppl 1 | pages = 805–10 | date = July 2000 | pmid = 10969925 | doi = 10.1515/jpem.2000.13.s1.805| s2cid = 25398066 }}</ref><ref name="pmid1838080">{{cite journal | vauthors = Neumann F, Kalmus J | title = Cyproterone acetate in the treatment of sexual disorders: pharmacological base and clinical experience | journal = Exp. Clin. Endocrinol. | volume = 98 | issue = 2 | pages = 71–80 | date = 1991 | pmid = 1838080 | doi = 10.1055/s-0029-1211103 }}</ref><ref name="pmid1903104">{{cite journal | vauthors = Holland FJ | title = Gonadotropin-independent precocious puberty | journal = Endocrinol. Metab. Clin. North Am. | volume = 20 | issue = 1 | pages = 191–210 | date = March 1991 | pmid = 1903104 | doi = 10.1016/s0889-8529(18)30288-3}}</ref><ref name="pmid16361981">{{cite journal | vauthors = Reiter EO, Norjavaara E | title = Testotoxicosis: current viewpoint | journal = Pediatr Endocrinol Rev | volume = 3 | issue = 2 | pages = 77–86 | date = December 2005 | pmid = 16361981 }}</ref> Spironolactone and bicalutamide require combination with an [[aromatase inhibitor]] to prevent the effects of unopposed [[estrogen]]s, while the others can be used alone.<ref name="pmid18345393" /><ref name="pmid1903104" /><ref name="pmid16361981" />

====Long-lasting erections====
Antiandrogens are effective in the treatment of recurrent [[priapism]] (potentially painful [[penile erection]]s that last more than four hours).<ref name="LeveyKutlu2011">{{cite journal | vauthors = Levey HR, Kutlu O, Bivalacqua TJ | title = Medical management of ischemic stuttering priapism: a contemporary review of the literature | journal = Asian Journal of Andrology | volume = 14 | issue = 1 | pages = 156–63 | year = 2012 | pmid = 22057380 | pmc = 3753435 | doi = 10.1038/aja.2011.114 }}</ref><ref name="BroderickKadioglu2010">{{cite journal | vauthors = Broderick GA, Kadioglu A, Bivalacqua TJ, Ghanem H, Nehra A, Shamloul R | title = Priapism: pathogenesis, epidemiology, and management | journal = The Journal of Sexual Medicine | volume = 7 | issue = 1 Pt 2 | pages = 476–500 | year = 2010 | pmid = 20092449 | doi = 10.1111/j.1743-6109.2009.01625.x }}</ref><ref name="ChowPayne2008">{{cite journal | vauthors = Chow K, Payne S | title = The pharmacological management of intermittent priapismic states | journal = BJU International | volume = 102 | issue = 11 | pages = 1515–21 | year = 2008 | pmid = 18793304 | doi = 10.1111/j.1464-410X.2008.07951.x | s2cid = 35399393 | doi-access = free }}</ref><ref name="DahmRao2002">{{cite journal | vauthors = Dahm P, Rao DS, Donatucci CF | title = Antiandrogens in the treatment of priapism | journal = Urology | volume = 59 | issue = 1 | pages = 138 | year = 2002 | pmid = 11796309 | doi = 10.1016/S0090-4295(01)01492-3 }}</ref><ref name="YuanDeSouza2008">{{cite journal | vauthors = Yuan J, Desouza R, Westney OL, Wang R | title = Insights of priapism mechanism and rationale treatment for recurrent priapism | journal = Asian Journal of Andrology | volume = 10 | issue = 1 | pages = 88–101 | year = 2008 | pmid = 18087648 | doi = 10.1111/j.1745-7262.2008.00314.x | doi-access = free }}</ref>

===Women and girls===

====Skin and hair conditions====
{{See also|Acne vulgaris#Hormonal agents|Seborrhoeic dermatitis#Antiandrogens|Hirsutism#Medications}}

Antiandrogens are used in the treatment of androgen-dependent [[skin condition|skin]] and [[hair disease|hair condition]]s including acne, seborrhea, hidradenitis suppurativa, hirsutism, and pattern hair loss in women.<ref name="pmid16828411" /> All of these conditions are dependent on androgens, and for this reason, antiandrogens are effective in treating them.<ref name="pmid16828411" /> The most commonly used antiandrogens for these indications are [[cyproterone acetate]] and [[spironolactone]].<ref name="BaranMaibach1998">{{cite book| vauthors = Baran R, Maibach HI |title=Textbook of Cosmetic Dermatology|url=https://books.google.com/books?id=yIVfq5Lpl2EC&pg=PA388|date=1 October 1998|publisher=CRC Press|isbn=978-1-85317-478-0|pages=388–}}</ref> [[Flutamide]] has also been studied extensively for such uses, but has fallen out of favor due to its association with [[hepatotoxicity]].<ref name="MaibachGorouhi2011">{{cite book| vauthors = Maibach HI, Gorouhi F |title=Evidence Based Dermatology|url=https://books.google.com/books?id=V2L1MAoGHVkC&pg=PA526|year=2011|publisher=PMPH-USA|isbn=978-1-60795-039-4|pages=526–}}</ref> [[Bicalutamide]], which has a relatively minimal risk of hepatotoxicity, has been evaluated for the treatment of hirsutism and found effective similarly to flutamide and may be used instead of it.<ref name="WilliamsBigby2009">{{cite book|vauthors=Williams H, Bigby M, Diepgen T, Herxheimer A, Naldi L, Rzany B|title=Evidence-Based Dermatology|url=https://books.google.com/books?id=SbsQij5xkfYC&pg=PA529|date=22 January 2009|publisher=John Wiley & Sons|isbn=978-1-4443-0017-8|pages=529–|access-date=27 December 2016|archive-date=10 January 2023|archive-url=https://web.archive.org/web/20230110085152/https://books.google.com/books?id=SbsQij5xkfYC&pg=PA529|url-status=live}}</ref><ref name="pmid24455796">{{cite journal | vauthors = Erem C | title = Update on idiopathic hirsutism: diagnosis and treatment | journal = Acta Clin Belg | volume = 68 | issue = 4 | pages = 268–74 | year = 2013 | pmid = 24455796 | doi = 10.2143/ACB.3267 | s2cid = 39120534 }}</ref> In addition to AR antagonists, [[oral contraceptive]]s containing [[ethinylestradiol]] are effective in treating these conditions, and may be combined with AR antagonists.<ref name="Becker2001">{{cite book| vauthors = Becker KL |title=Principles and Practice of Endocrinology and Metabolism |url= https://books.google.com/books?id=FVfzRvaucq8C&pg=PA1004 |year=2001|publisher=Lippincott Williams & Wilkins|isbn=978-0-7817-1750-2|pages=1004, 1196}}</ref><ref name="CamachoGharib2012">{{cite book| vauthors = Camacho PM, Gharib H, Sizemore GW |title=Evidence-Based Endocrinology |url=https://books.google.com/books?id=TrLaw_CX1i8C&pg=PA199 |year=2012 |publisher=Lippincott Williams & Wilkins |isbn=978-1-4511-1091-3 |pages=199–}}</ref>

====High androgen levels====
{{See also|Hyperandrogenism#Treatment}}

Hyperandrogenism is a condition in women in which androgen levels are excessively and abnormally high.<ref name="RabeGrunwald2009" /> It is commonly seen in women with PCOS, and also occurs in women with [[intersex condition]]s like [[congenital adrenal hyperplasia]].<ref name="RabeGrunwald2009" /> Hyperandrogenism is associated with [[virilization]] – that is, the development of masculine [[secondary sexual characteristic]]s like male-pattern facial and body hair growth (or hirsutism), [[voice change|voice deepening]], increased [[muscle]] [[lean body mass|mass]] and [[physical strength|strength]], and [[broadening of the shoulders]], among others.<ref name="RabeGrunwald2009" /> Androgen-dependent skin and hair conditions like acne and pattern hair loss may also occur in hyperandrogenism, and [[menstrual irregularity|menstrual disturbance]]s, like [[amenorrhea]], are commonly seen.<ref name="RabeGrunwald2009" /> Although antiandrogens do not treat the underlying cause of hyperandrogenism (e.g., PCOS), they are able to prevent and reverse its manifestation and effects.<ref name="RabeGrunwald2009" /> As with androgen-dependent skin and hair conditions, the most commonly used antiandrogens in the treatment of hyperandrogenism in women are cyproterone acetate and spironolactone.<ref name="RabeGrunwald2009" /> Other antiandrogens, like bicalutamide, may be used alternatively.<ref name="RabeGrunwald2009" />

====Transgender hormone therapy====
{{See also|Feminizing hormone therapy#Antiandrogens}}

Antiandrogens are used to prevent or reverse [[masculinization]] and to facilitate [[feminization (biology)|feminization]] in [[transgender women]] and some [[non-binary gender|non-binary]] transfeminine individuals who are undergoing [[feminizing hormone therapy|hormone therapy]] and who have not undergone [[sex reassignment surgery]] or [[orchiectomy]].<ref name="pmid21714669">{{cite journal | vauthors = Bockting W, Coleman E, De Cuypere G | title = Care of transsexual persons | journal = N. Engl. J. Med. | volume = 364 | issue = 26 | pages = 2559–60; author reply 2560 | year = 2011 | pmid = 21714669 | doi = 10.1056/NEJMc1104884 }}</ref> Besides estrogens, the main antiandrogens that have been used for this purpose are cyproterone acetate, spironolactone, and GnRH modulators.<ref name="pmid21714669" /> Nonsteroidal antiandrogens like bicalutamide are also used for this indication.<ref name="pmid30256230">{{cite journal | vauthors = Randolph JF | title = Gender-Affirming Hormone Therapy for Transgender Females | journal = Clin Obstet Gynecol | volume = 61 | issue = 4 | pages = 705–721 | date = December 2018 | pmid = 30256230 | doi = 10.1097/GRF.0000000000000396 | s2cid = 52821192 }}</ref><ref name="pmid21714669" /> In addition to use in transgender women, antiandrogens, mainly GnRH modulators, are used as [[puberty blocker]]s to prevent the onset of [[puberty]] in [[transgender youth|transgender girl]]s until they are older and ready to begin hormone therapy.<ref name="pmid25404716">{{cite journal | vauthors = Vance SR, Ehrensaft D, Rosenthal SM | title = Psychological and medical care of gender nonconforming youth | journal = Pediatrics | volume = 134 | issue = 6 | pages = 1184–92 | year = 2014 | pmid = 25404716 | doi = 10.1542/peds.2014-0772 | s2cid = 5743822 | url = http://pediatrics.aappublications.org/content/pediatrics/134/6/1184.full.pdf | access-date = 2018-05-14 | archive-date = 2018-05-15 | archive-url = https://web.archive.org/web/20180515045718/http://pediatrics.aappublications.org/content/pediatrics/134/6/1184.full.pdf | url-status = live }}</ref>

===Available forms===
{{See also|Steroidal antiandrogen|Nonsteroidal antiandrogen}}

There are several different types of antiandrogens, including the following:<ref name="pmid11502457" />

* '''Androgen receptor antagonists:''' Drugs that bind directly to and block the AR.<ref name="pmid10637363">{{cite journal | vauthors = Singh SM, Gauthier S, Labrie F | title = Androgen receptor antagonists (antiandrogens): structure-activity relationships | journal = Current Medicinal Chemistry | volume = 7 | issue = 2 | pages = 211–247 | date = February 2000 | pmid = 10637363 | doi = 10.2174/0929867003375371 }}</ref><ref name="ShenTaplin2010">{{cite book| vauthors = Shen HC, Taplin ME, Balk SP |title=Drug Management of Prostate Cancer |chapter=Androgen Receptor Antagonists |year=2010|pages=71–81|publisher=Springer |doi=10.1007/978-1-60327-829-4_6|isbn=978-1-60327-831-7}}</ref> These drugs include the [[steroidal antiandrogen]]s [[cyproterone acetate]], [[megestrol acetate]], [[chlormadinone acetate]], [[spironolactone]], [[oxendolone]], and [[osaterone acetate]] (veterinary) and the [[nonsteroidal antiandrogen]]s [[flutamide]], [[bicalutamide]], [[nilutamide]], [[topilutamide]], [[enzalutamide]], [[apalutamide]], and [[darolutamide]].<ref name="pmid10637363" /><ref name="ShenTaplin2010" /><ref name="SchröderRadlmaier2009" /><ref name="KolvenbagFurr2009" /> Aside from cyproterone acetate and chlormadinone acetate, a few other [[progestin]]s used in [[oral contraceptive]]s and/or in menopausal HRT including [[dienogest]], [[drospirenone]], [[medrogestone]], [[nomegestrol acetate]], [[promegestone]], and [[trimegestone]] also have varying degrees of AR antagonistic activity.<ref>{{cite journal | vauthors = Šauer P, Bořík A, Golovko O, Grabic R, Staňová AV, Valentová O, Stará A, Šandová M, Kocour Kroupová H | display-authors = 6 | title = Do progestins contribute to (anti-)androgenic activities in aquatic environments? | journal = Environmental Pollution | volume = 242 | issue = Pt A | pages = 417–425 | date = November 2018 | pmid = 29990947 | doi = 10.1016/j.envpol.2018.06.104 | bibcode = 2018EPoll.242..417S | s2cid = 51622914 }}</ref><ref name="pmid12600226">{{cite journal | vauthors = Raudrant D, Rabe T | title = Progestogens with antiandrogenic properties | journal = Drugs | volume = 63 | issue = 5 | pages = 463–492 | year = 2003 | pmid = 12600226 | doi = 10.2165/00003495-200363050-00003 | s2cid = 28436828 }}</ref><ref name="pmid14644837">{{cite journal | vauthors = Schneider HP | title = Androgens and antiandrogens | journal = Annals of the New York Academy of Sciences | volume = 997 | issue = 1 | pages = 292–306 | date = November 2003 | pmid = 14644837 | doi = 10.1196/annals.1290.033 | s2cid = 8400556 | bibcode = 2003NYASA.997..292S }}</ref>
* '''Androgen synthesis inhibitors:''' Drugs that directly inhibit the [[enzyme|enzymatic]] [[biosynthesis]] of androgens like testosterone and/or DHT.<ref name="IIIBarbieri2013">{{cite book| vauthors = Strauss III JF, Barbieri RL |title=Yen and Jaffe's Reproductive Endocrinology|url=https://books.google.com/books?id=KZ95AAAAQBAJ&pg=PA90|date=13 September 2013|publisher=Elsevier Health Sciences|isbn=978-1-4557-2758-2|pages=90–}}</ref><ref name="FiggChau2010">{{cite book| vauthors = Figg W, Chau CH, Small EJ |title=Drug Management of Prostate Cancer|url=https://books.google.com/books?id=4KDrjeWA5-UC&pg=PA93|date=14 September 2010|publisher=Springer Science & Business Media|isbn=978-1-60327-829-4|pages=71–72, 75, 91–96}}</ref> Examples include the [[CYP17A1 inhibitor]]s [[ketoconazole]], [[abiraterone acetate]], and [[seviteronel]],<ref name="IIIBarbieri2013" /> the [[CYP11A1]] (P450scc) inhibitor [[aminoglutethimide]],<ref name="IIIBarbieri2013" /> and the [[5α-reductase inhibitor]]s [[finasteride]], [[dutasteride]], [[epristeride]], [[alfatradiol]], and [[saw palmetto extract]] (''[[Serenoa repens]]'').<ref name="pmid19879888">{{cite journal | vauthors = Aggarwal S, Thareja S, Verma A, Bhardwaj TR, Kumar M | title = An overview on 5alpha-reductase inhibitors | journal = Steroids | volume = 75 | issue = 2 | pages = 109–53 | year = 2010 | pmid = 19879888 | doi = 10.1016/j.steroids.2009.10.005 | s2cid = 44363501 }}</ref> A number of other antiandrogens, including cyproterone acetate, spironolactone, medrogestone, flutamide, nilutamide, and [[bifluranol]], are also known to weakly inhibit androgen synthesis.
* '''Antigonadotropins:''' Drugs that suppress the [[gonadotropin-releasing hormone]] (GnRH)-induced release of [[gonadotropin]]s and consequent activation of [[gonadal]] androgen production.<ref name="Brueggemeier2006" /><ref name="FarmerWalker2012">{{cite book| vauthors = Farmer PB, Walker JM |title= The Molecular Basis of Cancer|url=https://books.google.com/books?id=Bva8BAAAQBAJ&pg=PA232|date=6 December 2012|publisher=Springer Science & Business Media|isbn=978-1-4684-7313-1|pages=232–}}</ref> Examples include [[GnRH modulator]]s like [[leuprorelin]] (a [[GnRH agonist]]) and [[cetrorelix]] (a [[GnRH antagonist]]),<ref name="LemkeWilliams2012" /> [[progestogen]]s like [[allylestrenol]], chlormadinone acetate, cyproterone acetate, [[gestonorone caproate]], [[hydroxyprogesterone caproate]], [[medroxyprogesterone acetate]], megestrol acetate, osaterone acetate (veterinary), and oxendolone,<ref name="pmid10997774" /><ref name="LedgerSchlaff2014">{{cite book| vauthors = Ledger W, Schlaff WD, Vancaillie TG |title=Chronic Pelvic Pain|url=https://books.google.com/books?id=ON-VBQAAQBAJ&pg=PA55|date=11 December 2014|publisher=Cambridge University Press|isbn=978-1-316-21414-5|pages=55–}}</ref> and [[estrogen (medication)|estrogen]]s like [[estradiol (medication)|estradiol]], [[estradiol ester]]s, [[ethinylestradiol]], [[conjugated estrogens]], and [[diethylstilbestrol]].<ref name="Brueggemeier2006" /><ref name="pmid10997774" />
* '''Miscellaneous:''' Drugs that oppose the effects of androgens by means other than the above. Examples include estrogens, especially [[oral administration|oral]] and [[synthetic compound|synthetic]] (e.g., [[ethinylestradiol]], [[diethylstilbestrol]]), which stimulate [[sex hormone-binding globulin]] (SHBG) [[biosynthesis|production]] in the [[liver]] and thereby decrease free and hence [[biological activity|bioactive]] levels of testosterone and DHT; [[anticorticotropin]]s such as [[glucocorticoid]]s, which suppress the [[adrenocorticotropic hormone]] (ACTH)-induced production of [[adrenal androgen]]s; and [[immunogen]]s and [[vaccine]]s against [[androstenedione]] like [[ovandrotone albumin]] and [[androstenedione albumin]], which decrease levels of androgens via the generation of [[antibody|antibodies]] against the androgen and androgen [[precursor (biochemistry)|precursor]] androstenedione (used only in [[veterinary medicine]]).

Certain antiandrogens combine multiple of the above mechanisms.<ref name="pmid11502457" /><ref name="HannaCrosby2015">{{cite book| vauthors = Hanna L, Crosby T, Macbeth F |title=Practical Clinical Oncology|url=https://books.google.com/books?id=wm_OCgAAQBAJ&pg=PA37|date=19 November 2015|publisher=Cambridge University Press|isbn=978-1-107-68362-4|pages=37–}}</ref> An example is the steroidal antiandrogen cyproterone acetate, which is a potent AR antagonist, a potent progestogen and hence antigonadotropin, a weak glucocorticoid and hence anticorticotropin, and a weak androgen synthesis inhibitor.<ref name="pmid11502457" /><ref name="HannaCrosby2015" /><ref name="Weber2015">{{cite book| vauthors = Weber GF |title=Molecular Therapies of Cancer|url=https://books.google.com/books?id=dhs_CgAAQBAJ&pg=PA316|date=22 July 2015|publisher=Springer|isbn=978-3-319-13278-5|pages=314, 316}}</ref><ref name="pmid9592622">{{cite journal | vauthors = Mahler C, Verhelst J, Denis L | title = Clinical pharmacokinetics of the antiandrogens and their efficacy in prostate cancer | journal = Clin Pharmacokinet | volume = 34 | issue = 5 | pages = 405–17 | date = May 1998 | pmid = 9592622 | doi = 10.2165/00003088-199834050-00005 | s2cid = 25200595 }}</ref>

{| class="wikitable sortable mw-collapsible <!--mw-collapsed-->" style="margin-left: auto; margin-right: auto; border: none;"
|+ class="nowrap" | Antiandrogens marketed for clinical or veterinary use
! Generic name !! Class !! Type !! Brand name(s) !! Route(s) !! Launch !! Status !! {{abbr|Hits|Google Search hits (February 2018)}}<sup>a</sup>
|-
| {{No selflink|Abiraterone acetate}} || Steroidal || Androgen synthesis inhibitor || Zytiga || Oral || 2011 || Available || 523,000
|-
| {{No selflink|Allylestrenol}} || Steroidal || Progestin || Gestanin, Perselin || Oral || 1961 || Available<sup>b</sup> || 61,800
|-
| {{No selflink|Aminoglutethimide}} || Nonsteroidal || Androgen synthesis inhibitor || Cytadren, Orimeten || Oral || 1960 || Available<sup>b</sup> || 222,000
|-
| {{No selflink|Apalutamide}} || Nonsteroidal || AR antagonist || Erleada || Oral || 2018 || Available || 50,400
|-
| {{No selflink|Bicalutamide}} || Nonsteroidal || AR antagonist || Casodex || Oral || 1995 || Available || 754,000
|-
| {{No selflink|Chlormadinone acetate}} || Steroidal || Progestin; AR antagonist || Belara, Prostal || Oral || 1965 || Available || 220,000
|-
| {{No selflink|Cyproterone acetate}} || Steroidal || Progestin; AR antagonist || Androcur, Diane || Oral, {{abbr|IM|Intramuscular injection}} || 1973 || Available || 461,000
|-
| {{No selflink|Darolutamide}} || Nonsteroidal || AR antagonist || Nubeqa || Oral || 2019 || Available || ?
|-
| {{No selflink|Delmadinone acetate}} || Steroidal || Progestin; AR antagonist || Tardak || Veterinary || 1972 || Veterinary || 42,600
|-
| {{No selflink|Enzalutamide}} || Nonsteroidal || AR antagonist || Xtandi || Oral || 2012 || Available || 328,000
|-
| {{No selflink|Flutamide}} || Nonsteroidal || AR antagonist || Eulexin || Oral || 1983 || Available || 712,000
|-
| {{No selflink|Gestonorone caproate}} || Steroidal || Progestin || Depostat, Primostat || {{abbr|IM|Intramuscular injection}} || 1973 || Available<sup>b</sup> || 119,000
|-
| {{No selflink|Hydroxyprogesterone caproate}} || Steroidal || Progestin || Delalutin, Proluton || {{abbr|IM|Intramuscular injection}} || 1954 || Available || 108,000
|-
| {{No selflink|Ketoconazole}} || Nonsteroidal || Androgen synthesis inhibitor || Nizoral, others || Oral, topical || 1981 || Available || 3,650,000
|-
| {{No selflink|Medroxyprogesterone acetate}} || Steroidal || Progestin || Provera, Depo-Provera || Oral, {{abbr|IM|Intramuscular injection}}, {{abbr|SC|Subcutaneous injection}} || 1958 || Available || 1,250,000
|-
| {{No selflink|Megestrol acetate}} || Steroidal || Progestin; AR antagonist || Megace || Oral || 1963 || Available || 253,000
|-
| {{No selflink|Nilutamide}} || Nonsteroidal || AR antagonist || Anandron, Nilandron || Oral || 1987 || Available || 132,000
|-
| {{No selflink|Osaterone acetate}} || Steroidal || Progestin; AR antagonist || Ypozane || Veterinary || 2007 || Veterinary || 87,600
|-
| {{No selflink|Oxendolone}} || Steroidal || Progestin; AR antagonist || Prostetin, Roxenone || {{abbr|IM|Intramuscular injection}} || 1981 || Available<sup>b</sup> || 36,100
|-
| {{No selflink|Spironolactone}} || Steroidal || AR antagonist || Aldactone || Oral, topical || 1959 || Available || 3,010,000
|-
| {{No selflink|Topilutamide}} || Nonsteroidal || AR antagonist || Eucapil || Topical || 2003 || Available<sup>b</sup> || 36,300
|- class="sortbottom"
| colspan="8" style="width: 1px; background-color:#eaecf0; text-align: center;" | '''Footnotes:''' <sup>a</sup> = Hits = Google Search hits (as of February 2018). <sup>b</sup> = Availability limited / mostly discontinued. '''Class:''' Steroidal = {{No selflink|Steroidal antiandrogen}}. Nonsteroidal = {{No selflink|Nonsteroidal antiandrogen}}. '''Note:''' For other antiandrogens not included in the table like [[5α-reductase inhibitor]]s, [[GnRH modulator]]s, and [[estrogen (medication)|estrogen]]s, see elsewhere. '''Sources:''' See individual articles.
|}