| Oral contraceptives (various) | One tablet daily | Gastrointestinal upset, headache | Recommended first-line agents; formulations containing norgestimate, desogestrel, or drospirenone are preferred | X |
| Metformin (Glucophage) | 500 to 1,000 mg twice daily | Gastrointestinal upset | Useful for treating polycystic ovary syndrome, but no data to support primary use for hirsutism | B |
| Spironolactone (Aldactone) | 100 to 200 mg daily | Hyperkalemia, irregular menses | Risk of pseudohermaphroditism in male fetuses if used during pregnancy | D |
| Finasteride (Propecia) | 2.5 mg daily | Hepatotoxicity | — | X |
| Glucocorticoids (prednisone) | 5 to 10 mg daily | Weight gain, bone density loss, adrenal suppression | Indicated in congenital adrenal hyperplasia | C |
| Leuprolide (Lupron) | 3.75 to 7.5 mg intramuscularly monthly | Hot flashes, atrophic vaginitis, bone density loss | Consider adding back hormone therapy; expensive | X |
| Ketoconazole | 400 mg daily | Dry skin, headache, hepatotoxicity | Typically used only after failure of other therapies | C |
| Eflornithine (Vaniqa) | Apply topically twice daily | Acne, erythema, burning | FDA approval is only for use for unwanted facial hair | C |
