Short answer: There is no over-the-counter medicine proven to work as an anti-androgen for hirsutism. The anti-androgens that do work, such as spironolactone, are prescription-only, and guidelines recommend them only alongside reliable contraception. [1][2] Supplements sold as “natural anti-androgens” have limited evidence at best, and we found no studies showing that progesterone cream reduces unwanted hair.
It makes sense to look for something you can buy without an appointment. Hirsutism can feel urgent and personal, and getting a doctor to take it seriously is not always easy. But the products sold over the counter as testosterone blockers are not the same as the medicines tested in clinical trials. This article explains what anti-androgens are, what you can and cannot buy without a prescription, what the evidence says about popular alternatives, including progesterone cream, and how to get treatment that works.
What are androgens and anti-androgens?
Androgens are hormones such as testosterone. Women make them too, in the ovaries and the adrenal glands, but in smaller amounts than men. When androgen levels are high, or hair follicles are especially sensitive to them, fine hair on the face and body can turn dark and coarse. This is hirsutism. [1] The most common cause is PMOS, the condition known until 2026 as polycystic ovary syndrome (PCOS). [1][3]
Anti-androgens, sometimes called testosterone blockers or androgen blockers, are medicines that block androgens from attaching to cells, so the hormone has less effect on hair follicles. [4] Other medicines lower the amount of androgen in the blood instead. The combined birth control pill, for example, reduces the brain signal that drives the ovaries to make androgens and raises a protein (SHBG) that binds testosterone. [1]
Is there an over-the-counter anti-androgen?
No. Every anti-androgen with good evidence for hirsutism requires a prescription:
- Spironolactone is the most commonly used anti-androgen for hirsutism. [4] It is available only on prescription, partly because it can raise potassium levels and is not usually recommended in pregnancy. [2]
- Finasteride and flutamide also reduced hirsutism in trials, but the evidence was low or very low quality. [5] Flutamide can damage the liver, and the Endocrine Society recommends against it. [1]
- Eflornithine cream, which slows facial hair growth, is also a prescription medicine. [6]
What about the birth control pill? In the US, the only daily pill approved for sale without a prescription is a progestin-only pill containing norgestrel. It is approved for preventing pregnancy, and other pill formulations remain prescription-only. [7] The guideline recommendations for hirsutism are about combined pills that contain both an estrogen and a progestin, not progestin-only pills, so an over-the-counter minipill is not a hirsutism treatment. [1]
You may also see anti-androgen creams and serums. The Endocrine Society suggests against topical anti-androgen therapy for hirsutism. [1]
Why anti-androgens need a doctor
There are two important safety reasons, beyond the fact that these medicines are prescription-only.
Pregnancy. Anti-androgens can affect the development of a male baby. Guidelines recommend against taking them unless you use reliable contraception, which is why they are often prescribed together with the pill. [1][8]
The cause matters. Hirsutism is usually a sign of an underlying condition, most often PMOS, and occasionally of something that needs prompt investigation, such as a hormone-producing tumor. The Endocrine Society recommends blood tests for androgen levels in women with abnormal hair growth. [1] Treating the hair without checking the cause can delay a diagnosis that matters for your health. You can start with our hirsutism self-check and take your score to an appointment. If you are unsure who to see, read which doctor to see for hirsutism.
What about “natural” anti-androgens?
Many supplements and herbal products claim to lower testosterone. When you read about them, keep one distinction in mind: A study showing lower testosterone in the blood is not the same as a study showing less hair. Hair grows slowly, so trials need at least 6 months to show a real effect on hirsutism. [1]
Spearmint tea
Evidence: Limited Spearmint is the most researched herbal option. In a small randomized trial, 42 women with PCOS and hirsutism drank spearmint tea or a placebo herbal tea twice a day for 30 days. Free and total testosterone fell in the spearmint group, and women reported feeling less bothered by their hair. However, the doctor-rated hair score (Ferriman-Gallwey) did not change significantly, and the author noted that 30 days was too short to see changes in hair growth. [9] Read more in our spearmint guide.
Inositol
Evidence: Limited Inositol is a supplement often marketed for PMOS. The International PCOS Guideline says it could be considered based on personal preference, but found limited clinical benefits for ovulation, hirsutism or weight, and could not recommend any specific type or dose. It also says metformin, a prescription medicine, should be considered over inositol for hirsutism. [8]
Other supplements
Saw palmetto, licorice, zinc, green tea, DIM and many others are sold for “hormone balance”. We review each one in our supplements guide and our guide to natural remedies. In short, none comes close to the evidence for prescription treatment. If you take a supplement, tell your doctor and pharmacist, especially if you also take hormonal medicines.
Does progesterone cream work for hirsutism?
Evidence: None You may have seen progesterone cream sold as a “natural” or “bioidentical” hormone for hormone balance. We could not find any controlled trials testing progesterone cream for hirsutism, either for hair growth or for androgen levels. Neither the Endocrine Society hirsutism guideline nor the International PCOS Guideline recommends it. [1][8]
It is easy to see where the idea comes from. Some prescription birth control pills contain progestins with anti-androgen activity, such as drospirenone and cyproterone acetate. [1] But these are specific synthetic drugs in measured doses, combined with an estrogen. Even these anti-androgenic progestins did not work clearly better for hirsutism than pills with other progestins. [1][10] None of that tells us anything about rubbing progesterone onto your skin.
If you are already taking the pill, hormone replacement therapy or any other hormonal medicine, do not add a progesterone cream without talking to your doctor first.
What works instead
The good news is that effective treatment exists, and the first step is usually not an anti-androgen at all. For most women with bothersome hirsutism who are not trying to get pregnant, the Endocrine Society recommends the combined birth control pill first. If hair is still bothersome after 6 months, it suggests adding an anti-androgen such as spironolactone. [1] A 2018 network meta-analysis of randomized trials found that the pill, anti-androgens and the combination all reduced hirsutism more than placebo, with the combination working best. [10]
For facial hair, eflornithine cream led to marked improvement in about a third of women in trials, though hair returns within about 8 weeks of stopping. [6] Any medicine needs at least 6 months before you judge it. [1] Most women also use hair removal alongside medication. See our full guide to hirsutism medication for the details, including which pill to ask about and how to combine treatment with laser or electrolysis.
When to see a doctor
See a doctor before starting any hormone-based treatment, and see one promptly if you have:
- Hair growth that started suddenly or is getting worse within months
- A deepening voice, an enlarged clitoris, increased muscle mass or male-pattern balding, which are signs of virilization
- Irregular or missing periods
These can be signs of higher androgen levels that need investigating. [1]
Frequently asked questions
Can I buy spironolactone over the counter?
No. It is a prescription medicine, and it is not usually recommended in pregnancy. [2]
What is the strongest natural anti-androgen?
Spearmint tea has the most research, but it is one small, 30-day trial that lowered testosterone without a measurable change in hair growth. [9]
Does progesterone cream reduce facial hair?
We found no studies showing that it does, and hirsutism guidelines do not recommend it. [1][8]
Is the over-the-counter birth control pill good for hirsutism?
The US over-the-counter pill is progestin-only and approved for contraception. The hirsutism guidelines recommend combined pills, which still need a prescription. [7][1]
Key takeaways
- There is no over-the-counter anti-androgen with good evidence for hirsutism.
- Proven anti-androgens such as spironolactone are prescription-only and must be combined with reliable contraception.
- Spearmint and inositol have limited evidence, and we found no evidence for progesterone cream.
- The pill, with an anti-androgen added if needed, is the guideline-recommended path, and it takes at least 6 months to work.
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Sources
- Martin KA, Anderson RR, Chang RJ, et al. Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(4):1233-1257. PubMed 29522147
- NHS. Spironolactone. Accessed October 2026. Link
- Teede HJ, Khomami MB, Morman R, et al. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. Lancet. 2026;407(10545):2329-2339. PubMed 42119588
- Mayo Clinic. Hirsutism: Diagnosis and treatment. Accessed October 2026. Link
- van Zuuren EJ, Fedorowicz Z, Carter B, Pandis N. Interventions for hirsutism (excluding laser and photoepilation therapy alone). Cochrane Database Syst Rev. 2015;(4):CD010334. PubMed 25918921
- US National Library of Medicine, DailyMed. Vaniqa (eflornithine hydrochloride) cream, 13.9%: Prescribing information. Accessed October 2026. Link
- US Food and Drug Administration. FDA approves first nonprescription daily oral contraceptive (July 13, 2023). Accessed October 2026. Link
- Teede HJ, Tay CT, Laven JJE, et al. Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023;108(10):2447-2469. PubMed 37580314
- Grant P. Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. A randomized controlled trial. Phytother Res. 2010;24(2):186-188. PubMed 19585478
- Barrionuevo P, Nabhan M, Altayar O, et al. Treatment Options for Hirsutism: A Systematic Review and Network Meta-Analysis. J Clin Endocrinol Metab. 2018;103(4):1258-1264. PubMed 29522176
This article is for education and is not medical advice. Talk to a doctor about diagnosis and treatment.