Which birth control pills have anti androgen properties?

October 9, 2025 •

3 min read

Anti-androgenic birth control pills can significantly improve symptoms related to excess male hormones, such as acne and hirsutism, with studies showing noticeable improvement within 6 to 12 months. Knowing which birth control pills have anti androgen effects is crucial for addressing these hormonal imbalances and achieving clearer skin and reduced hair growth.

Quick Summary

Several birth control pills contain progestins with anti-androgenic effects, including drospirenone, cyproterone acetate, and desogestrel, to treat conditions like acne and hirsutism.

Key Points

Drospirenone (Yaz, Yasmin): Contains a progestin with moderate anti-androgenic effects, beneficial for treating acne, PMDD, and hirsutism.
Cyproterone Acetate (Diane-35): Offers the strongest anti-androgenic effects for severe cases but carries a higher risk of blood clots and has limited availability in the US.
Third-Generation Progestins (Desogestrel, Norgestimate): These are low or minimally androgenic options that can effectively improve milder hormonal symptoms.
Estrogen's Role: The estrogen component in combined pills is vital for increasing SHBG, which binds to and deactivates excess testosterone.
Informed Choice: Factors like symptom severity, overall health, and blood clot risks must be considered with a healthcare provider before selecting an anti-androgenic birth control pill.
Combination Therapy: For persistent or severe androgenic symptoms, combining anti-androgenic birth control with other medications like spironolactone may be necessary.

How Anti-Androgenic Birth Control Works

Anti-androgenic birth control pills are combined oral contraceptives (COCs) that contain estrogen and progestin to counteract the effects of androgens. They primarily work by reducing ovarian androgen production, increasing sex hormone-binding globulin (SHBG) which binds to testosterone, and blocking androgen receptors in tissues like skin and hair follicles.

Key Anti-Androgenic and Low-Androgen Progestins

Certain progestins in birth control pills have anti-androgenic effects, while others may be androgenic.

Drospirenone (e.g., Yaz, Yasmin, Beyaz)

Drospirenone is a progestin with moderate anti-androgenic properties. It is effective for treating moderate acne and hirsutism and can help with bloating. Yaz is approved by the FDA for treating moderate acne and PMDD. However, drospirenone-containing pills may have a slightly higher risk of blood clots and should be used cautiously in those with certain health conditions.

Cyproterone Acetate (e.g., Diane-35, Cyestra-35)

Cyproterone acetate (CPA) is a potent anti-androgenic progestin used for severe acne and hirsutism when other treatments fail. It strongly blocks androgen receptors and reduces androgen production. Due to a significantly higher risk of blood clots, its use is restricted in many areas and it is not available in the United States.

Desogestrel (e.g., Desogen, Mircette)

Desogestrel is a third-generation progestin with minimal androgenic activity, suitable for milder androgenic symptoms. It is generally well-tolerated but may carry a slightly higher risk of blood clots than older progestins.

Norgestimate (e.g., Ortho Tri-Cyclen)

Norgestimate, another third-generation progestin, has a low androgenic profile and is effective for treating acne. Ortho Tri-Cyclen was the first birth control pill approved by the FDA for acne. Risks are similar to other COCs.

Comparison Table


Progestin Type	Brand Names (Examples)	Anti-Androgen Potency	Main Benefit for Androgen Symptoms	Notable Risks & Considerations
Drospirenone	Yaz, Yasmin, Beyaz	Moderate	Effective for acne, PMDD, and hirsutism; reduces bloating.	Slightly higher risk of blood clots compared to some alternatives; check potassium levels.
Cyproterone Acetate	Diane-35, Cyestra-35	Strongest	Highly effective for severe acne and hirsutism.	Higher risk of blood clots; use is restricted in many countries (not available in the US).
Desogestrel	Desogen, Mircette	Minimal/Low	Good for milder cases of acne/hirsutism; well-tolerated.	Potential slightly higher risk of blood clots compared to levonorgestrel.
Norgestimate	Ortho Tri-Cyclen	Low	Specifically approved for acne treatment.	Standard COC risks, but low androgenic activity.

Potential Side Effects and Safety Considerations

Discuss potential side effects with a healthcare provider, considering individual health factors. Risks include venous thromboembolism (blood clots), which is slightly higher with drospirenone and significantly higher with cyproterone acetate. Other potential side effects include cardiovascular risks, mood changes, breast tenderness, headaches, nausea, or weight changes.

Combining Birth Control with Other Anti-Androgens

For more severe cases, combining a COC with other anti-androgenic medications like spironolactone may be recommended. Spironolactone can boost effectiveness for hirsutism. Metformin may also be used in women with PCOS and insulin resistance.

Conclusion

Several birth control pills offer anti-androgenic effects to treat hormonal acne, hirsutism, and PCOS. Options like Yaz and Yasmin (containing drospirenone) are common, while Diane-35 (cyproterone acetate) is for severe cases with a higher risk profile. Third-generation progestins like desogestrel and norgestimate provide milder benefits. Consult a healthcare provider to determine the best option based on your symptoms, health risks, and availability.

Learn more about anti-androgenic progestins and their use in managing hyperandrogenic conditions on the National Institutes of Health website.

Frequently Asked Questions

Pills containing cyproterone acetate, such as Diane-35, are considered the strongest for anti-androgen effects. However, their use is limited in many countries, including the US, due to an increased risk of blood clots.

Yes, Yaz and Yasmin are commonly prescribed for treating acne and hirsutism because they contain drospirenone, a progestin with moderate anti-androgenic properties. Yaz is specifically FDA-approved for treating moderate acne.

Some progestin-only pills, like Slynd (which contains drospirenone), have anti-androgenic properties. However, progestin-only 'mini-pills' with other progestins typically do not help with androgen-related symptoms and can sometimes worsen them.

It typically takes about 3 to 12 months to see significant improvements in androgen-related symptoms like acne and hirsutism when using anti-androgenic birth control.

The primary risk, especially with more potent progestins like cyproterone acetate and drospirenone, is an increased risk of venous thromboembolism (blood clots).

Ortho Tri-Cyclen contains norgestimate, a progestin with a low androgenic profile, making it a good option for treating acne. While not as strongly anti-androgenic as drospirenone, it is a favorable choice for managing hormonal skin issues.

Individuals with certain pre-existing conditions, such as uncontrolled high blood pressure, active liver disease, a history of blood clots, or those who smoke and are over 35, should avoid anti-androgenic birth control pills.