Systemic MHT in individuals with hirsutism

For individuals with hirsutism who need systemic MHT, an oral formulation may be preferred because oral estrogen therapy increases sex hormone–binding globulin, reducing bioavailable testosterone. If combined MHT is used, use a formulation with a less androgenic progestogen (eg drospirenone, dydrogesterone, medroxyprogesterone, micronised progesterone).