The hair regrowth effects these women experienced were thought to be associated with the medication’s testosterone-blocking properties.Bicalutamide is an anti-androgen drug, used to stop testosterone reaching cancer cells in the hope of shrinking them, or at least slowing down their growth. It is also known by various brand names, including Casodex which is manufactured by AstraZeneca Pharmaceuticals.Androgens are male hormones, present in both men and women, which play a key role in the development of male sexual characteristics and reproductive health during puberty. The key androgen is testosterone. Bicalutamide is a potent non-steroidal anti-androgen that binds to androgen receptors and prevents testosterone and its derivatives from exerting their effects at target tissues. While its primary FDA-approved indication is prostate cancer, it is sometimes used off-label in hormone therapy settings where significant androgen suppression is required—under specialist supervision. Because it affects endocrine function significantly, it requires thorough monitoring (liver enzymes, bone density, cardiovascular risk, lipid profile) and is typically used only when other anti-androgens are insufficient or inappropriate. In hormone therapy, bicalutamide may be combined with estrogens or gonadotropin-releasing hormone (GnRH) analogues to provide a comprehensive suppression of endogenous androgens. Its side-effect profile (including gynecomastia, hot flashes, liver toxicity, reduced libido, bone loss) means it should be prescribed by a specialist. Given its higher cost and intensive monitoring requirements, it is less often used than lower-cost alternatives in everyday hormone therapy.
