There were some differences in clinical outcome between CPA and spironolactone, CPA and flutamide, and CPA and finasteride. There were no clinical differences between CPA and the other medical therapies, possibly because of small study size, lack of standardised assessment and objective determinants of improvement in many studies. There are insufficient data presented to compare the adverse effects of all the treatment options. Larger, carefully designed studies are needed to compare efficacy and safety profiles between the therapeutic options available.