| Side Effect | Description |
| Liver function abnormalities | Cyproterone acetate may cause liver toxicity, including elevated liver enzymes. Periodic monitoring of liver function through blood tests is recommended during treatment. |
| Depression and mood changes | Some individuals may experience mood swings, depression, or changes in emotional well-being while taking cyproterone acetate. It’s essential to monitor mood changes and consult with a healthcare provider if significant mood disturbances occur. |
| Reduced libido | A decrease in libido (sex drive) can occur as a side effect of cyproterone acetate due to its anti-androgenic effects. |
| Fatigue and lethargy | Some users may experience increased fatigue or feelings of lethargy while taking cyproterone acetate. |
| Osteoporosis | Long-term use of cyproterone acetate can increase the risk of osteoporosis due to decreased bone density. Bone density monitoring and supplementation with calcium and vitamin D may be recommended. |
| Weight changes | Weight gain or weight loss can occur as a side effect of cyproterone acetate treatment, though individual responses may vary. |
| Breast tenderness | Cyproterone acetate may cause breast tenderness or enlargement, which can be a desired effect for transgender women but may cause discomfort in some individuals. |
| Headaches | Headaches, including migraines, have been reported as a side effect of cyproterone acetate use. |
| Decreased fertility | Cyproterone acetate can suppress sperm production and fertility in individuals assigned male at birth. It’s essential to discuss fertility preservation options with a healthcare provider if fertility preservation is desired. |
| Thromboembolic events | While less common, there is a risk of thromboembolic events (such as blood clots) associated with cyproterone acetate use, particularly at higher doses or in individuals with other risk factors for thrombosis. |
| Gynecomastia | In individuals assigned male at birth, cyproterone acetate can cause breast development (gynecomastia), which may be desired but can also cause distress in some cases. |
| Hyperkalemia | Cyproterone acetate can lead to elevated levels of potassium in the blood, which can be dangerous, especially in individuals with kidney problems or those taking medications that affect potassium levels. |