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The intermediates from de novo lipogenesis in the liver will disrupt mitochondrial function and produce ROS, and then cause endoplasmic reticulum (ER) stress, ultimately leading to inflammation, and the broken cells releasing cytokines will cause more cell death ( The excess free fatty acids (FFAs) and de novo lipogenesis would break the homeostasis of lipid metabolism

Spironolactone at 100-200 mg/day, given long enough (12+ months is the realistic timeframe), modestly slows progression and produces visible regrowth in a subset of women but its not the dramatic facial-hair-and-acne win

10.1016/j.physbeh.2014.01.015 [DOI] [PMC free article] [PubMed] [Google Scholar] Kreisler, A

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