In meta-analysis, anti-androgens + lifestyle were superior to metformin + lifestyle for hirsutism (weighted mean difference [WMD] [95% CI]: −1.59 [−3.06, −0.12], p = 0.03; I2 = 74%), SHBG (7.70 nmol/l [0.75, 14.66], p = 0.03; I2 = 0%), fasting insulin and fasting insulin: glucose ratio (−2.11 μU/ml [−3.97, −0.26], p = 0.03; I2 = 0% and −1.12 [−1.44, −0.79], p < 0.0001, I2 = 0%, respectively), but were not superior to placebo + lifestyle for hirsutism (−0.93, [−3.37, 1.51], p = 0.45; I2 = 76%) or SHBG (9.72 nmol/l [−0.71, 20.14], p = 0.07; I2 = 31%). This evidence concerns the gene SHBG and Hirsutism.