What is spironolactone?
- Spironolactone is used in PCOS when you have too many androgens in your body.
- Spironolactone is a potassium-sparing diuretic (water pill) that prevents your body from absorbing too much salt and keeps your potassium levels from getting too low.
- Spironolactone also treats fluid retention (edema) in people with congestive heart failure, cirrhosis of the liver, or a kidney disorder called nephrotic syndrome. This medication is also used to treat or prevent hypokalemia (low potassium levels in the blood).
This medicine was originally developed to treat certain forms of high blood pressure. In high doses (75-200 mg per day), it is very effective in treating excess hair growth and slowing hair loss due to male hormone elevations. It also decreases skin oiliness and acne. (NOTE: It is not FDA-approved for the treatment of male hormone elevations, though this is a very common off-label use for the drug and it is widely prescribed for PCOS.)
Decreases in skin oiliness and acne can be seen after 1 to 2 months of treatment with spironolactone. The rate of excess hair growth will slow and the hair will become finer and lighter, becoming much less noticeable. The hair, however, will not fall out. Maximum benefits might not be seen until one year of therapy and hair growth will resume if therapy is discontinued. In women with hair loss, it often takes approximately one year to notice a benefit from therapy. Usually, further hair loss is arrested. It is uncommon to see re-growth of hair that has already been lost.
Spironolactone has few side effects. If it is not given in combination with an oral contraceptive agent, it can cause irregular vaginal bleeding. Because spironolactone blocks male hormones, it is essential that it not be taken by women who are pregnant because it can interfere with sexual development of a male fetus. If you think you might be pregnant, DO NOT take spironolactone. If you are not on oral contraceptive agents, you must use an effective birth control method while on spironolactone. Spironolactone may cause elevations in serum potassium levels. Therefore, women taking the medication should not take supplemental potassium.
In animal studies with high doses of spironolactone, certain tumors developed. Therefore, long-term therapy with the drug is not recommended. Every several years, the need for spironolactone treatment should be reassessed.