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How Effective is Spironolactone for PCOS?

By Kelly Ferguson
Updated Mar 03, 2024
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Many medical professionals prescribe a drug called spironolactone for women who suffer from a condition called polycystic ovary syndrome (PCOS). Taking spironolactone for PCOS is one way to address and treat some of the symptoms associated with PCOS, rather than to cure the condition itself. Currently, there is no absolute cure, but using spironolactone is a very effective way for some women to manage some of the potentially emotionally harmful side effects of the disease, such as hair growth and skin problems.

PCOS is a condition characterized by excess male hormones, or androgen, in the female body. This usually leads to several problems, including acne and hirsutism, or male-like hair growth in a female, in addition to irregular ovulation, possible fertility troubles, and metabolic problems such as insulin resistance and a tendency toward obesity. Hirsutism and acne are very emotionally damaging symptoms, robbing many PCOS sufferers of feelings of confidence and femininity. Some women grow a small amount of facial or body hair that appears darker and coarser than normal, and it is very visible and difficult to remove. Taking spironolactone can sometimes reduce the severity of the acne and hirsutism by acting as an anti-androgen, balancing out the hormones to a more feminine level.

Using spironolactone for PCOS works for many women who take it, but it does not work for everyone. There are varying dosage schedules that can be adjusted to fit the individual, such as a continuous daily dosage or a cycling schedule that reduces or eliminates the medication during menstruation. Increasing the dosage with a healthcare professional’s permission may also help achieve or intensify results, but side effects are possible. Even women who successfully take this drug and get significant results may need to wait several months after starting the medication to notice any difference. Sometimes, additional medications, such as birth control pills and metformin, can be used alongside spironolactone to regulate the menstrual cycle, decrease insulin resistance, and reduce the appearance of hirsutism and acne to achieve the maximum amount of control over PCOS symptoms.

Spironolactone should not be taken while pregnant, because it interferes with the male hormones and may negatively affect the fetus. It is also a diuretic, and may increase the frequency of urination, so it is important for those taking the drug to stay hydrated. In addition to its uses for PCOS, spironolactone is also used to treat hypertension.

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Discussion Comments
By manykitties2 — On Sep 28, 2011

@Sara007 - PCOS syndrome can be a pretty tough thing to face, and having gone through the physical signs myself, I can say that I hope your sister tries the spironolactone. It worked really well for me and helped me get rid of the acne that was plaguing my skin.

I think that with spironolactone and PCOS that you really just have to try it and take your chances with the side effects. For myself, my doctor said it wasn't very risky. That was true, and all I ended up facing was a little dry mouth, which was easy enough to take care of.

By Sara007 — On Sep 28, 2011

My sister was recently given spironolactone for her PCOS and I am a bit concerned about the spironolactone side effects. From what I have heard, besides being a diuretic the drug can also commonly cause fatigue and weakness, as well as sleeplessness.

While I know my sister hates the physical signs of her PCOS, I worry that she will be trading one set of problems for another. I can imagine that not being able to sleep and constantly having to run to the bathroom will make her life pretty unpleasant.

Has anyone actually taken spironolactone for PCOS? Did you find the side effects harsh, or did you not have any trouble?

By dfoster85 — On Sep 28, 2011

@MrsWinslow - Have you been eating foods low on the glycemic index? That's what really seemed to help my friend with PCOS. And then when Newsweek came out with its fertility diet, she started following those suggestions even though she wasn't trying to get pregnant right then - just to regularize her periods.

It stands to reason that if you are trying to induce regular periods (meaning regular ovulation) with PCOS, the same diet that prevents ovulatory infertility would be helpful. I don't remember the details but she said she had to have some whole milk and no skim milk. She also cut down on meat and ate more beans.

Good luck with your baby dreams!

By MrsWinslow — On Sep 27, 2011

I think for a lot of women, the problem with this PCOS treatment is that the main reason they're aware of PCOS is that they've been trying to get pregnant and failing. That's what it was in my case.

Sure, I had to bleach some key areas on a monthly basis and I still used acne face wash in my early 30s, but I just didn't think those were all that unusual (I still don't think they are). And irregular periods seemed like more of a blessing than a curse - every six or eight weeks seemed pretty comfortable!

Clomid can be helpful for PCOS women who want to get pregnant, but my doc told me to lose thirty pounds first. I've had some success improving my diet and exercise habits.

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