PCOS: Spironolactone

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Spironolactone (pronounced: spi–ro–no–lac–tone) is a diuretic or “water pill” that’s prescribed for people who have high blood pressure and for those who have swelling due to extra fluid, but it also has other benefits. Spironolactone is often prescribed for young people with PCOS who are taking oral contraceptive pills and are “hirsute” (have extra hair in unwanted places).

How does Spironolactone work?

Spironolactone, the generic name for Aldactone®, works by blocking the effects of androgen. Androgens are hormones that both males and females have, but males have higher levels of them. Androgens such as testosterone are responsible for hair growth on the face, chest, and stomach that some young people with PCOS have. Androgens can also cause acne. Spironolactone may work by lowering the level of androgens, which lessens hair growth and improves acne.

How effective is Spironolactone?

Spironolactone is very effective in lessening hair growth and improving acne for young women, especially those who have not seen desirable results with oral contraceptive pills. Most young people taking spironolactone medication will see positive results; however, it can take up to 6 months to see an improvement in.

Are there any side effects?

Most young people who take spironolactone have few or no side effects. The side effects are only temporary and will go away when spironolactone is stopped. Spironolactone should be prescribed along with contraception to prevent pregnancy as the drug can be harmful to a developing baby.

Possible side effects may include:

  • Irregular menstrual bleeding (if not taking the Pill)
  • Frequent
  • Rash
  • Dry mouth, thirst
  • Loose bowel movements
  • Nausea
  • Tiredness
  • Headache

Other things to know about Spironolactone:

  • Before taking Spironolactone, tell your health care provider if you have liver or kidney problems
  • Depending on the level of spironolactone you are on, your health care provider may want to repeat blood tests to monitor your potassium levels
  • Your health care provider may suggest you to take spironolactone during the daytime so that frequent urination is not disrupting your sleep
  • Don’t take spironolactone if you’re pregnant or might become pregnant
  • It’s best to take both spironolactone and contraception together
  • Don’t take potassium supplements while taking spironolactone

Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.