Should You Take Spironolactone for PCOS?

Polycystic ovarian syndrome (PCOS) is a common hormonal condition experienced by women of reproductive age. Since it’s hormonal, you can have a LOT of symptoms that make day-to-day life difficult. Because of this, Cysters often wisely seek out ways to improve their PCOS and live symptom-free! 

There are lots of ways to naturally treat PCOS, but after consulting with a doctor, some Cysters have a need for prescription medications. One of the most common drugs to help with the hormonal issues associated with PCOS is spironolactone! 

So, today, I’m going to dive in and give you all the details on what spironolactone is and how it can be used for PCOS. This information will help equip you with the tools to talk with your own doctor and see if spironolactone is a good choice for your healing journey.  

Should You Take Spironolactone for PCOS?

There are lots of medications that are prescribed for PCOS. You’ve probably heard taking birth control pills or metformin, but spironolactone is another common PCOS drug. Of course, my focus is on naturally healing your PCOS, but I know that every body and circumstance is different! So, today, I’ll be giving you an honest look at spironolactone for PCOS!

What is Spironolactone? 

Spironolactone is a prescription medication that has lots of uses! It’s a potassium-sparing diuretic that makes it useful for improving blood pressure and fluid retention problems. Aside from the diuretic benefits, spironolactone has also been shown to block aldosterone, which is responsible for high levels of male hormones in the female body. The balance of sex hormones is essential to a healthy body, so spironolactone can help improve symptoms of endocrine disorders like polycystic ovarian syndrome. 

What Does Spironolactone Do for PCOS? 

Spironolactone is often prescribed to Cysters to help with high testosterone! Elevated androgen levels are present in about 50% of PCOS cases and they can be the cause of a lot of PCOS symptoms. Things like hirsutism, acne, irregular periods, hair loss, mood swings, weight gain, infertility, and more can all find their root in high testosterone levels. Since so many symptoms of PCOS come from imbalanced sex hormone levels, some women find relief from taking spironolactone! 

Like all prescription drugs, spironolactone has a few common side effects. You may experience dizziness, nausea, vomiting, headaches, fatigue, breast tenderness, muscle cramps, skin problems, and irregular menstrual periods. It’s my opinion that all medication should have an exit plan, so know that there are also natural ways to reduce testosterone levels with PCOS and find symptom relief totally side effect-free! 

How Does Spironolactone Help for PCOS?

Improves hormonal acne.

High testosterone levels can lead to an overproduction of sebum, which is the oil that keeps our skin moisturized and healthy. Too much of it clogs our pores and lets bacteria grow. Eventually, acne forms! This is the reason a lot of Cysters struggle with acne way past their teen years! Since spironolactone can help regulate testosterone levels, it often relieves acne for women with PCOS! Here are more natural ways of improving hormonal acne with PCOS. 

Reduces unwanted body hair. 

Hirsutism is when women develop hair on areas of the body associated with male-pattern hair growth. (Think chin, upper lip, chest, etc.) High testosterone can cause this by stimulating the hair follicles in those areas to develop thicker and darker hair than normal. Women taking spironolactone usually see improvements in hirsutism since it lowers those androgen levels! 

Reverses hair loss. 

On that same note, high androgens can cause male-pattern baldness in women with PCOS. This happens because when free testosterone is converted to dihydrotestosterone (DHT) it often binds with hair follicles on the head and shrinks them over time. Once hair follicles get so small, they can’t produce hair any more. 

In women without PCOS, hair loss like this isn’t as common since testosterone levels aren’t high enough to have a significant effect. So, spironolactone can reverse hair loss and help protect your hair follicles from shrinking as a result of DHT! Beyond the medication route, there are other ways to improve hair loss naturally with PCOS. 

Regulates menstrual cycles. 

So, you’ll probably notice that one of the side effects of spironolactone is irregular menstrual periods. This one really depends on the person and your current hormone state. If your menstrual cycle is already irregular (like most women with PCOS), spironolactone can help regulate it by balancing those sex hormones. However, some women who already had regular cycles found spironolactone messed up their cycles due to the same anti-androgen effects. You may or may not see improvements here, but if you don’t, here’s how you can regulate your period with PCOS. 

Blocks the development of ovarian cysts. 

Cysts form on ovaries when Cysters have an overproduction of androgens and that hormonal imbalance disrupts the normal growth and release of eggs. (Basically, high testosterone messes up your periods, like we discussed.) If eggs can’t release properly, they can form small follicles (cysts) on the ovaries that eventually grow and can become super painful. Spironolactone can help manage this by regulating periods and reducing the activity of sebaceous glands. 

Relieves bloating and water retention. 

I’ve talked a lot about the hormone balancing effects of spironolactone, but it’s also a diuretic! Many women with PCOS experience bloating and water retention from insulin resistance as well as high testosterone, which contributes to high body weight. However, spironolactone can help flush out the excess fluid and help you find relief and balance!

Betters insulin sensitivity. 

High testosterone and insulin resistance go hand-in-hand. Excess androgens interfere with insulin functioning and the cells become less responsive. When this happens, the body produces more insulin to keep blood sugar levels in check, raising insulin levels and insulin resistance! 

Insulin resistance is something a lot of Cysters struggle with (up to 80%!) and it contributes to things like weight gain, headaches, cravings, fatigue, irregular periods, acne, skin problems, and more! It can even lead to type 2 diabetes if not managed. Spironolactone can help with insulin resistance because it helps manage those testosterone levels! However, there are a lot more ways to improve insulin sensitivity like getting on a PCOS-friendly balanced diet and exercising! 

Pros and Cons of Spironolactone for PCOS

Pros

• Lowers high testosterone levels
• Reduce water retention and bloating
• Betters insulin sensitivity 
• Improves acne, unwanted body hair, and hair loss
• Regulates menstrual cycle
• Blocks the development of ovarian cysts

Cons

• Doesn’t fix the root issue
• Worsened menstrual irregularity
• Increased fatigue
• Possible digestive problems, dizziness, and headaches
• Potential muscle cramps, skin problems, and breast tenderness

Spironolactone can help relieve symptoms in some women with PCOS.

There are a lot of medications out there used to mask the symptoms of PCOS. However, few of them actually solve the problem. While you’re on the medication, it will work! But, when you get off it, your body will return to the state it was before. Instead, I recommend trying natural remedies like changing your diet, exercise habits, and other aspects of your lifestyle to lower your testosterone levels on your own and find true freedom from PCOS symptoms!

You can learn more about this by reading the PCOS Weight Loss blog, listening to the A Cyster and Her Mister Podcast, and downloading The Cysterhood app. All are AMAZING resources for finding the root of your symptoms and healing your PCOS. Of course, consult with a doctor before trying anything new, but know there is hope for living a life totally symptom-free!