Understanding Spironolactone for PCOS

Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects women of reproductive age. It can cause symptoms like irregular periods or lack of ovulation, high levels of androgens, and cysts on the ovaries. PCOS often leads to problems like infertility, weight gain, insulin resistance, and skin conditions such as acne and excess hair growth (hirsutism).

One standard conventional treatment option for managing some of these symptoms is spironolactone. Let’s break down what spironolactone is, how it works, and why it’s commonly prescribed to women with PCOS.

What Is PCOS?

PCOS is a complex interplay of genetic factors, hormonal imbalances, and lifestyle influences, with the primary culprit being a combination of high androgen levels and insulin resistance, where the body doesn't use insulin effectively, leading to increased insulin production, which further contributes to the hormone imbalances like irregular periods and excess hair growth. PCOS can cause:

• Insulin Resistance: Many women with PCOS, whether they’re lean or overweight, have trouble using insulin effectively. This can lead to weight gain, high androgen levels, and disrupt fertility.
• High Androgen Levels: Too much testosterone in the body can cause issues like acne, hirsutism, and irregular periods.
• Increased Risks: Family history, exposure to environmental toxins, and certain chemical reactions in the body can raise the risk of developing PCOS.

Because PCOS is complex, doctors often recommend a combination of medications, lifestyle changes, and dietary adjustments to manage symptoms.

What Is Spironolactone?

Spironolactone is a potassium-sparing diuretic, which means it helps your body get rid of extra water and salt without losing potassium. However, spironolactone also has a unique benefit: it lowers testosterone levels by interfering with how the body makes this hormone.

Because of its ability to affect hormone levels, spironolactone is often used to treat:

• Hirsutism: Excessive hair growth on the face or body.
• Acne: Especially stubborn, hormone-driven breakouts.
• Hair Loss: Some types of hair thinning caused by high androgens.

Spironolactone for PCOS Symptoms

Spironolactone targets PCOS symptoms caused by high androgen levels. Here’s how it can help:

1. Reduces Excess Hair Growth

   Research shows that spironolactone can improve hirsutism, helping women feel more confident about their appearance.

2. Clears Up Acne

   Many women notice fewer breakouts and smoother skin after using spironolactone.

3. Lowers Testosterone

   By lowering testosterone levels, spironolactone helps reduce some of the effects of PCOS.

However, spironolactone doesn’t treat all PCOS symptoms. For issues like insulin resistance or menstrual irregularities, doctors may combine it with other medications, such as:

• Insulin-Sensitizing Drugs: These help the body use insulin more effectively.
• Hormonal Birth Control is often prescribed to bypass the irregular periods caused by PCOS and keep the body out of an estrogen-dominant state. This does not genuinely balance natural hormone production but exposes the body to consistent dosing of synthetic hormones that allow for a monthly withdrawal bleed.

Potential Side Effects of Spironolactone

Spironolactone is generally safe, but it can cause side effects, including:

• Breast Tenderness or Swelling
• Irregular or Absent Periods
• High Potassium Levels: This can be dangerous if not monitored.
• Other Possible Effects: Some women report headaches, nausea, dizziness, or mild dehydration.

If your doctor prescribes spironolactone, they’ll monitor your potassium levels and adjust your dose as needed to reduce the risk of side effects.

Managing PCOS Holistically

While Spironolactone is commonly prescribed for managing androgen-related symptoms like acne, hirsutism, and hair thinning, it isn’t the only option. At Naturopathic by Design™, we rarely need to use Spironolactone because we see excellent results with natural alternatives that address the root causes of high androgen levels.

You can read about some effective natural options for lowering androgens in this blog post. These alternatives not only minimize the potential side effects associated with medications like Spironolactone but also address the underlying root causes of androgen imbalances.

We understand that living with PCOS can feel overwhelming, but you don’t have to face it alone. Book a free 15-minute call to see how we can help get to the root cause of your symptoms and put a plan in place so you can start feeling your best.

Sources:

https://pmc.ncbi.nlm.nih.gov/articles/PMC8957463/

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000194.pub2/full

https://pubmed.ncbi.nlm.nih.gov/27233760/

https://pubmed.ncbi.nlm.nih.gov/10792338/

https://www.nhs.uk/medicines/spironolactone/common-questions-about-spironolactone/#:~:text=Because it affects hormones%2C spironolactone,a specialist for these conditions.

https://pubmed.ncbi.nlm.nih.gov/27510481/

https://www.ncbi.nlm.nih.gov/books/NBK554421/