This spironolactone post is dedicated to all of my readers and patients who struggle with Pill-induced hair loss and PCOS. If the comments section on my Hair Loss post is to be believed, there are a LOT of you out there.
As a doctor and a human being, I am concerned about the growing magnitude of this problem. More than anything, I am concerned that we try to solve a drug-induced problem by throwing another drug at it.
Here is a question from my reader Ashley:
I would love your opinion about the drug Spironolactone, one of the most famous drugs prescribed to treat PCOS. My Doctor called it ‘the safe drug’, but I hardly believe this is true.
The cutely nick-named Spiro was mentioned again and again the comments section of my Hair Loss post. Its trade name is Aldactone. Is spironolactone a safe drug? By safe, Ashley’s doctor presumably meant that it not as likely to cause life-threatening liver-damage as the other anti-androgen drug cyproterone (Androcur).
But spironolactone is not safe. It is a synthetic steroidal drug. Pseudo-steroids intrude into your body’s normal hormone functioing. They fit crudely (like the wrong key for a lock) into your hormone receptors. Spironolactone is just like the pseudo-steroid drugs in the pill. In fact, spironolactone is very similar to the progestin drospirenone used in Yasmin and Yaz Pills.
Spironolactone fits (blocks) your testosterone receptor, which is why it’s used, but unfortunately, it also disrupts ovulation, estrogen metabolism and adrenal function. The drug causes loss of libido, menstrual irregularity, and breast pain. It has been linked with breast cysts, and possibly breast cancer. By interfering with your hypothalamic-pituitary-adrenal (HPA) axis, spironolactone causes low blood pressure, headaches, fatigue, and depression. It increases the risk of blood clots.
I know you want a fast, effective solution for your hair loss, but spironolactone is not it. To be honest, it does not work all that well anyway. More importantly, it perpetuates the problem of PCOS and hair loss by preventing you from ever reclaiming your own hormones. Your own estradiol and progesterone are—by far!—the best repair for your hair.