A prescription medicine with anti-androgen effects, sometimes used for hirsutism and acne in PCOS.
What spironolactone is
Spironolactone is a medicine that was originally developed as a diuretic, a medicine that helps the body remove excess water and salt through the kidneys. It also has anti-androgen effects. That means it blocks the action of androgens such as testosterone on the skin and hair follicles, reducing the effect of those hormones on the tissue. Because excess androgen is a common feature of PCOS, this blocking effect is the reason a doctor sometimes considers it. However, it is prescription-only and should only be started when a doctor directs it after a careful assessment.
How it is considered in PCOS
Doctors sometimes choose spironolactone for androgen signs such as hirsutism or acne in PCOS, especially when other measures are not enough. That choice is made after weighing your overall situation, including your health history and other medicines you take, not as a first step for everyone. Its effect on skin and hair usually takes several months before it can be judged, so patience and regular follow-up are often needed. You can read background on PCOS symptoms and the role of hormones to understand why these signs appear.
Key precautions
Spironolactone should never be self-started without a prescription. A doctor needs to monitor its use, because it can affect potassium levels in the blood and blood pressure, and follow-up tests are sometimes needed. It is also not safe in pregnancy without medical advice, so contraception is often discussed beforehand. If you are pregnant, trying to conceive, or breastfeeding, tell your doctor before any decision is made. Also tell your doctor or pharmacist about every other medicine and supplement so that possible interactions can be checked. See also PCOS and fertility for further context.
What it means for you
Understanding how spironolactone works helps you have a more meaningful conversation with your doctor, but this information is not an instruction to start the medicine. This page does not give a dose, because that decision depends on the individual and must be set by a doctor. Any decision to start, continue, or stop it should be made with a doctor or pharmacist who knows your medical history.
This glossary is education, not diagnosis. For your own situation, ask a doctor or pharmacist.