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Spironolactone For Hair Loss: How Does It Work?

Around 1 in 10 women in the UK experience polycystic ovary syndrome (PCOS) [1], an endocrine disorder affecting the ovaries, caused by an underlying hormonal imbalance.

Along with being one of the leading causes of fertility problems and additional health problems later on in life, hair loss is a major side effect of PCOS. It’s thought that between 20-30% of women who have PCOS also experience female pattern baldness [2].

To help combat the symptoms that come with PCOS, along with hair loss, many women are prescribed spironolactone. In this article, we’ll discuss whether spironolactone is an effective treatment for hair loss, or whether it could be exacerbating the problem.

What is spironolactone?

Spironolactone is a drug that’s used to treat PCOS, as well as other conditions such as high blood pressure, heart failure, kidney disease, and liver disease. It’s a diuretic, which means it helps expel water from the body.

Not only is it effective at helping patients who are suffering from the above conditions, but it’s also started to be given to women who are experiencing female pattern baldness. Spironolactone is an anti-androgen, which means it can help treat androgenetic alopecia in women. This is a condition often associated with the overproduction of or high sensitivity to male sex hormones in women.

How does spironolactone work?

Spironolactone reduces androgen levels in women affected by PCOS and the menopause. In doing so, it reduces hormone-related side effects like hair loss.

By cutting down the production of androgen, spironolactone slows down the progression of hair loss. It’s also been proven to help hair regrow.

In one 2015 study [3], researchers found that 75% of women suffering from hair loss noticed an improvement when they started taking spironolactone. Similarly, another study found equally positive results when patients were given a combination of both spironolactone and Minoxidil [4].

Although the results are promising, patients shouldn’t expect to see results instantly. It normally takes a few weeks to notice the full effects of spironolactone. For some people, it can take up to 6 months, and others may not notice any improvements until after a year of consistent use.

When you’re first prescribed spironolactone, you’ll typically be given a daily dose of 100 to 200 milligrams (sometimes as low as 25 milligrams a day). If, after six months, you haven’t noticed any results, your GP may suggest increasing your dosage.

It’s important to note that spironolactone is not able to treat male pattern baldness. It’s also unsuitable for treating non-hormone-related female hair loss that’s caused by stress, chemotherapy, or nutrition deficiencies. Find out why your hair is falling out.

Does spironolactone cause hair loss?

Spironolactone does not cause hair loss. It can actually prevent it if you’re a woman with hereditary hair loss. This is a treatment that has very impressive results when tackling PCOS-related hair loss and menopause-related hair loss.

The vast majority of women who take spironolactone will see positive effects when they start using the drug for hair loss, although they may have to wait up to 6 months before they see any large improvement.

Who can take spironolactone?

Many women can take spironolactone if they’re suffering from female pattern hair loss, regardless of their menopause status and other hair loss therapies [5]. The drug is often particularly effective for women who have PCOS.

However, certain women are not advised to take it, including those who are pregnant or breastfeeding.

The FDA has given spironolactone a pregnancy category D rating. That means that it has the potential to harm a foetus. Because of this, women who are pregnant or breastfeeding should only use spironolactone if it’s agreed that the benefits may actually outweigh the potential risks.

Because this is a prescribed drug, the decision will ultimately be made between you and your doctor as to whether you’re eligible to take spironolactone.

What are the other side effects of spironolactone?

It’s very unlikely that you’ll experience any side effects when taking spironolactone, but there is a small percentage of people who may experience some of the following symptoms.

One fairly common side effect is low blood pressure. Spironolactone is sometimes prescribed to tackle high blood pressure – so it’s important that you regularly check your blood pressure levels when taking this medication.

Other side effects you may experience include:

  • Drowsiness
  • Headache
  • Diarrhoea
  • Nausea
  • Irregular periods
  • Breast tenderness
  • Weight gain
  • Low sex drive
  • Depression
  • Fatigue

To avoid experiencing any of these symptoms, you should follow your doctor’s advice when it comes to how much spironolactone you should take and how often.

Should you try spironolactone for hair loss?

Ultimately, spironolactone is an effective and safe treatment that is prescribed to many women who are experiencing hair loss.

There are studies that prove that it’s an effective treatment that works in the vast majority of cases. However, like with most medications, you should be aware of how to take it properly and the different side effects that you may run into.

If you’re interested in trying spironolactone in an attempt to prevent hair loss, we’d recommend speaking to your GP. They can advise you on whether this treatment will be a good choice for you.

Find out more about female hair loss, including causes, conditions, and other hair loss treatments that could work for you.

Spironolactone For Hair Loss: How Does It Work?, Wimpole Clinic

References:

[1] http://www.verity-pcos.org.uk/what-is-pcos.html
[2] https://pubmed.ncbi.nlm.nih.gov/30785992/
[3] https://www.jaad.org/article/S0190-9622(15)01878-2/fulltext
[4] https://onlinelibrary.wiley.com/doi/abs/10.1111/ijd.13838
[5] https://www.jaad.org/article/S0190-9622(20)30510-7/fulltext
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