Aldactone or Spironolactone

[Akiwican]

Has anyone been on Aldactone or spironolactone? I have been prescribed it for excess hair growth {hirsutism} as my hormones are out of wack. It is actually a high blood pressure medication. I was tested for PCOS by ultrasound and I dont have any cysts, but seem to have alot of the other symptoms....

:wave: Akiwican

[Rosebud]

Hi Lesley,

You probably know this, but remember that Aldactone is potassium sparing so be very cautious about taking any potassium supplements.

Hope it helps yer hormones!

Roz

[Akiwican]

Yes thanks Roz, I just read that in a search on here. I really haven't decided if I will take it or not? I mean, the hair growth bothers me {thank god alot of it is blonde} but is it worth it to take a blood pressure medication in the long term for a vanity thing? I just wondered if anyone had good/bad experiences with it......

:wave: Lesley

[tigersue]

I take aldactone and it is a diuretic it is used for that more than blood pressure because the effects on blood pressure is very minimal. I started it last November and I have felt very good, and there is a visible change in my hair growth. It is finer, lighter grows back slower and more normal. I have never had that at all.
I also started glucophage for insulin resistance and I noticed a decrease in cravings of carbs right off. Before I started "lowcarbing" I was doing it on my own.
I take the lowest dose of aldactone and I dont' want to increase it very much at all. You do have to be careful with potassium intake but I have been okay there too. I'm monitored every 4 to 6 months now to see how things are going. Make sure you increase the amount of water you would normally drink to make up for the effects of the diuretic so you stay hydrated and becareful with ketones because that can be harder on the kidneys.
Tanya

[Akiwican]

Hi Tanya

Just curious as to what dosage you are taking? Did your Dr prescribe it for the hirsutism problem specifically? Have you seen a decrease in hair everywhere ? Have you noticed any side effects {bad} or benefits to taking aldactone?

:wave: Lesley

[tigersue]

Yes I'm taking it for the Hirutism specifically. Many years ago the first doctor put me on a pill (demulen) that was also suppose to help the hair issue. I never saw the results for the year of being on that as I have on the aldactone in the past 8 months.
I'm on 25 mg. I refuse to take any higher since it seems to work well for me. My doctor said that it helps in about 60% of cases and you should be able to start seeing a difference in just a few weeks, somewhere around 6 to 8 I think up to about 3 months.
I have noticed a difference everywhere except for my head, I have very thick hair and the only thing that ever effected that was a low protein diet.
As for side effects the only thing I notice and you would notice this with any diurectic including caffeine is that I use the restroom more in the morning but on this low dose it doesn't last very long.
I haven't noticed anything else that concerns me at this time. I will eventually drop it because I don't like taking prescriptions but since I'm trying to heal my body I'm willing to take the risk. Obviously something is working right for testosterone to not be effecting my hair growth.
Tanya

[Akiwican]

I will eventually drop it because I don't like taking prescriptions but since I'm trying to heal my body I'm willing to take the risk.
Tanya

From what my Dr said I would have to be on it continuously to control the hair growth. If I stop the hormone level will increase and so will the hair. Thats part of the reason I am hesitant to start it. I also hate taking pills and the thought of taking them on the long term does not appeal to me much. He has prescribed 100mg for me.. .thats 4 times what you are on!

Sounds like you have had good results so far. He also said that I might get spotting and irregular periods. Has that happened to you? I know you have PCOS so it might affect you differently? I was recently tested for that {ultrasound} as I have many symptoms but i dont have it.

:wave: Lesley

[tigersue]

The only time I have spotting is when I don't take my BCP properly, like being late taking one or missing it.
You are on a very high dose and I wouldn't think you would need that much. My doctor started me on the low dose and was willing to increase it if it didn't work. I would insist on the lowest dose and go from there if you feel like taking it. there is no sense in taking more if you don't need it.
I never had lab results that specifically said that I have the disorder but I have all the symptom of it. Give me a check list and I can check about every symptom there is.
I also seem to have darker hair growth than you do. Even on my upper lip it is very dark and at least now it comes in fine and lighter so it is easier to remove.
I'm not sure what exactly to tell you, other than my experience as a nurse is always the lowest dose and move up if you think you need to. 100 mg of aldactone is a lot.
I'm also 5'3 (a little shorter) and weight right now about 195, I have lost about 27lbs in the past 15 months.
Tanya

[Akiwican]

Sorry to bug you with all these questions.... I didnt know you were a nurse :thup:

I have already looked into PCOS quite throughly and seem to have alot of the symptoms but since nothing showed up on the ultrasound {cysts} he said I dont have it. Thats why I went on to have further tests done {thryoid, insulin} and all came back normal. {results posted in thyroid forum} Only my hormones {male} were out of wack.

Yes, I am very grateful that my hair is mainly fair coloured, but the few dark, course ones really bug me on my face, people stare.... :(

Maybe I could cut the pills in half? i.e. 50 mg and try that. Would that reduce the effectiveness? I really dont want to go on the waiting list to go back and see him. He is in another city and I had to wait weeks to see him last time... then 6 weeks for the results to come back. Maybe he thought that 100 mg was good for an initial shock to my system and then reduce the doseage next time?

Thanks very much for helping me with this Tanya.

:wave: Lesley

[tigersue]

I had never heard of aldactone for this purpose until I went to my doctor this past year. I'm not sure what to tell you on the dosage I would think 50mg would be more reasonalbe that 100mg. My best advice at the moment would be to do several searches on the web with aldactone and PCOS as the search words. Perhaps you could find some suggestions from other doctors online. I would also check around for other doctors opinions in the area. I know it is a pain, but the higher increase in male hormones is a great indicator of PCOS and you don't absolutely have to have cysts seen on ultrasound. The cysts of PCOS and ovarian cysts are two very different things. PCOS is still a very underestimated syndrome and you need a doctor that will really adress it with you and not treat you as it is not a problem. If you indeed have the syndrome I would venture a guess that you do, you need someone that will work with you when you are so willing to heal yourself.
Just my 2 cents worth.
Don't start taking anything until you feel like that it is right for you.
This happened to be the right thing for me, but my goal has been to heal and get my health back. You may have different ways of trying to get there, but if it works for you more power to you. Medicine can be very benefical but it can also have it's draw backs as well so you are very correct in being careful, asking questions to make the best informed choice you can.
I also use surgicream to remove my hair on my face, and I'm looking at buying something I saw on qvc one time. I have to wait for some money to do so.
Tanya

[tigersue]

I forgot to mention one other thing about aldactone. When you are on it you can not take NSAIDS (nonsteroid anti-inflamitory drugs), these are Ibuprofen(advil, motrin), asprin, aleve, any of those type of pain killers. They all effect the kidneys, I get migrains fairly frequently and even one Ibuprofen can cause me to swell up. The pharmasist told me that occasional use is okay but not frequent, I prefer to avoid them all together.
Tanya

[Akiwican]

For the heads up on that one Tanya. I very rarely take any sort of pain killer... dont seem to need them. I should also stop my Potassium suppliments right?

:wave: Lesley

[tigersue]

Yes stop the potassium, aldactone is potassium sparing so you have to be very careful there, my doctor always asks if I'm eating banana's(yuck), or orange juice because they are both high in potassium. So far my levels have been fine.
Tanya

[Akiwican]

Picked up my prescription tonight and found out that I am supposed to take 150 mg per day! :eek: 1/2 a 100 mg tablet three times a day! :eek: This is going to be hard... I hate taking pills. :( Do you take it 3 times a day? I guess that ensures a steady stream of medication...

How often do you get your potassiuim levels checked Tanya?

:wave: Lesley

[Rosebud]

G'day Lesley,

Found a bit more info about dosage...

"Treatment protocols may involve continuous spironolactone use at 50mg to 200mg per day or cyclic use. For example 50mg or 100mg twice daily from the 4th to the 22nd day of the menstrual cycle. Numerous treatment protocols involving spironolactone have been used in different studies, but no particular treatment approach has been shown to be significantly superior. Combination therapy with an oral contraceptive pill or dexamethasone appears to have an improved beneficial effect on hirsutism and limits side effects.

Spironoolactone is a diuretic, so it's advised to drink plenty of water while taking it. Side effects with spironolactone are generally transient. As with all antiandrogens , spironolactone use should be avoided during pregnancy and in women who have a family history of breast cancer, although there is no proven association between spironolactone and breast malignancy."
http://www.hairfacts.com/methods/rxoral.html

and...

"iii) Spironolactone (Aldactone®) was originally marketed as a diuretic, but has limited uses in that field. Its efficacy as an antiandrogen was noticed through its ability to decrease testosterone production, increases the rate of testosterone metabolism, to inhibit dihydrotestosterone binding to the androgen receptor and to retard the conversion of testosterone to dihydrotestosterone by its effect on 5 a - reductase. Spironolactone is a stronger antiandrogen than cyproterone, but also has progestational effects. The dosage is 50 - 100 mg. by mouth twice a day. Cyproterone acetate is taken up in adipose tissue and then slowly released, thus rendering the patient susceptible to menstrual irregularity. A reversed sequential regimen was developed to avoid this side effect. It consists of giving cyproterone acetate on days 5 though 15 of the cycle in doses initially of 50 to 100 mg. per day. Ethynyl estradiol is given in a dose of 50 µg daily from days 5 through 26 of the cycle. Dose reduction is possible once effective remission of hirsutism occurs. A combination oral contraceptive (Diane) containing cyproterone acetate (2 mg.) and estrogen ethinyuloestradiol (50 µg) is sometimes used for maintenance. Side effects include nausea, fatigue, irregular menses, and headache. Because of its previous use as a diuretic, high serum potassium and low blood pressure have been postulated, but do not occur in practice. Spironolactone like cyproterone interrupts the masculinization of a male fetus so contraception should be practiced by a woman previously infertile with polycystic ovarian disease as ovulation has been induced with spironolactone."
http://www.electrology.com/jour93h.html

and...

"Female Hirsutism 100mg to 200mg daily in divided doses is usual however 50mg daily has also been shown to be effective.

Clinical improvement is usually shown within 3 to 6 months and an initial course of treatment should continue for 12 months.

ALDACTONE may be administered continuously or as a cyclical dosage for approximately three weeks out of every four. Dosing from day 5 to 21 of the menstrual cycle, with a drug free interval during menstruation has been effective.

Cyclical dosing may reduce menstrual irregularities in women with previously regular cycles.

Combined use with oestrogen-progestogen oral contraceptives may also be considered to provide both regular menstrual cycles and adequate contraception."
http://www.medsafe.govt.nz/Profs/Datasheet/a/aldactonetab.htm


That's a long way of saying I think your doctor is right - but maybe in the future you'll be able to lower your dosage.

I would suggest (and I'm sure Tanya will agree) that you go back to your doc after a week or so and get your potassium level checked.

HTH!

Roz

[Akiwican]

Thankyou so much for all that info Roz. I am beat right now but I will get into it tomorrow more. It mentions more than once about the cyclic method of taking it but my Dr didnt say anything about having a break. It might be a good idea. I really dont want to have spotting throughout the month.

Yes, I will get my potassium levels checked. The warning level that came with the meds mentions it more than once and in bold type I guess its a blood test?

:wave: Lesley

[Rosebud]

You're welcome, matey!
I guess its a blood test?
Yep!

One more thing (can't remember if Tanya mentioned this), Aldactone has a slight diuretic effect so if you seem to be peeing a bit more than usual....I don't think I need to tell you what to do! :p Just something to watch out for.

Sleep well!

Roz

[tigersue]

I take 25 mg, once a day. That is it. I can't imagine taking it more than that. Diuretics are rarely administered any other time than in the morning because you don't want to disturb sleep by taking it later in the day. I would really double check with the doctor on that. Call the nurse at the office, and say you want to be sure you are taking this correctly, give the info you have on taking it on cycles and ask for a call back on recomendation of how to take it.
I had my first potassium level about 2 months after I started the meds, but I'm on such a low dose that I doubt it was going to be that much of a problem before that. You are on a much higher dose and I still question that, because with everything else I have taken in the past they always start low and work up.
Definitely ask when your doctor wants to check your levels. Mine checks mine now everytime I go in and that is anywhere from every 4 to 6 months.
Tanya

[Akiwican]

I actually asked the Pharmasist about the doseage when I picked up the prescription and she said that was completely normal for what I was being treated for. I also saw that doseage on a web site re: hirsutism. I have been on it for a week and no side effect at all so far Havent noticed any difference in peeing either, even with taking the last one at dinner time. I will get my potassium levels checked within the month.

Thanks for your concerns in this, so far everything is going fine.

:wave: Lesley

[Scarlet]

[I was tested for PCOS by ultrasound and I dont have any cysts, but seem to have alot of the other symptoms....

:wave: Akiwican [/B]

[QUOTE][I have already looked into PCOS quite throughly and seem to have alot of the symptoms but since nothing showed up on the ultrasound {cysts} he said I dont have it. Thats why I went on to have further tests done {thryoid, insulin} and all came back normal. {results posted in thyroid forum} Only my hormones {male} were out of wack.

:wave:Akiwican [B][QUOTE]

Cysts on the ovaries are only one symptom of the condition. In fact many PCOS experts would like to rename the syndrome for this very reason. You have excess androgens, insulin resistance and hirsutism alonhg with skin problems. I would bet all my wordly goods that you have PCOS. Please try to find another doc or give your one articles on PCOS so that he becomes informed.

One does not have to have all the symptoms to suffer from it. I was not dx for years because I was skinny and it was not till I reached 168lbs that I was dx. Also, my severly carb intolerant friend who gained 90lbs in two months does not test as having PCOS, even though she clearly does, and has lost tone of weight since doing Atkins and being on medicine. Moral of the story, keep fighting for that dx :)

[Akiwican]

Could well be that I do have PCOS despite the fact that I dont have cysts.

I have always had a weight problem {from childhood} so its not like I just gained a huge amount in a short time frame.

I am not insulin resistant.

I have read that you can gain some control of PCOS symptoms with diet i.e. low carb. Since starting l/cing I have cleared up my acne, regulated my periods and lost 27 lbs.

So for now I am going to continue on as is. Thanks for the input though.

:wave: Lesley

[Hiz Baby]

Hi, I was on spironolactone and it didn't help me. I still have excess hair growth and thinning hair on my head. I keep telling my husband, "I'm going to be the weird bald lady with the mustache and beard that all the kids will point to and laugh at".

I don't know what to do about it and neither do the doctors, so I quit going to them.

If you or anyone else finds a solution, please keep me in mind.

Thanks and good luck. :-) :wave:

[offdoodykc]

(brief introduction: I am 33 years old, first diagnosed with PCOS when I was 14 because of irregular periods. I didn't have a weight problem until pregnancy (gestational diabetes), and since then have been up and down on the scale. Sept 28th of this year I decided to take some drastic measures. I was tired of my primary care doc saying, " You need to eat less and exercise more..." without offering any help beyond that. :mad: He just couldn't understand it wasn't about my lack of self control or deficient will power. He could not comprehend anything beyond :daze: ,"its all in your head - you just have to make up your mind to do it. Try some slimfast." I am a cancer research nurse and I work in an oncology group. We give slimfast to patients to help them gain weight. So I ordered phentermine on the web to help with my appetite, and while I don't recommend it for everyone, it sure works for me.)

Sorry to ramble on... ANYWAY - how wierd are your hormone levels? About 5-6 months ago I started to notice my hair thinning and light facial hair - a little more than usual, anyway, so I made an appointment with an endocrinologist, did a bunch of lab work thinking this is classic PCOS with some insulin resistance - all I need is some BCP and spironolactone.

Instead, it turns out that my estrogen is normal, my androgen level is normal, but my testosterone level is three times what it should be. This explains my symptoms, but where is it coming from? More tests to schedule. Does anyone else have this problem? Could it be just PCOS? My doc and I discussed possibilities - none of which I liked - an ovary acting like a gonad, or a stray gonad (ack!) or a tumor that secretes testosterone, or a pituitary tumor. I would really appreciate any feedback. :(

[mbutterfly]

I also have unusual levels of testosterone and found the following in a website (http://www.gynob.com/pcos.htm):



Recent advances in understanding this disorder have demonstrated other problems besides alterations in the menstrual cycle and ovulation. For one thing, there's a certain tendency toward diabetes with a phenomenon called "insulin resistance." It's not that there's too little insulin, but that the insulin made is not as good. Therefore, handling sugar is impaired. The body responds by making even more insulin, and the extra insulin tends to stimulate other tissues that normally aren't particularly responsive to insulin. One of the tissues is the ovary, which is stimulated to make extra androgen (testosterone). Other effects on other tissues include:

stimulation of the lining of blood vessels, causing hypertension;
effects on the liver and on cholesterol metabolism, contributing further to heart disease;
and a decrease in sex hormone-binding globulin (SHBG), which means less sex hormone is bound ("tied up") and therefore free to act.

The "bound up" testosterone is fairly unreactive. The free testosterone is what has the classical male hormone-like effects, like hair growth, acne, and disruption of the normal ovulation and cycling. There accumulates a collection of early follicles that don't go any further. (An ovary in such a state is, however, "loaded" such that there is an exaggerated response to induction of ovulation with a greater risk of twins and triplets from multiple simultaneous ovulations.)

The "full-blown typical" PCOS patient has a history of only occasional ovulations (<8 per year) and prolonged cycles of greater than 35 days, male-like hair distribution or hair loss, obesity, multiple ovarian cysts, acne, and laboratory assessment demonstrating too much testosterone. But there are varying degrees of PCOS, and many women with it have only few or isolated aspects of the disorder.

Hope that helps!!

[offdoodykc]

Thanks so much for the info. It really helps just knowing I'm not crazy or alone in this. What has me worried is that my doc said that usually if it were the PCOS - other hormone levels - particularly androgens and adrenal related stuff - would be out of whack, too - but they are not. He couldn't - or wouldn't speculate on the likelyhood that it's a mass (cancer) that is producing testosterone - which happens with some kidney cancers, or something wrong with my pituitary gland, or PCOS that just isn't behaving like most other PCOS cases.

[mbutterfly]

This disease is SOO complicated and everyone's case is different from another. Try not to get too worried about cancer - it could just be the PCOS.

Keeping my fingers crossed that your tests come back good.

Take Care!

[offdoodykc]

It would be easier to dismiss if I didn't work with cancer patients 40-60 hours a week. I guess I am so accustomed to seeing the worse case scenario - I expect it for myself. Thanks for the positive vibes.

[nitrovixen]

Hi!
I'm on 100 mg Spironolactone & ortho tri-cyclen because of all the PCOS symptoms.. irregular heavy periods, acne, hirsutism, etc. My doctor told me I can wait to see if I have PCOS until I want to have chitlins, but I am tired of taking Spironolactone... I haven't noticed any lightening or lessening of body hair (however, I've had a lot of it lasered off). I don't know what effect it has had on my acne (I know it didn't stop it because I take minocycline for that, and tried to stop taking it and it came back) Do you know of anyone who has stopped taking Spironolactone and taken L-taurine instead? If I take that instead will a fresh crop of hair sprout up? Will it be bad for my (possible) PCOS?

since taking Spironolactone & ortho-tricyclen I started getting cavities (never had any before in my life) and gained weight.. I have NO IDEA what it's doing to my bones!

Sheri

[Mara]

Sheri,

You might want to talk to your doc about the bcps - Ortho Tri-Cyclen are triphasic, which tend to be the worst for PCOS, as they don't usually contain enough hormones on a constant basis to keep our own hormones in check.

From the INCIID PCOS faq page:
One concern about the triphasic pills is that the low starting dose may not be enough to inhibit follicle production, and the small follicles produced can contribute to the appearance of polycystic ovaries.

Which also makes sense - more follies sitting around, the more testosterone they're putting out.

You might be better off with a biphasic pill, like Desogen or Demulin. Or, for that matter, monophasics like Yasmin, which is supposed to help with hair growth & skin issues. For what it's worth, my acne and hair growth literally exploded when a new GYN changed me to the Ortho Tri-Cyclen. Most docs simply aren't up enough on the research to know which pills work best for women with PCOS.

Hope that helps a bit.

Mara

[nitrovixen]

Hi Mara!

I went for my follow up appointment today and did an ultrasound (to see if there were cysts on my ovaries) and she said they looked normal. There was an average amount of follicles! Even so, I asked to be switched to Yasmine rather than Ortho-tricyclen. Thanks for the advice!
I'm going to try and stop taking Spironolactone since the Yasmine has a similar substance in it. I asked about taking L-taurine instead and she didn't even know what it was. :rolleyes:
We'll see what happens! thanks!

Sheri

ps- you should go introduce yourself in the new member's area!

[Misa]

My doctor warned me against taking Spironolactone because my blood pressure (which, before LC, was high) is actually normal... and she worried that it would drop too low.

This bummed me out because I was hoping to take it for the hair problem.

That being said, I'm now trying to get off the BC pill (I had a tubal ligation on Friday!) and wouldn't want to get on any additional pills now.

[nitrovixen]

Hi Misa!
I don't think spironolactone does much anyway. There's always bleach and lasers for us :rolleyes: I think my blood pressure is pretty normal and the doctor prescribed it to me anyway! hmm...
I envy you for being able to stop taking BC! The doctor put me on it to control the the PCOS (If I do indeed have it) so looks like there's not much chance of going off of it. :(

does anyone know if Yasmine has the same amount of Spironolactone-like ingredients? Can I stop taking it if I take Yasmine? I mean, the doctor told me I could stop taking if if I wanted and if hair started coming back start taking it again.. but it takes 6 months to do anything! so I hate to stop taking it, just in case.

rrrgh.

Sheri

[Misa]

Sheri,

I am on the birth control pill for my PCOS, too. However, I'm working with a low-carb diet and trying to see if that helps regulate the periods, which is my main concern, as I hate bleeding for three months nonstop.

I couldn't go off the pill without some other form of BC, though, as I didn't want to run the risk of getting pregnant.

[Akiwican]

I'm back here to report that I went to my Dr yesterday and I am now off Aldactone as it [B]did not[b] work to reduce my excess hair growth at all.

So I have taken a pill 3 times a day for 8 months for nothing! :( He has scheduled repeat blood tests in about a month {once the Aldactone is out of my system} and I go back to see him again in July when the results are back!

When will this get sorted out........ :(

:wave: Akiwican

[heatly]

hey guys, just so you know i have been on aldactone for a year. i have heard by very good doctors that anything less than 75mg per day does not seem effective. however, everybody is different and reacts different so some people will see results on only 25mg. also, yasmin is the BEST birth control pill to be on. the progestin that is in it is a spironolactone-like agent. meaning it does the same thing. so yasmin is the best for women with PCOS. Also if you are taking Yasmin you do not need to be on as high of dosage with the spiro because it is in the yasmin. yasmin is equivilent to 25mg per day of spiro. so you could be on 75mg a day of spiro and yasmin and really you would be on 100 mg a day of spiro. i was on both 100mg a day and found it was too drying and i was too thirsty. so i dropped to 75mg a day and took yasmin. my suggestion to all is if you are going to be on birth contol pills for irregular periods and hirsutism or acne that yasmin is the one to go on. also make sure if you are on spiro also to get potassium checked within the first month of taking it. hope this is helpful!

[Lobstergal]

I took spiro for about 6 years when I was diagnosed with PCOS in 1997. It did not do a darn thing for the hair growth on my face and I was taking 100 mg per day. It *did* bring my acne under control but I do that now with lowcarbing. My acne is no where near as bad as it used to be before I lowcarbed.

Last summer I went off spiro because I felt it was not helping me with anything and not one of my doctor's...2 GPs and an Endo were not even monitoring me on a regular basis while I was on the spiro. I felt a little weird being on something where the doctors seemed unconcerned and gave me no information about the medication. I never even knew about the potassium/ibuprophen issues until just recently so I choose to toss the spiro for good.

I am going to see a new GP in October (my last doctor retired) so when I see him I will tell him I have PCOS and see what he says about that.

[bike2work]

From the summer of 1999 to summer of 2000, I did Atkins, and was losing weight until I started taking spironolactone. I didn't make the connection at the time, but I think the spironolactone stalled me for eight months. I finally gave up on Atkins, thinking that the diet didn't work. Now I think it was the spironolactone.

And it didn't do a thing for the hair problem.

While I was on that stuff, though, I loved the fact that I only needed 4 - 5 hours of sleep per night. I got so much done! I don't know how I would have finished grad school without it!

[mar1971]

From an article I have:
*********************************************

We compared the efficacy of spironolactone (50 mg/d) with metformin (1000 mg/d) after random allocation in 82 adolescent and young women with polycystic ovary syndrome (PCOS).

The number of menstrual cycles in the spironolactone and metformin groups increased from 6.6 +/- 2.1 and 5.7 +/- 2.3 at baseline to 9.0 +/- 1.9 and 7.4 +/- 2.6 at 3rd month and to 10.2 +/- 1.9 and 9.1 +/- 2.0/ year at the 6th month (P = 0.0037), respectively.

The hirsutism score decreased from 12.9 +/- 3.2 and 12.5 +/- 4.9 at baseline to 10.1 +/- 3.1 and 11.4 +/- 4.1 at the 3rd month and to 8.7 +/- 1.9 and 10.0 +/- 3.3 at the 6th month, respectively.

Both groups showed improvement in glucose tolerance and insulin sensitivity, although the metformin effect was significant in the latter. Serum LH/FSH and testosterone decreased in both groups. BMI, waist-to-hip ratio, and blood pressure did not change with either drug. We conclude that both drugs are effective in the management of PCOS.

Spironolactone appears better than metformin in the treatment of hirsutism, menstrual cycle frequency, and hormonal derangements and is associated with fewer adverse events.

****************************************

Hi all - new member. I'm a physiologist and have worked in drug-development for years. I have PCOS, take 1000mg of Met and 200mg Spiro. I've had great results from that, and almost no side effects. I plan to stay on both unless or until I decide to become pregnant.

I want you to know that relatively low doses of spironolactone typically aren't "monitored" by docs because it's been proven safe for a long time, and because PCOS patients aren't at any higher risk of negative effects from Spiro than the regular population. Members of the "regular" population aren't monitored constantly, so why should we be? Sometimes in the elderly or other at-risk groups, they occasionally check potassium levels. That's because generally - in people who do not have reduced kidney function or kidney failure - it is really a very safe drug.

Also, in those who do not have high blood pressure, Spiro typically doesn't lower it. It's okay to take it for the testosterone. If docs had started using it to treat PCOS fifty years ago and THEN discovered it lowered BP, too - we'd be telling our grammas who have high BP that they're taking a PCOS drug! Do you know what I mean? What I'm saying is that the BP thing doesn't matter (unless you have extremely low BP in the first place and pass out a lot).

Spiro is an old, old, old drug that's been used safely for years. If you have excess testosterone (and that would be why you were put on it) - it could help you in ways other than just hair growth - it could keep you from developing other serious complications of excess testosterone (and we all know what they are!). That's because it inhibits testosterone, which for women - is a very GOOD thing. PCOS is more than just hair growth, as we all know - so the other benefits are really important (excess T can lead to heart disease, diabetes, various cancers, stroke, etc).

To me, that sounds like a pretty good trade off: taking pretty low risk meds (Spiro), with potentially great returns on longevity and life quality. If it's not giving you any negative side effects, and you trust your doc (very important), I'd recommend you stay on it.

My read on Yasmin is that the spiro dose in it is 12.5 mg/day. That's a really, really low dose - and may have beneficial effects in women with very mild PCOS or in normal women - but most PCOS patients do not respond to such a low dose. It's helpful to take additional Spiro, in many cases.

Finally, try to keep it all in perspective, and question what you read - specificaly the 'internet literature.' A lot of it is wrong, dead wrong. I fear for the health of those who take it as gospel. Read everything you can, remember who's writing it, keep in mind that individuals vary (so one individual's advice might not be right for you) and then make your informed decision.

Regards to all,
Maura
:D

[heatly]

hi maura, i have a question for you. What is metformin? is it a form of birth control or no? why are you on both spiro and metformin? i am currently on 75mg of spiro and on yasmin, the pill. i have heard about metformin but dont know exactly what it is, can you fill me in? thanks

[WantsMore]

I have a bad case of PCOS and the hair problem of course. I was put on Yasmin a year ago for the hair growth. The doctor thought it would help, plus she does not want me on certain birth controls. She said some have hormones that could make me worse off. Well the hair is the same. I see her again in about a month or a little less. I'm going to ask her about the Aldactone, I also have high blood pressure. I'm a little weary some of you have had results, some not. But I guess it's worth a try right? I'm so sick of the hair I'm willing to do anything. I've had laser already, getting it again is inconvenient due to the time where you have to let it grow out and I refuse to go in public when it is. The plucking has caused scarring on my neck. The hair is gone for a few hours, but I'm left scarred. Really frustrated with the facial hair issue. I've learned to just live with it elsewhere oh well, but not the face.

[heatly]

a word of encouragemnt. i have bad hair issues too. the aldactone keeps new hair from coming on, and it has lightened the hair on my stomach and chest a lot. It also has lightened the hair on my face. i also use vaniqa cream on my face which keeps the hair from growing fast. i used to have to take care of the hair everyother day, if that long. now i wait 6 or 7 weeks to do anything to the hair on my face. granted, i have been on aldactone for a year. yasmin is not enough alone to make it bettter but it does keep it from getting worse. i am currently on 75mg of aldactone and on yasmin. i was in a state of despair when this first happened to me, i have PCOS too, but now after finding the right kinds of products and getting help from good doctors, i feel very satisfied and secure. Vaniqa is a miracle for us women with hair on our faces. it seriously changed my life. i feel much more confident and normal now. hope this helps!