Spironolactone for PCOS: How It Works, Side Effects, and What to Expect

When you have polycystic ovary syndrome, a hormonal disorder that causes irregular periods, acne, unwanted hair, and difficulty losing weight. Also known as PCOS, it often means your body makes too many male hormones—called androgens—which trigger those symptoms. Spironolactone, a medication originally designed to lower blood pressure by helping the kidneys remove extra salt and water. Also known as Aldactone, it’s now widely used off-label to block those excess androgens and calm down PCOS symptoms.

Spironolactone doesn’t cure PCOS, but it tackles the root of many symptoms. It blocks androgen receptors in your skin and hair follicles, which reduces oily skin, acne breakouts, and facial or body hair growth. Many women see clearer skin in 2 to 4 months. It also helps slow down scalp hair thinning. Unlike birth control pills, it doesn’t suppress ovulation, so it’s often chosen by women who want to get pregnant soon or can’t take estrogen. But it’s not a one-size-fits-all fix. You’ll need to take it daily, and results come slowly. It also comes with side effects—like needing to pee more often, dizziness, or low sodium levels—so your doctor will monitor your potassium and kidney function. It’s often paired with other PCOS treatments, like metformin for insulin resistance or topical acne creams.

What you won’t find in every doctor’s office is a clear roadmap for using spironolactone long-term. Some women stay on it for years. Others switch once their symptoms improve. It’s not a magic pill, but for many, it’s the missing piece. The posts below cover real-world experiences and clinical insights: how to time it with other meds to avoid interactions, what blood tests matter most, how it compares to other anti-androgens like finasteride, and why some women see dramatic results while others don’t. You’ll also find advice on managing side effects, what to expect when you stop, and how to tell if it’s working for you. This isn’t theoretical—it’s what people actually use and live with.