So, as promised, an entry about spironolactone for those who are just learning about it.
I'm just going to share what I heard from the endocrinologist and the pharmacist I spoke to for clarification. As always, none of this should be substituted for your own doctor's advice.
Spironolactone (aka Aldactone, Novo-Spiroton, Spirotone, spiro) was first developed to treat certain types of fluid retention and high blood pressure. Its androgen-blocking features were noticed later. It is a mild water pill, but is apparently still being prescribed for some kinds of hypertension, as well as androgen related issues like acne and hirsutism. How it works for those of us with hormone imbalances is it competes with the male hormones for binding to androgen receptors. If androgen receptors don't bind with those hormones, they can't cause male characteristics. This is not a cure for hirsutism, but it can reduce the amount of hair, it's texture, color, and rate of growth. It sounds like it's different with every woman. My endo also solidified what I've read that hair removal methods like laser can become more effective in conjunction with this treatment.
Because it's a diuretic, the endo said some women notice they're peeing more in the first couple of weeks. It doesn't flush out potassium like other diuretics do, so it can pull your electrolytes out of whack and should not be used if you already have an issue with that--which is apparently rare. The endo said I would not need to avoid potassium rich foods, but the pharmacy's papers on the drug recommended limiting the intake of things like potatoes and bananas, and not taking potassium supplements. I'd rather be safe than sorry. In any case, electrolytes need to be watched carefully via blood tests. (Yay.)
Although this is a water pill and sources say NSAIDs (non-steroidal anti-inflammatory drugs like ibuprofen and aspirin) should be avoided, that is only because those types of pain killers raise your blood pressure. If you're not taking Spiro for high blood pressure, using NSAIDs should be fine (good news for me, I love my Advil). When in doubt, call your pharmacist like I did. The endo also said I shouldn't worry about any other drug interactions, and the pharmacy paper does list some obscure ones--nothing I recognize.
Also, because it's meant to lower blood pressure, some women have reported dizziness or fainting. The endo also said the rare woman has complained of tiredness. Upset stomach is another one, so taking it with food is supposed to help. And of course, there's the wonderful irregular cycles. If these sorts of things persist or get worse, that's when you're meant to call your doctor. That's why I'm waiting it out. The body needs time to adjust.
Of course, I've also heard of women who truly hated being on Spiro. I have read about some pretty wacky side effects on the Internet, but responses are so varied that it's hard to know if Spiro is right for you until you try it. The very best thing is to talk to your doctor.
Everything else I (think I) know about Spiro I learned from these sites:
- Wikipedia - A better explanation of how Spiro works
- HairTell Forums - Positive results and cautions here
- Drugs.com - Info similar to what the pharmacy handed me
- Rxlist.com - An even more detailed version (and I like the organization better)
- Acne.org Forum - Acne related, but still interesting. Questions seem to be answered faster.
So, I hope that helps the curious. If anyone else has been on spiro and wants to add something, you're welcome to. Until next week.