Spironolactone for Hair Thinning in Women

Female pattern hair loss is more common than you may realize--up to 40 percent of women develop some hair loss before menopause. Hair loss in women can result in low self-esteem, social anxiety and introversion, so it is important to treat it to regain your self-confidence. In addition to topical treatments, some women respond to treatments that control hormone levels in the blood. Spironolactone is one drug that can do that.

What is Female Pattern Hair Loss?

• Female pattern hair loss is excessive hair shedding resulting in thinning of the hair, usually across the top of the head. The pattern is different from male pattern hair loss, where the hairline recedes and progresses to a bald spot at the crown of the head. Female pattern hair loss, also called androgenic alopecia, often results from too much male sex hormones, or androgens, such as testosterone, in the body. It is progressive and incurable, but the progress can be halted and in some cases even reversed with long-term treatment.

What is Spiranolactone?

• Spiranolactone is actually a diuretic prescribed to control fluid around the heart in patients with congestive heart failure. It is also used for certain liver and kidney conditions, and to treat low potassium levels. Use of spiranolactone for treatment of female pattern hair loss is not approved by the U.S. Food and Drug Administration (FDA), but it is a common off-label use.

How does Spiranolactone Work for Hair Loss?

• Spiranolactone can be used as an anti-androgen medication. According to the New Zealand Dermatological Society, it suppresses release of the pituitary hormone gonadotrophin, which in turn reduces androgen production by the ovaries. This controls the hormone levels that govern hair growth and shedding.

Alternatives

• Some dermatologists recommend long-term use of Rogaine, a topical solution that helps to regrow lost hair. Used in combination with spironolactone, Rogaine can stop the hair-loss process. Over the long term, as long as you continue treatment, you may see less hair loss and may even regrow some of what you have lost. Some women with certain types of hair loss may be candidates for hair transplantation. Talk to your hair stylist about changing your hairstyle or using hair care products to create a fuller look with the hair you have.

Dosage and Side Effects

• According to the New Zealand Dermatological Society, the dose of spironolactone is usually slowly increased from 25 to 200mg daily, taken at night. It may take six or more months to see improvement in the skin condition. Side effects to report to your dermatologist include breast pain, diarrhea, dizziness, drowsiness (possibly due to high blood potassium levels) headache, menstrual cycle irregularities including increased or decreased frequency of menstruation, mid-month bleeding or stopping periods altogether, and nausea.