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[Susie28]

Hi, I am a first time user of this website and have a question about spironolactone. Up until about three months ago I was on Diane-35 for about a year and a half to control the acne but because of the increased risk of stroke (I get migraines) had to discontinue using it. I have been taking the spiro for about three months now to deal with acne. I was taking 25 mg daily at first, and upped it to a dose of 50 mg within the first month. I didn't have any side effects at that time. I have upped the dose to 100 mg over the last two months. I have recently (within the last month) experienced irregularities with my menstrual cycle and have had spotting (which I have never had before in my life). The question is, whether the irregularity is due to stopping birth control or increasing the dose of the spironolactone. I have read that increased doses (100 mg or higher) tend to increase the likelihood of having irregular menstruation. I have spoken to my doctor and she said it could be caused by either going off birth control or by the increased dose of the spiro. I have read that the irregular periods usually subside after three months. I guess my question is that I have only upped the dose to 100 mg in the last two months (even though I have been on spiro for three months total), so do you guys think that it could still be within the time frame that it could still fix itself (in that my periods will return to normal)? I have been told by my doctor to try lowering the dose slightly (to 75 mg) to see if this makes a difference. I have had acne for a long time and the spiro seems to mostly correct a lot of it. The period thing isn't a huge deal but it's really an inconvenience. Please let me know what you think, I would appreciate any advice that you have. Thanks in advance.

[Astra_99]

It could be a combination of the two - stopping BCP and dose change with Spiro. Both have a hormonal influence. It would be my opinion that it is more likely the Spironolactone though. Possible changes in cycle - no menstrual bleeding, irregular bleeding, spotting etc is one of the main reasons for ceasing treatment with the medication. Adding a BCP helps to regulate this.

When I ceased taking Diane 35 and took no other medication I had no problems. When I started taking Spironolactone at 25mg I had two cycles within two weeks of each other and then stopped completely for a year. It was when I had my IUD inserted periods returned due to the local affect of the copper on the uterus. Even then some irregular pattern is experienced.

In animal studies Spironolactone was shown to have a progestational affect on the uterus and it was thought that this was the reason for the irregularity in human females. A further study however showed that the drug does not act with either progestational or anti-progestational activity on the human uterus. It however does something and the mechanism of action is not clear or agreed upon.

What you are experiencing is not uncommon with this medication. It really varies as to what dosage causes side effects in the individual. Some women have side effects with very low doses and others can take quite high doses with limited side effects. In others they adjust over time and cycles balance out again. It's really a case of seeing what happens over time. Don't take more than you need to.