So I'm 23, I was started on Metformin 500mg at bedtime, and Spironolactone 25mg daily. I did that for 4 months, with only mild improvement. I saw my dermatologist yesterday, and she told me to increase it by 25mg every month (max 100mg) and increase my Metformin to 850mg. Everything i've read in these forums says you need at least 50mg, and most say to fully clear up you need 100mg, so I jumped the gun a little and am taking 75mg. I've also been reading about the side effects, anybody have any comments on the spiro + metformin regimen, AND specifically, what dose if any did you start to notice excessive hair growth?? I want to go to 100mg, but if its guaranteed that I'm gonna start having chin hair, i'll pass!! My acne is bad, I've been through 2 partial courses of Accutane - got perfectly clear skin with rebound acne about 18 months later as well as multiple other regimens. In the past 7-8 years I have become an expert in covering all my acne scars with makeup and making it look natural, excessive hair though, I would not be able to hide. Any comments?????
My advice: follow your doctors instructions. Both of those medications are used to treat PCO disease and excessive androgenic effects on the skin. If anything, they decrease facial hair growth if you have a problem with that but they definitely do not cause hair growth in areas where there is none. I've never heard of both being used together, I am a medical professional but that is not my area of expertise. Spiro is used more commonly for hormonal acne and metformin for elevated testosterone levels. So together, they should have a synergistic effect on acne. HTH. 
Hey, so I see that you're taking spiro as well. I had to abruptly discontinue it. When I stopped and thought about it, I realized that since I'd been taking it, I'd been sleeping a lot more than usual, and still not feeling refreshed despite the extra hours of sleep. As soon as I stopped taking it, I felt a ton better. But I know that it helped my skin, I'm not sure what to do now. It seems like so many of the acne meds I get on are great for skin, but have the worst side effects. I myself am in the medical profession as well, I work a ton of hours, and I can't afford to feel so tired like I did on the spiro. I'm using my moisturizers and antibacterial face washes, but I'm afraid that now that i've discontinued the meds, my acne will return again. Any advice??
Hi, sorry it took so long to respond...havent been back on the site till now. I can sympathize with the long hours and need to have energy but honestly, after being on spiro for over 6 months, i hardly feel tired anymore. I'm not as sleepy as I used to be, and I'm back to my usual exercise routine which I was too tired to keep up with before. It has been a gradual improvement as my body's gotten used to the medication. For me it took about 5 months before my skin quit being so dry and my energy started returning but I have no regrets! I would definitely do it all over again to have the skin I have now. I was so miserable that it was affecting me emotionally and psychologically. I think every individual has to weigh the pros and cons for their situation. I remember you said you were on metformin so that may be enough for your situation and you could always add the spiro after a few months if not. But definitely, everyone adjusts to the side effects eventually. You just have to give it time.
Hey, so I see that you're taking spiro as well. I had to abruptly discontinue it. When I stopped and thought about it, I realized that since I'd been taking it, I'd been sleeping a lot more than usual, and still not feeling refreshed despite the extra hours of sleep. As soon as I stopped taking it, I felt a ton better. But I know that it helped my skin, I'm not sure what to do now. It seems like so many of the acne meds I get on are great for skin, but have the worst side effects. I myself am in the medical profession as well, I work a ton of hours, and I can't afford to feel so tired like I did on the spiro. I'm using my moisturizers and antibacterial face washes, but I'm afraid that now that i've discontinued the meds, my acne will return again. Any advice??
I realize your comments are several years old but hopefully you'll read this. I can completely relate to everything you said! Spiro made me feel awful. I realized after quitting it how the fatigue I felt was related to its effect. It seriously messed with my periods too. What did you wind up doing? My doctor switched me to metformin. I am scared to start due to side effects but I believe my underlying problem is insulin resistance. Thanks!