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Spironolsctonefor and hormonal adult acne

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I've had acne since I was 16 and I'm now in my early 30s. In my early 20s, I was on accutane, and that's what actually worked and stopped the acne for some years. I got pregnant, breastfed, now the acne is back. It started coming back when I was pregnant, but then it was manageable with just some natural cream I bought from amazon. Now acne is back to those big nodule/cystic type. I stopped breastfeeding and went to the dermatologist. He thinks it's hormonal so he prescribed clindamycin cream, antibiotic and birth control pill. I NEVER took the pill, but decided to try it since we weren't planning on getting pregnant. The pill gave me headaches almost each day, nausea and the worst is constipation! I eat healthy and I never had such horrible constipation. I went back to the dr after a month and now he prescribed instead of antibiotics, a hormonal medicine called spironolsctone. Even though the dr thinks it's hormonal, I don't feel comfortable taking hormonal pills. Aren't there different creams that could work for hormonal acne?? I never had to take any hormonal pills before when I had acne. I feel like this dr doesn't listen to what I'm saying. When I told him I feel uncomfortable taking the birth control pill and was just using the family awareness method, he then said "what's that?" what did women do before the pill?? I don't like the side effects and all these pills are really not healthy. So maybe it would clear my skin a bit more, but what about the long term health effects?? I don't like altering my hormones.  Did you find a doctor that just prescribed creams for hormonal acne and did it work? I'm also not sure he's right that it's hormonal, I get acne all through my cycle. I need to find another doctor that would respect my decision not to take hormones to clear acne.

I know that accutane is also a big drug, but I took it back when I was young and not married. I am planning on having another baby in a year or two and I'd be scared to take any hormonal pills even before I plan on getting pregnant. If I have to take spironolsctone, did it really improve your skin? how long did it take until it started working? any side effects you had? Thanks!

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I took Spironolactone form about Dec/16- Feb/17 It worked to clear my skin quite quickly, I think about after a month I didn't get any new cysts and skin looked great. However the side effects for me were too much. I felt sick all day everyday and I completely lost my sex drive. I was so thankful for the clear skin but I couldn't handle the side effects. worse yet, when I went off of it, I gained close to 15 pounds with cellulite and it took me over 6 months to lose most of the weight. I was only on 25mg but I am also very sensitive to drugs. Despite this though, I will go back on at a lower dose if the Accutane doesn't work.  

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