From an article I have:
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We compared the efficacy of spironolactone (50 mg/d) with metformin (1000 mg/d) after random allocation in 82 adolescent and young women with polycystic ovary syndrome (PCOS).
The number of menstrual cycles in the spironolactone and metformin groups increased from 6.6 +/- 2.1 and 5.7 +/- 2.3 at baseline to 9.0 +/- 1.9 and 7.4 +/- 2.6 at 3rd month and to 10.2 +/- 1.9 and 9.1 +/- 2.0/ year at the 6th month (P = 0.0037), respectively.
The hirsutism score decreased from 12.9 +/- 3.2 and 12.5 +/- 4.9 at baseline to 10.1 +/- 3.1 and 11.4 +/- 4.1 at the 3rd month and to 8.7 +/- 1.9 and 10.0 +/- 3.3 at the 6th month, respectively.
Both groups showed improvement in glucose tolerance and insulin sensitivity, although the metformin effect was significant in the latter. Serum LH/FSH and testosterone decreased in both groups. BMI, waist-to-hip ratio, and blood pressure did not change with either drug. We conclude that both drugs are effective in the management of PCOS.
Spironolactone appears better than metformin in the treatment of hirsutism, menstrual cycle frequency, and hormonal derangements and is associated with fewer adverse events.
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Hi all - new member. I'm a physiologist and have worked in drug-development for years. I have PCOS, take 1000mg of Met and 200mg Spiro. I've had great results from that, and almost no side effects. I plan to stay on both unless or until I decide to become pregnant.
I want you to know that relatively low doses of spironolactone typically aren't "monitored" by docs because it's been proven safe for a long time, and because PCOS patients aren't at any higher risk of negative effects from Spiro than the regular population. Members of the "regular" population aren't monitored constantly, so why should we be? Sometimes in the elderly or other at-risk groups, they occasionally check potassium levels. That's because generally - in people who do not have reduced kidney function or kidney failure - it is really a very safe drug.
Also, in those who do not have high blood pressure, Spiro typically doesn't lower it. It's okay to take it for the testosterone. If docs had started using it to treat PCOS fifty years ago and THEN discovered it lowered BP, too - we'd be telling our grammas who have high BP that they're taking a PCOS drug! Do you know what I mean? What I'm saying is that the BP thing doesn't matter (unless you have extremely low BP in the first place and pass out a lot).
Spiro is an old, old, old drug that's been used safely for years. If you have excess testosterone (and that would be why you were put on it) - it could help you in ways other than just hair growth - it could keep you from developing other serious complications of excess testosterone (and we all know what they are!). That's because it inhibits testosterone, which for women - is a very GOOD thing. PCOS is more than just hair growth, as we all know - so the other benefits are really important (excess T can lead to heart disease, diabetes, various cancers, stroke, etc).
To me, that sounds like a pretty good trade off: taking pretty low risk meds (Spiro), with potentially great returns on longevity and life quality. If it's not giving you any negative side effects, and you trust your doc (very important), I'd recommend you stay on it.
My read on Yasmin is that the spiro dose in it is 12.5 mg/day. That's a really, really low dose - and may have beneficial effects in women with very mild PCOS or in normal women - but most PCOS patients do not respond to such a low dose. It's helpful to take additional Spiro, in many cases.
Finally, try to keep it all in perspective, and question what you read - specificaly the 'internet literature.' A lot of it is wrong, dead wrong. I fear for the health of those who take it as gospel. Read everything you can, remember who's writing it, keep in mind that individuals vary (so one individual's advice might not be right for you) and then make your informed decision.
Regards to all,
Maura
