Low-Dose Spironolactone in the Treatment of Female Hirsutism

In a study conducted 37 years ago, twelve women, eleven with hirsutism and one with alopecia areata, were treated with low-dose spironolactone (50 mg daily) from the 4th until the 22nd cycle day over 12 consecutive menstrual cycles. Eight of the hirsute women observed a favorable effect on hirsutism in 3 to 8 months, and hair loss ceased in the one patient with alopecia areata. No significant side effects were reported. The treatment decreased the concentration of total and free testosterone and elevated the concentration of prolactin on the 10th cycle day, while LH, FSH, estradiol, progesterone, DHEAS, SHBG, and cortisol levels remained unchanged. The plasma aldosterone concentration increased significantly during the treatment, although serum potassium and sodium concentrations remained unchanged. The study concluded that low-dose spironolactone is safe and effective in the treatment of hirsutism and could be useful as an initial or alternative treatment.