Do Pleiotropic Effects of Spironolactone in Women With PCOS Make It More Than an Anti-Androgen? Evidence From a Systematic Review and Meta-Analysis

March 2023 in “ Current Pharmaceutical Design ”

Rohina Bashir, Mir Mahmood Asrar, Idrees Ahmad Shah, Imtiyaz A Wani, Mohd Ashraf Ganie

spironolactone PCOS anti-androgen Ferriman-Gallwey score idiopathic hirsutism finasteride cyproterone acetate flutamide serum total testosterone HOMA-IR metformin Aldactone Propecia Androcur Eulexin testosterone insulin resistance Glucophage

TLDR Spironolactone is effective for idiopathic hirsutism but has limited effects on other PCOS symptoms.

Spironolactone, at a dose of 100 mg/day, significantly reduces the Ferriman-Gallwey (FG) score in women with idiopathic hirsutism compared to finasteride and cyproterone acetate, but shows no significant difference in PCOS subjects when compared to flutamide and finasteride. A lower dose of 50 mg/day does not significantly impact FG score, serum total testosterone, or HOMA-IR in PCOS women relative to metformin. The main side effects include menstrual irregularity, mild nausea, vomiting, and diarrhea. Overall, spironolactone is well tolerated and effective for idiopathic hirsutism, with limited effects on other PCOS-related parameters.

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