Spironolactone May Cause Hormonally Associated Vestibulodynia and Female Genital Arousal Disorder

    L. Mitchell, V. Govind, K. Barela, A.T. Goldstein
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    TLDR Spironolactone may cause sexual pain and arousal issues in women, which can improve after stopping the drug and using hormone cream.
    The document discusses two case studies where women developed hormonally associated vestibulodynia and female genital arousal disorder after using spironolactone for androgen-mediated cutaneous disorders. The first case involved a 47-year-old woman who took spironolactone for alopecia and experienced introital dyspareunia and vulvar pain, while the second case was a 46-year-old woman who used the medication for acne and suffered from vulvar irritation, soreness, decreased arousal, and dyspareunia. Both cases improved after discontinuing spironolactone and using a compounded estradiol/testosterone cream. The document highlights the need for healthcare providers to be aware of the potential sexual dysfunction side effects when prescribing spironolactone. Additionally, the study included a survey of 1,140 Mexican females, with 1,055 completing the Female Sexual Function Index (FSFI), which revealed significant differences in perceptions of sexual desire and arousal, with 26 out of 32 descriptors showing significant differences, mostly indicating a preference for sexual arousal over desire.
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