Short-Term, Low-Dose Spironolactone for Treatment of Hyperandrogenic Symptoms of Polycystic Ovary Syndrome: A Systematic Review

    November 2025 in “ Clinical Endocrinology ”
    Telma Martins Viveiros, Neha Deshpande, Irene Karderinis … Bassel Wattar
    Studysummary This analysis reports no significant differences between spironolactone and metformin for managing PCOS, noting spironolactone remains a potential off-label option for patients unable to use hormonal contraceptives, but larger studies are necessary to confirm its efficacy.
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    Research cited in this study 9

    1. Efficacy and Safety of Anti-Androgens in the Management of Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomised Controlled Trials EClinicalMedicine · 2023
    2. Effects of Low-Dose Spironolactone Combined with Metformin or Either Drug Alone on Insulin Resistance in Patients with Polycystic Ovary Syndrome: A Pilot Study International Journal of Endocrinology · 2022
    3. The Mechanism of Androgen Actions in PCOS Etiology Medical Sciences · 2019
    4. Treatment Options for Hirsutism: A Systematic Review and Network Meta-Analysis The Journal of Clinical Endocrinology & Metabolism · 2018
    5. Comprehensive Overview of Polycystic Ovary Syndrome Nature Reviews Disease Primers · 2016
    6. Comparison of Spironolactone and Spironolactone Plus Metformin in the Treatment of Polycystic Ovary Syndrome Gynecological Endocrinology · 2015
    7. Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline The Journal of Clinical Endocrinology and Metabolism · 2013
    8. Improved Efficacy of Low-Dose Spironolactone and Metformin Combination Than Either Drug Alone in the Management of Women With Polycystic Ovary Syndrome: A Six-Month, Open-Label Randomized Study The Journal of Clinical Endocrinology and Metabolism · 2013
    9. Comparison of Spironolactone, Flutamide, and Finasteride Efficacy in the Treatment of Hirsutism: A Randomized, Double-Blind, Placebo-Controlled Trial The Journal of Clinical Endocrinology and Metabolism · 2000