Spironolactone For Hair Loss: Benefits, Dosage, and Risks

    Kristin Hall, FNP
    Medically reviewed by Kristin Hall, FNP Written by Our Editorial Team Last updated 5/20/2021

    Female pattern hair loss — or female androgenic alopecia — is the most common cause of hair loss in women. 

    As women, our hair can be a big part of our identity and femininity, which is why losing it can be devastating.

    If this is happening to you, don’t freak out. The good news is that female pattern hair loss can be treated with medications — one of them being spironolactone. 

    In this article, we’ll explore what spironolactone is, how it works, and who can take spironolactone as well as side effects of the medication.

    What Is Spironolactone?

    Spironolactone is a type of medication known as an aldosterone receptor agonist. That’s basically a fancy way of saying it suppresses the actions of aldosterone in the body. 

    It has an antiandrogenic effect because it binds to steroid receptors.

    The FDA has approved spironolactone to treat fluid retention caused by liver disease and kidney disease. 

    It can also be used to treat high blood pressure, heart failure and hyperaldosteronism.

    However, spironolactone is used to treat another condition, which is why you probably clicked the title of this article. 

    Healthcare providers have begun to prescribe spironolactone to treat female pattern hair loss, or female androgenic alopecia. 

    In fact, some research indicates that spironolactone is the most commonly used off-label anti-androgen for the treatment of female pattern hair loss.

    How Does Spironolactone Treat Hair Loss?

    As we already covered, spironolactone is a medication that has antiandrogenic effects. Spironolactone both decreases testosterone levels in the blood and lessens its effect in the body. 

    After you take spironolactone, the drug is rapidly absorbed and metabolized by the liver and turns into canrenone and potassium canrenoate, which is the active antagonist of aldosterone. 

    It also decreases testosterone production in the adrenal gland.

    Although there isn’t a ton of high-quality research on the use of spironolactone for female pattern hair loss, several studies have demonstrated promising results.

    In a case study of four patients, a 200mg daily dose of spironolactone reduced hair loss by up to 62.9 percent and also increased the total number of anagen hairs.

    Another study documented the combined benefits of 200mg spironolactone and minoxidil 5% twice daily. 

    This study suggested that the addition of spironolactone to topical minoxidil therapy is a solid option for women who have reached a plateau in treatment efficacy with topical therapy alone.

    Spironolactone Dosage

    The standard dosage of spironolactone for female pattern hair loss is 100mg to 200mg daily. This dosage should be continuously measured and adjusted, starting at 50mg daily (in divided doses of 25mg twice daily). 

    Research indicates that lower dosages (50mg to 75mg daily) may stabilize hair loss, but higher doses are likely to be more beneficial in the long run.

    Taking spironolactone in conjunction with birth control pills may also be beneficial. Birth control helps with irregularities in your period while also improving acne and female pattern hair loss. Win-win-win.

    Who Can Use Spironolactone?

    Spironolactone pills can help many women—especially whose hair loss starts before menopause.

    Spironolactone may be most effective for women who are experiencing female pattern hair loss as a result of excessive androgen production. 

    In fact, the medication may be most effective in women who suffer from polycystic ovarian syndrome (PCOS). 

    The medication is not without risk, however, especially for pregnant or breastfeeding women. 

    The FDA has currently rated spironolactone as pregnancy category D, which means the drug is considered harmful to the fetus. 

    Spironolactone should only be used during pregnancy or breastfeeding when the benefit to the mother outweighs fetal risk.

    Side Effects of Spironolactone

    Side effects of spironolactone depend on the dosage you take. Aldosterone has several effects on the renal system, including hypotension, hyperkalemia (high potassium levels), fatigue, headache, weight loss, increased urinary frequency and dry skin. 

    The antiandrogenic effects of spironolactone can also predispose you to menstrual irregularities and breast tenderness. 

    Spironolactone For Hair Loss

    TL;DR and you found yourself scrolling to the bottom of this article, here’s what you need to know. 

    Female pattern hair loss can be devastating and anxiety-inducing, but there are treatments that can help. 

    Spironolactone is an off-label medication used for hair loss treatment—especially FPHL caused by excess androgen production.

    If you’re experiencing female pattern hair loss and you’d like to do something about it, spironolactone could be a promising option for you. 

    Start a conversation with your healthcare provider to see if this is the best treatment option for you.

    If you’d like to read more about spironolactone, check out our complete guide to spironolactone side effects and spironolactone dosage guide.  

    This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.