What PCOS.PMOS treatment options improve my hormones?

Question

Hello doctor,

I have PCOS/PMOS, whose symptoms are extremely effectively managed by both my oral contraceptive (Sprintec) and miracle drug Spironolactone, which I take 100 mg a day. It has greatly lessened my period pain, cleared my skin and hirsutism, and kept my ovaries safe for around four years now.

Now I have perfect skin and extremely regular periods, for which I am very grateful. After my period ended last week, within the past few days, all of my symptoms have suddenly returned, as if I never took the Spironolactone at all.

I am afraid that either the medication randomly stopped working, or there is a deeper hormonal issue present that is overpowering its effects. I am also worried about the reproductive consequences of not taking care of this properly.

My questions are:

Have you ever heard of Spironolactone suddenly not working out of nowhere?
What medications can I take instead of Spironolactone that can also target my PCOS/PMOS and extreme hormonal cystic acne?
If there seems to be another hormonal issue present, what blood work would you order?

Kindly suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I have gone through your query. Yes, sometimes, the Spironolactone dose is insufficient to suppress the androgens. So, the maximum you may take is up to 100 mg twice a day. Even if symptoms have not improved, you have to take Finasteride, like anti-androgens, under your doctor's advice to decrease inflammatory acne and hirsutism.

Also, check the weight for increased or not. Alongside the below suggested investigations:

Serum testosterone.
Serum creatinine and electrolytes.
Ultrasound abdomen.
Blood sugar levels.

Please do not take spironolactone if you are pregnant or have high serum potassium.

Follow up with reports or consult with your gynecologist. They will examine and treat you accordingly.

I hope this helps you.

Thank you.