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Q. My PCOS symptoms recurred even with Spironolactone. Why?

Answered by
Dr. Penchala Prasad Kandikattu
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 03, 2020

Hello doctor,

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

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 and extreme hormonal cystic acne? If there seems to be another hormonal issue present, what blood work would you order?

Dr. Penchala Prasad Kandikattu

General Medicine Internal Medicine


Welcome to

I have gone through your query. Yes, sometimes, the dose of Spironolactone is not sufficient to suppress the androgens. So maximum you may take up to 100 mg twice a day. Even though if symptoms not improved you have to take Finasteride like anti-androgens under your doctor advice to decrease inflammatory acne and hirsutism. Also, check weight for increased or not.

Investigations to be done:

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

Preventive measures:

If you are pregnant please do not take Spironolactone. If your serum potassium is higher do not take Spironolactone.

Regarding follow up:

Review with reports or consult with your gynecologist she will examine and treat you accordingly.

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