Some women lose their hair because they have an overproduction of male hormones. When that happens, there is a drug that can help: Aldactone.
There are many reasons why women may experience female pattern hair loss, which is when the hair thins gradually over time and eventually leads to thin or bare patches on the top or front of the scalp. This type of hair loss, also referred to as androgenetic hair loss, tends to worsen after menopause, and is usually hereditary.
But some women lose their hair in this type of pattern due to higher-than-normal levels of androgens — hormones normally made in very small quantities by women and in larger quantities by men — or increased sensitivity to androgens such as testosterone, says Chad Prather, MD, clinical assistant professor in the department of dermatology at Louisiana State University Health Sciences Center in Baton Rouge, La. Women with polycystic ovary syndrome (PCOS), for example, tend to produce more androgens, which can cause hair growth on the face and hair loss on the head, as well as infertility and metabolic problems.
Aldactone (spironolactone) helps to restore the hormone balance and treat female pattern hair loss.
Aldactone as a Hair Loss Treatment
Aldactone isn’t approved specifically for hair loss treatment, so when doctors use it, it’s considered an “off-label” use. Aldactone is a potassium-sparing diuretic, which means it rids the body of excess fluid as do other diuretics (water pills), but it doesn’t make you lose potassium in the process as many diuretics do. It’s normally used to treat swelling, high blood pressure, and potassium deficiency.
But because Aldactone acts as an anti-androgen, it can help when women are experiencing hair loss due to higher levels of androgens. The drug causes the adrenal glands and ovaries to slow down their production of androgens, and also blocks the action of androgens that are produced. One way it does that is by stopping dihydrotesterone — the form of testosterone that causes the hair loss — from binding to its androgenetic receptor and affecting the hair follicle.
Aldactone won’t help you grow new hair, says Francesca J. Fusco, MD, assistant clinical professor of dermatology at Mount Sinai School of Medicine in New York. But it can help the thinning hairs become thicker and fuller.
Pros and Cons of Aldactone for Hair Loss
Like any drug, Aldactone has its pros and cons. Read on to find out why it may be a good idea to talk to your doctor before deciding to take Aldactone for hair loss:
Pros of Using Aldactone
- It’s easy to determine if it’s an appropriate treatment for you. If your dermatologist suspects that androgens are behind your hair loss, a simple blood test can confirm it and let your doctor know if you’re an ideal candidate for the treatment.
- It targets the problem. Because it helps stop the production of androgens and the action of androgens by preventing them from binding to their androgenetic receptors, Aldactone gets to the source of the problem. “It helps fight some of those hormones that are causing the hair loss in the first place,” Dr. Prather says. At the same time, it can help get rid of hair growth in unwanted areas, such as on the face, and helps clear up acne, he says.
- It’s affordable. Aldactone is a medication that’s usually covered by insurance, Prather says. Even without insurance coverage, it only costs about $20 to $30 a month.
- It can be taken with other medications. Some women take Aldactone while using over-the-counter minoxidil (Rogaine), a solution that’s applied to the scalp, for even better results.
Cons of Using Aldactone
- It can make you urinate more often. One side effect of taking a diuretic is that it may make you run to the restroom more often. It’s usually not a problem for women taking lower doses of Aldactone (up to 100 milligrams), Prather says. But if you’re taking a higher dose of up to 200 milligrams, you may have to urinate more frequently. Dr. Fusco tells her patients to make sure they’re home or can get to a bathroom for about 90 minutes after taking the medication.
- It may cause irregular menstrual cycles. Anything that interferes with your hormones may cause a change in your menstrual cycle, Prather says. Women often take oral contraceptives when they’re taking Aldactone to regulate their cycles and also to be sure they don’t get pregnant while taking the drug.
- It can raise potassium levels. It’s important to get your potassium levels checked by your doctor every few months while you’re taking Aldactone, Prather says. “This is one of those times when you want to see somebody who has expertise in this area, such as a dermatologic surgeon” who can monitor you while you’re taking the drug, Prather says. High levels of potassium can cause dangerous side effects, including heart rhythm abnormalities.
- It can lower blood pressure. Be aware that dizziness and lightheadedness might be signs that Aldactone is causing your blood pressure to go too low, especially if you tend to have low blood pressure to begin with, Fusco says.
- It can interact with other drugs. Aldactone may interact with other medications, such as blood pressure medications, so it’s important to let all of your doctors know when you’re taking it.
Don’t hesitate to call your doctor if you’re experiencing any side effects of Aldactone, Fusco says.
The good news: If you’re experiencing hair loss at a young age and you start this medication, you may be able to restore the hormone balance, see improvement in the thickness of your hair, and eventually stop needing the medication.
Last Updated: 2/8/2011