How Effective is Spironolactone for Female Hair Loss?

Spironolactone has worked very well for my patients with androgenetic alopecia with Ludwig pattern where there is preservation of hairline along anterior scalp but with significant thinning on the crown. I typically start spironolactone 25mg 2x/day though sometimes dose may have to be increased to 100mg 2x/day. Finasteride is also a good alternative but should be prescribed by board-certified dermatologist. Concurrent use of Rogaine 5% foam also is quite helpful. For women and men who seek relatively quicker and consistent clinical results, NeoGraft hair restoration should be considered where there is no linear scarring, sutures with less downtime compared to traditional hair transplant.

Hello,There are multiple solutions to hair loss for women that are nonsurgical including:
Rogaine- There is a specific formulation for women
Supplements- This includes but not limited to Viviscal and Nutrafol which contain marine extract and anti-inflammatory substances to promote hair growth
PRP- Platelet rich plasma can promote hair growth and is a nonsurgical procedure in the office
Low level laser- Can promote hair growth in some patients
Regenerative medicine- There are additional growth factors which can be injected to promote hair growth
Seek advice from an expert or team of experts. 
Best,
Dr. Anil Shah

Medications for hair loss is generally a life time commitment.  This goes for Propecia, Rogaine, and Spironolactone.  I do not recall ever meeting a patient where Spironolactone really helped for them to say: "it was worth it". It is always a good idea to discuss treatment options with your doctor to weigh out the pros and cons.

Spironolactone for female hair loss is an option, but not one of the first options that I present to most of my patients for several reasons. First, the evidence that patients get significant improvement in hair loss or hair density from spironolactone is limited. Secondly, this requires an oral pill to be taken indefinitely, or the results will be lost, and there are side effects of spironolactone and potential medication interactions. Finally, there are several other options that I usually recommend for women instead of spironolactone, including topical minoxidil, PRP injections, hair transplant, and other topical therapies.
All the best,

I have actually had decent results using Spironolactone starting at 50mg per day and increasing up to 100mg twice a day.  As far as Minoxidil, I have never been a big fan.  Despite being over the counter, Minoxidil should be used with caution as it can make some scalp conditions worse while doing very little for the hair.