Can spironolactone work for AGA (genetic)? I’m a 24 year old female and AGA runs in my family.

This needs an in-person evaluation. I suggest seeing a hair loss expert now to evaluate and go over your condition and provide you information about your best treatment options. There are great non-invasive options like prp/progesterone and/or hair transplantation. See an expert. Best, Dr. Emer

In my opinion, it is not possible to predict which medication, spironolactone or finasteride will work better for female pattern hair loss. In most cases, spironolactone is superior. However, finasteride can work better in certain individuals. Spironolactone is more effective for Androgen side effects, however this does not always indicate the response in the scalp. Discuss the side effects of these medications with your hair loss expert and see which is more appropriate.Good luck.

You should be evaluated by a board certified dermatologist who specializes in hair loss.  You didn't mention an evaluation.   A thorough history and comprehensive blood work, and sometimes a biopsy of the scalp is necessary to arrive at a diagnosis of AGA.  Only after all this is done can treatment be considered.  Just because there is a family history doesn't mean that this is the etiology in your instance.  You could have a thyroid disorder, anemia, or other cause for thinning.  There are multiple drugs that can treat AGA.  Sometimes a dose has to be increased; sometimes drugs get switched. 

Female hair loss is a complicated diagnosis that requires a careful history and many blood tests to rule out the various causes of hair loss.  See your doctor and get this work-up