Can a Male Use Spironolactone?

Question

I asked this qn before here. Besides low dose accutane, a dermatologist on realself recommends spironolactone to reduce hormone levels and thus controls sebum. I am male, can I take it?

Melissa Chiang, MD, FAAD · Answer

Spironolactone is only for women.  It makes skin less receptive to androgens, and it will feminize a man.  This is why pregnant woman should not take spironolactone (it will feminize a male fetus).

Otto Joseph Placik, MD · Answer

Spironolactone is a diuretic (water pill) that was noted to have anti-androgenic effects. Other uses are for acne or facial hair as can be seen in PCO disease particularly in females where the anti-testosterone effects were desireable. In men these side effects are undesireable as outlinded by Dr. Lupo.

Jeff Donovan, MD, PhD · Answer

Spironolactone
is not used in men, other than for short periods of time in individuals with
heart failure, and other related issues.

It is
mainly used for women. There are no FDA approved uses formally – but it is
often used by clinicians around the world for 3 primary 'off use' uses: 1) treatment of
acne in women 2) treatment of female pattern hair loss (genetic hair loss in
women) and 3) treatment of hirsuitism in women.

The drug
blocks the ability of the body to produce testosterone and also blocks the
hormone’s receptors in the body. It causes low testosterone in men and
hypogonadism. In men, side effects may include loss of male body hair,
increased breast development (gynecomastia), impotence and loss of spontaneous
erections. All in all, the drug belongs to a group of drugs that can cause ‘feminiziation’
in men.

Spironolactone
is not advised for men with hair loss or acne.

Mary P. Lupo, MD · Answer

Spironolactone blocks the action of androgens at the receptor sites in tissue. While it does reduce sebum production, it is not used in men because of the feminizing physical side effects, not to mention the loss of libido and sexual preformance. It takes higher dosages to get the benefit against acne and then you would have the side effects too. It is not worth it!

Emily Altman, MD · Answer

Spironolactone works in acne by blocking androgens, or male hormones.  That may have a fairly significant effect on sexual function in a man.  I do not recommend it.

Can a Male Use Spironolactone?

Answers (5)

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