Should Spironolactone for Acne Be Stopped Before Pregnancy? If So, How Long Does It Need to Be Discontinued Before Conceiving?

Spironolactone is pregnancy category C.  It should not be used during pregnancy.  I recommend stopping it as soon as you decide that you are trying to conceive.

Absolutely stop Spironolactone before conceiving as it can cause feminization of a male fetus and may also lead to miscarriages.  It is unclear how long you need to be off the medication.  Please discuss this with your Ob/Gyn.  

There are no double-blind controlled studies that have been conducted on this specific topic. Based on the metabolism of the medication, I would recommend a 6 week wash out of the drug, just to be absolutely certain.