Spironolactone Started for Acne, Continued Use for PCOS - Chicago, IL

I had acne issues from age 11 till my mid 20s, when I started seeing a dermatologist. My acne cleared up well, and as I was on the pill, my face stayed pretty clear till I hit my early 30s and had to go off the pill due to high blood pressure. I started using Proactiv, which took care of my acne very nicely. Then around age 36 I started having difficult monthly periods and pain, and my skin started breaking out despite using Proactiv. I finally had enough and went to see a dermatologist again. The doctor took one look at me and prescribed spironolactone (for long term use) and doxycycline (to clear the current outbreak). Because I was taking lisa optic, a blood pressure medication that is potassium sparing, I had to have blood draws every 3 months to test my potassium levels, as spironolactone is also potassium sparing. Too much potassium can cause heart problems, starting with palpitations, so I make sure to drink plenty of water daily.
I was initially taking 50mg/day of spironolactone, and the diuretic effect was apparent. My doctor told me to take it in the morning rather than night, so I won't wake up to use the bathroom at night. After several months of tests, my potassium levels stayed in the normal range, so I went up to 100mg/day. Because I was taking doxycycline to clear up the breakout I had, I can't say when the spironolactone kicked in, however after 3 months of doxy, I went off and my skin stayed clear. Because I was having weird period issues, I cannot say whether or not it was affected by the spironolactone at that point.
A couple years later, after seeing several more doctors about my period issues, I was diagnosed with Polycystic Ovarian Syndrome (PCOS), and went back on the pill due to the hormone imbalance caused by this. Spironolactone is another drug commonly prescribed for PCOS, as it's an androgen blocker, and helps the hormones get to a better balance. I have been on spironolactone for just under 9 years now and have only had one potassium test come out high, but it was normal after a retest. My body acclimated to the diuretic effect long ago, and while I have a "tiny tank", I don't have to use the bathroom as often as when I started on it. I've been on Lo-Estrin and Minastrin since 2009, and my periods are very light to non-existent. With my current skin care regimen, I will get maybe 1 pimple every 4-5 months, and it usually resolves quickly. I have been very happy with my experience using spironolactone, and my clear complexion shows it! My sister recently started taking it (she is 8 years younger than me), but is the same age I was when I started. She is still getting used to the diuretic effect, and has had some breakthrough bleeding, but she too has always had irregular or "iffy" periods like me. Her dermatologist did not give her doxycycline, but her skin is clearing up nicely after a couple months (she is also using RetinA and another topical). I believe she is also moving up to 100mg from 50mg, and is happy with her results so far.