Irregular periods from Spironolactone

Irregular menstrual cycles from Spironolactone: What are the options?

Irregular periods are common with spironolactone. In fact, nearly 80 % of women will experience irregular periods.

Some women with irregular periods on spironolactone do not require adjustments in their spironolactone dose. If periods are reduced, but occurring every 2-3 months, there is sufficient shedding of the uterine lining to reduce the risk of endometrial cancer. If women using spironolactone are not getting periods, this is a concern and doses need to be adjusted and consultation with a gynaecologist may be advised.

There are several options to help regulate periods while on spironolactone. 

**** All women must keep in mind the importance of not becoming pregnant while on spironolactone*****

1. Use 21 days of the month

The medication can be used for 21 days of the month rather than every day. The 7 days off the medication should overlap with the same 7 days as the period falls. This would be the same 7 days as one would normally take the placebo (sugar) pills if using an oral contraceptive.

Day 1 is considered the day the period starts. Strictly speaking, individuals using this method would not use spironolactone during the first 7 days of their period (days 1 to 7). Spironolactone would be used as prescribed from days 8-28.

2. Reduce the dose below 100 mg

Irregular periods from spironolactone tend to be dose dependent. So the use of higher doses give a higher chance of irregular periods. Doses 50-75 mg are the least likely but may be slightly less effective for treating androgenetic alopecia. 

3. Add a birth control pill

Using a birth control regulates cycles in the vast majority of women.