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PCOS and Spironolactone

by Stephanie
(Utah)

Hello Wray,

I hope my message finds you well. I am 24 years old and have been diagnosed with PCOS. I have elevated testosterone levels, irregular cycles (period every other week), and experience cystic acne. Knowing that low progesterone levels go hand in hand with PCOS, supplementing progesterone seemed like the ideal solution. Last month was my first cycle using Natpro (200 mg). Near the end of my cycle, around day 23, I experienced the worst acne outbreak I have had in years. I have been successfully treating my acne with Spironolactone (100 mg) for nearly five years. How do you suggest combating oily skin and acne while using Natpro? Should I increase my dose? I am puzzled, because I have read that natural progesterone is supposed to bind to testosterone and reduce acne. Would decreasing my Spironolactone dose help? I am so confused and feel like giving up. Any advice will be greatly appreciated.

Thank you.

Comments for PCOS and Spironolactone

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Sep 29, 2015
 PCOS and Spironolactone
by: Joy

Hi Stephanie

I take it that you have read the PCOS page as well as How to use Progesterone Cream and Estrogen Dominance. It is recommended that Natpro be used for 2-6 months, possibly longer, before following your cycle. Once you feel stable enough and your symptoms improve then that is the time to follow your cycle. Also bear in mind that progesterone therpay is not an overnight fix, it takes time and patience. Your Acne breakout is not uncommon when first using progesterone, it happens to those who do not even suffer from PCOS. Also excess free testosterone is often to blame. Please cut out all sugars, even those hidden in grains, fruit and vegetables. I feel you should stay on the 200mg per day and see how you get on with that, but what is your Vitamin D3 level, if deficient it reduces the benifits of progesterone. It will also help with acne.

What does concern me is the Spironolactone that you are taking, it carries a cancer risk - see here. Please consider taking the nutrients listed on the PCOS page rather.

Hope this helps.
Sep 30, 2015
 Thank you
by: Stephanie

Hi Joy,

Thank you for your suggestions. I already follow a low carbohydrate diet to avoid insulin spikes and reduce the other lovely PCOS symptoms. Yes, I have read the pages on PCOS, Estrogen Dominance, and many others on this site. Do you know how long the initial acne outbreak lasts? I know it may sound vain to worry so much about my skin, but the acne takes a huge toll on my self esteem.

About the Spironolactone: would you recommend tapering off of it, or quitting cold turkey? I am wary to continue using progesterone without it, in fear that the acne will get even worse.

If any of you have gone off of Spironolactone and continued using Natpro, would you mind please sharing your experiences?

Thank you.

-Stephanie
Sep 30, 2015
 Vitamin D
by: Anonymous

I forgot to mention in my previous comment that I take 5,000 IU vitamin D every morning.

Thanks!
Oct 01, 2015
 PCOS and Spironolactone
by: Wray

Hi Stephanie I can't add anything further to the info Joy has given you, except to do a search using the word spironolactone. There are five pages on the subject and hopefully you will find your answer there. Take care Wray
Oct 01, 2015
 Vitamin D
by: Joy

Hi Stephanie

That is excellent, but what is your D3 level? This is most important because if it is still low, you may need to take 10 000iu's per day for a while to get your level up.

:)
Mar 12, 2018
 Remove spiro
by: Anonymous

Did you get off the spiro? What happened?
Mar 14, 2018
 Still on it...
by: Stephanie

Hello,

I noticed your reply to my question from years ago. Unfortunately, I am still on the spironolactone. While progesterone worked great to regulate my cycles, I couldn't stand the constant oily skin and acne. Not to mention, I felt tired, bloated, and nauseous all the time. Although my side-effects may have gone away over time as estrogen dominance subsided, I got tired of feeling crummy all the time and went off of the cream.

I know it's not the healthiest or most holistic solution, but I am taking a low estrogen birth control pill as well as 100 mg spironolactone. I am a firm believer in natural and holistic treatments and hope to consult a naturopath in the future about holistically treating my condition, but for now, this is what is working or me.

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