Progesterone cream and spironolactone

by Caroline
(UK )

Hi Wray

I would really appreciate some advice.
I have been taking a low dose of spironolactone for acne for the past year. I have had problems since coming off the Contaceptive pill about 9 years ago I'm 29 now.
I have been using the natpro for about four months, three months continuously. I'm still taking the spironolactone. I have cycled the cream for the last month but the spironolactone has made my periods very light and brown?! I sometimes get two periods per month.
I've done quite a lot of research which suggests it reduces estradiol at the beginning of the cycle by reducing testosterone which would convert to oestrogen, therefore retarding ovulation.(correct me if I'm wrong) It also increases circulating estriol. I want to stop the spiro but it has helped a lot with what I now realise are oestrogen dominance symptoms. Please could you advise me on the best way to wean myself of spiro. I was wondering whether to completely stop when I get my period and take it with the cream at the end of the month and gradually decrease my dose. I'm not even sure when the last time I ovulated was, I'm a bit concerned about this as I may want to have children in the future. I have not produced the mucus at ovulation for some years which seems to be the best indication of ovulation. I'm concerned that the pill has permanently damaged my fertility. I'm very thin and find it hard to put on weight. Before I took spiro my periods were mostly regular 31 days, but I had acne, dry eyes and anxiety and do not think I was ovulating regularly.

I'm also in the uk. The NHS haven't been very helpful and I can't afford to go private

I would appreciate any advice.
Thank you

Comments for Progesterone cream and spironolactone

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Nov 03, 2011
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by: CamperKat

I recently came off Spiro, and it was a nightmare because I quit cold-turkey. Please search this website for my name and all the postings I have made regarding this.

I have since learned that the best way to quit Spiro is to go slowly--over an almost 7 month period. Yes, this is a long time--but you are talking about a steroid hormone and you MUST go slow in order to give your body a chance to start generating it's own stuff.

I was on a 200mg per day dose, and this is what I SHOULD have done:

Reduce the dose for month 1 by 25mg per day, meaning I should have taken only 175mg per day.

During month 2, reduce by 50mg per day, meaning take 150mg per day.

During month 3, reduce by 75mg per day, meaning take 125mg per day.

During month 4, reduce by 100mg per day, meaning take 100mg per day.

During month 5, reduce by 125mg per day, meaning take 75mg per day.

Now you start speeding things up: during month 6, for the first week, reduce by 150mg per day, meaning take 50mg per day. For the second week, take 25mg per day. For the third week, take 25mg every second day. For the 4th week, take 25mg every third day.

During month 7: for the first week, take 25mg every 4th day. For the second week, take 25mg every 5th day. For the third week, take 25mg seven days after your last dose. Now you are done.

By taking this very slow and careful route--which may well mean that you have to request your MD to prescribe Spiro in lower dosage pills of 25mg each so you don't have to buy a pill cutter and cut your 100mg pill into 4 pieces--you will have avoided what I went through, which is significant joint pain and discomfort, and from which I still suffer. I have had almost 11 months of 24/7 daily pain in the level 6-9 category.

Wray can best advise you about what dose of Natpro you should take in conjunction with lowering your Spiro dose.

Good luck to you.

Nov 04, 2011
Progesterone cream and spironolactone
by: Wray

Hi Caroline We do have a page on Acne you might like to look through. Excess free testosterone is to blame, but this only rises if SHBG (sex hormone binding globulin) is low. Fructose, sucrose and glucose reduce SHBG by 80, 50 and 40% respectively, see here. It's essential to avoid all sugars, even the hidden ones in grains, fruit and veggies. I can't find anything good about spiro, but then I wasn't really looking for it! I have these few papers here, here, and here. I've not done much research on it, but if it does retard ovulation, this would explain why you have not produced mucus, well certainly in the past year. And of course all Contraceptives have the potential to cause harm and upset the cycle. Particularly once off it. Has anyone checked for PCOS? This might account for the acne and the problem with your cycle. Dry eyes is a symptom of high oestrogen, see here. I'm running out of space so will start a new comment below. Take care Wray

Nov 04, 2011
Progesterone cream and spironolactone
by: Wray

Hi Caroline It's always best to slowly reduce any drug, although if there are any dangers attached to taking it, I would be tempted to go cold turkey. Vitamin D is vital for normal ovarian function and ovulation, please have a test done. You live in the UK where levels of sunshine are low, vitamin D levels are too. For info on testing see the Birmingham Hospital and Vitamin D Links websites. BH now send out test kits for £20. Here are two more excellent sites, see Vitamin D Council, GrassrootsHealth. Blood levels should be 70-100ng/ml and not the 30ng/ml labs and doctors regard as adequate. And the minimum daily dose should be 5000iu's per day, although the latest research indicates it should be 10,000iu's per day, see here. It's only now that I thought I recognised your query and name, so I seem to have repeated everything I said to you in my previous reply! Or maybe you didn't see it? I'll give the link here. Take care Wray

Oct 27, 2016
by: Anonymous

Caroline, just an FYI many of these studies that found spironolactone to be carcinogenic determined that it was dose-dependent. They used doses 10-100x the normal dose. For acne your dose should be 25-50mg. These studies were using doses 10-100x the dose that is used for hypertension - which is in the 200mg range. So we are talking about dosages of 2000mg-20,000mg. Nothing even remotely close to the dosage you are taking.

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