What effects does it have?
What is it?
Medication that temporarily reduces production of testosterone.
It's also known as Aldactone or Spirotone.
How long does it last?
Spironolactone is taken as daily pills and the effects stop if the medication is discontinued. Prolonged use may have some effects that are permanent and cannot be reversed.
Spironolactone can cause renal failure (kidney damage), permanent liver damage, and hyperkalemia 1. It should be taken under medical supervision with regular blood testing.
Prolonged anti-androgen treatment can cause infertility, erectile dysfunction and genital shrinkage.
Taking anti-androgens without also taking another sex hormone (e.g. oestrogen and/or testosterone can cause osteoporosis.
Spironolactone is a type of drug called an anti-androgen. These drugs reduce testosterone levels.
Spironolactone is a commonly used antiandrogen in the US. In the UK, endocrinologists usually prescribe GnRH agonists instead, as while spironolactone is much cheaper to obtain, it can often have serious side effects 2. GnRH agonists are considered to have a very good side-effect profile 1.
A study has suggested that taking spironolactone with oestrogen may reduce the breast development caused by oestrogen 3, though this has not been confirmed by other researchers.
Spironolactone may cause erectile dysfunction. If this is not desired, it can be treated with sildenafil, tadalafil or vardenafil.
- 1 Seal, Leighton J (2017) “Hormone Treatment for Transgender Adults,” in Bouman, W. P. and Arcelus, J. (eds.), The Transgender Handbook: A Guide for Transgender People, Their Families and Professionals, Nova Science Publishers Inc, pp. 227–249.
- 2 Seal, Leighton J (2007) “The practical management of hormonal treatment in adults with gender dysphoria,” in Barrett, J. (ed.), Transsexual and other disorders of gender identity: A practical guide to management, Radcliffe Publishing, pp. 157–190.
- 3 Seal, LJ, Franklin, S, Richards, C, Shishkareva, A, et al. (2012) “Predictive markers for mammoplasty and a comparison of side effect profiles in transwomen taking various hormonal regimens.” The Journal of Clinical Endocrinology & Metabolism, 97(12), pp. 4422–4428.
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Page last updated: September 2017