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What is spironolactone?

Medication that temporarily reduces production of testosterone.

It's also known as Aldactone or Spirotone.

What does spironolactone do?

  • Facial hair

    Prevents additional growth and may reduce and thin

  • Body hair

    Prevents additional growth and may reduce and thin

  • Muscles

    Weakens and makes smaller

  • Head hair

    Prevents some forms of hair loss

  • Fertility

    Causes temporary or permanent infertility

  • Lower body

    Causes genital shrinkage, reduces erections

  • Face

    Softens skin, reduces acne

  • Libido


  • Fragrance

    Prevents change of body odour due to puberty

Occasionally, people experience these effects:

Who can have spironolactone?

  • Children with moderate to severe kidney disease must not have this

  • This is not normally available on the NHS

How long does spironolactone 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.

What should I be aware of?


There are a number of health risks associated with hormone therapies. It’s important to get regular blood tests, both to spot problems before they arise and to make sure your dosage is correct.


Spironolactone can cause renal failure (kidney damage), permanent liver damage, and hyperkalemia 1, p.236. 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, p.170. 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.

What else might I want?

Spironolactone may cause erectile dysfunction. If this is not desired, it can be treated with sildenafil, tadalafil or vardenafil.


  1. 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. Link
  2. 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. Link
  3. 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. Link

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