Spironolactone Therapy for Hirsutism in a Hyperandrogenic Woman

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Spironolactone is generally used in clinical situations that take advantage of its action as an aldosterone antagonist. It has a number of side effects such as gynecomastia, decreased libido, and impotence, which suggest that it also interferes with androgen action (1). Explanations for the antiandrogenic action of this drug include decreased testosterone formation (2), increased peripheral conversion of testosterone to estradiol (3), and competitive inhibition of the binding of dihydrotestosterone to its receptor (4).

Regardless of the mechanism, spironolactone-induced antiandrogenic activity could theoretically benefit the patient with polycystic ovarian disease or ovarian hyperthecosis. These disorders are marked by elevated levels

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