Assessing the efficacy of spironolactone on adult acne in subjects with polycystic ovary syndrome

Abstract

Aim: The present prospective clinical study was conducted to assess the long‑term spironolactone therapy and its effect with and without dietary‑induced weight‑loss, on insulin levels, lipid profile, and clinical features in females with PCOS (polycystic ovary syndrome). Methods: The present study included 22 females 12 normal weight and 10 obese within the age of 17-32 years having symptoms of PCOS including hyperandrogenism with clinical or biochemical evidence with amenorrhea and/or oligomenorrhea. These subjects were assessed before spironolactone therapy and after 100mg/day spironolactone orally for 12 months. Lifestyle modification was advised for obese females. Before starting and following antiandrogen therapy, metabolic, endocrine, and clinical parameters were assessed. Results: Spironolactone orally resulted in a significant reduction of triglycerides in overweight females and an increase in HDL (high-density lipoproteins) in subjects who were lean and have normal weight. After 12 months of oral spironolactone therapy, the area under the curve of insulin, insulin resistance with hemostasis model, and levels of insulin during OGTT at 60 minutes were significantly reduced in obese females. In females with PCOS following therapy, no negative change in insulin sensitivity and secretion and weight loss was seen after pharmacologic treatment.