SAT379 Potassium Levels in Women with PCOS Using Spironolactone for Long-term

Abstract

Abstract Disclosure: T.A. Oliveira: None. L.B. Marchesan: None. P.M. Spritzer: None. Introduction. Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. Spironolactone (SPL) has been used off-label to manage hyperandrogenic manifestations in women with PCOS but the incidence of hyperkalemia in these population is scarce. Materials and Methods. In this retrospective study, we assessed data collected from electronic medical records of women with PCOS that received spironolactone, in addition to other drugs, to manage hyperandrogenic manifestations. Women with PCOS, defined by the Rotterdam criteria, without heart or kidney disease, who were treated with SPL for a minimum of 12 months and had records of serial potassium concentrations, were included for the analyses. Mild hyperkalemia was defined as potassium concentration between 5.1 to 5.5mEq/L, moderate 5.6 to 6,0mEq/L or severe ≥ 6,0mEq/L. Results. Data from 78 women with PCOS with potassium dosages totaling 98 measurements, were analyzed. Mean age was 29.1 ± 9.6 years, BMI 32.2 ± 8.1 kg/m², 9 had Diabetes (9.2%) and 22 (22.4%) pre-diabetes. SPL was used in association with combined oral contraceptives (COCP) in 55 participants (56.1%), progestin only pill (POP) in 21 (21.4%), metformin (MTF) in 35 (35.7%) and ACEi/angiotensin receptor blockers (ARBs) in 15 (15.3%). The median SPL dose was 100mg (50 to 150mg). Ten(12,8%) women had hyperkalemia, 4 of them more than once during follow-up, all classified as mild. The most common minor adverse effects included menstrual irregular bleeding in 8 (8.2%) in 5 using POP irregularly and 3 using COCP, followed by dizziness in 6 (6.1%) and postural hypotension in 3 (3.1%). Only in two cases (2.1%) SPL was discontinued due to poor tolerance, one due to breast pain and the other due to cramps. Conclusion: The present study suggests that women with PCOS, without kidney or heart diseasee, using SPL associated with hormone contraception for managing clinical hyperandrogenism, have a low incidence of hyperkalemia, no life-threatening episodes, well-tolerated minor adverse effects and a low rate of drug discontinuation. Sources of research support: INCT/CNPq and FAPERGS. Presentation Date: Saturday, June 17, 2023