aldactone

So I’m sure many ladies have already run up against the issue of having difficulty in getting Aldactone (brand name for Spironolactone) prescribed to them. Not all doctors are aware that this drug is used to treat androgenetic alopecia, and most of the ones I have met refuse to prescribe it at all, or in a dosage sufficient to actually potentially be of any help.

After a recent visit to a local dermatologist I left feeling smaller than slug, completely deflated, misunderstood and humiliated. My current prescribing physician is not local, and I was hoping to find someone close to home that would provide me with the prescription I need to help keep my hair from falling out of my head.

A few months ago my fiance went to a local dermatologist, and while there he thought to ask if he prescribes Aldactone to female patients with hair loss.  The doctor stated a resounding “Yes,” and seemed to be fully aware of the potential benefits of it for hair loss and for hirsutism. So knowing this, I make a visit there in the hopes of leaving with a prescription for 200mg (100mg/ 2x day) of Aldactone, that is after all what I currently take. I even went to the appointment armed with my existing prescription bottle to prove that I am in fact currently taking this.

To make a long story short, the nurse and the doctor were completely shocked at the dosage, telling me “That is way too much!” and that they only prescribe 25mg, or tops 50mg. What? They then proceeded to ask me if I’ve ever had any blood work to determine what is causing my hair loss. Well gosh darn, why didn’t I ever think of that? I’ve only had every blood test known to man done a 100 times over. The doctor then continues to tell me that this is the culprit of my dry skin, when in reality I’ve had eczema and dry skin my entire life. I try and explain my situation, my 11 years of hair loss and that for 10 of those I’ve been taking Aldactone and that ceasing to take it now would cause a tremendous hair shedding, and at the thinness where it is now, that would leave me with basically no hair. I’m the first to admit that I don’t like taking this drug, I hate it, in fact I’ve written on numerous occasions that I feel like a prisoner to it. My saving grace is knowing that once I make the choice to wear a bonded lace hair system that I’ll ditch the meds and be done with it, but that time isn’t now.

The doctor then suggested we try 100mg. 100mg? I let the doctor know at that dosage my hair will shed. How do I know this? Last year I tried to wean myself off the Aldactone and guess what? My hair shed.. a lot. I guess I probably looked super pathetic and desperate in that doctor’s room since he decided to go ahead and have the nurse write me a prescription for it. The doctor leaves and a short while later the nurse who is in the room with me still, says “I don’t care what you say, you have to get off that, it’s not good for you” and she didn’t say it in a caring way, it was a stern rude way. Of course this is coming from the woman who is probably in her 50′s and has never lost a hair in her life. How easy to judge when you sit there with a full head of perfectly coifed hair. And my favorite part of the whole conversation comes next, she then says to me, “Well, what do you think is causing your hair loss?” Yes you read that right, that is exactly what she asked me in her cold harsh way. Well lets see, hummmm bad genetics? the Loestrin FE pill? A curse? You take your pick. I just told her it’s genetic, that’s it, nothing more to it. I can treat it, glue it, or let it fall out. Those are my options.

I could feel my face getting red, and my eyes feeling like the ocean was about to pour out of them. I couldn’t get out of there fast enough, once I got to my car I burst out into hysterical tears.

That day was just another reminder of how much suffering hair loss has caused me, it’s not bad enough that this is happening, but I have constantly been confronted with doctors that have no compassion or understanding and who fail to do one simple thing… LISTEN. On multiple occassions I have asked the various doctors I have seen to prescribe me the Aldactone and they all look at me like I was asking them for crack. Actually it probably would have elicited less of a reaction if I’d asked for crack. The doctors are usually aghast that I would be taking such a dosage, their reactions make me feel like I am taking arsenic.

Anyways this rant is something I had to get off my chest. I would love to get a list of doctors together that do prescribe Aldactone at the higher dosage levels of 100mg – 200mg / day. Does your doctor prescribe it? If so, please share the name and location of your doctor because I know I am not alone in my struggles to find a doctor that can support my hair loss treatment decisions without making me feel like a piece of garbage in the process.

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More About Spironolactone - Success StoryI got an email from Tracy regarding a post she found on another website about a woman writing about her success with Spironolactone, so I’m posting it here for all of you. Thanks Tracy for this great find!

Hey Y,

I read the new story on the front page on the website asking a question on the effectiveness of spiro. I came across this blog entry by someone on soulcysters.com which you might want to post:

I just want to post my SUCCESS STORY here regarding PCOS and hairloss. I know this is something that is so devastating to many of us PCOS women and seems to respond slowest to treatment, so here’s my story….

On December 4, 2003 I went to get highlights and my hairdresser told me I was “thinning” on top. I had no idea. My hair was always long and thick, my pride & joy. Now thinning? Huh??? Sure enough after examining it under bright lights, the crown showed signs of diffuse thinning… I was DEVASTATED. I had the good sense acknowledge that thinning hair on a woman is not NORMAL, and thus there must be an underlying medical condition with was causing the loss. I researched and researched until my fingers were raw, and everything kept coming back to me saying “PCOS unmasked by coming off the BCP” .

I went to many doctors and none could confirm my self-diagnosis. After 4 months, I had gone from “thinning” to downright “Balding”. My self-esteem hit rock bottom, and my weight ballooned by 30 lbs. I was devastated. I was having anxiety and depression which I have NEVER experienced before in my life, and it stemmed from my hairloss. Having great hair had always been my crutch if I was feeling too fat or too zitty, oh well, at least I had this really great hair, right???? Luckily my husband and mother intervened at this point, and to make a long story short, I got into an Endocrinologist who said PCOS right away and started me on aggressive treatment. That was March 29, 2004. [click to continue…]

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Questions About Spironolactone – Ame

by admin on April 15, 2008

Questions About Spironolactone - AmeSo I went to a new derm, who diagnosed me with telogen efluvium AND androgenetic alopecia, for which he is going to prescribe me Spiro (sorry can’t spell the full name) and Minoxidil, however I told him about my misfortune with taking Minoxidil previously and he said well then just take the Spiro, 50mg (IMO I need 200, because I have less than a fifth of my original hair left). I appreciate that there is already a lot of info in this site with regards to Spiro, but can anyone specifically answer me these questions please?

1. Providing that it helped at all, how long did it take before it started
to work?
2. How well did it work/is it working?
3. Were there any unpleasant side effects?

Thanks
Ame

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Hi Ame,

I do take 200mg Aldactone (brand name for Spironolactone) so I can speak from my own experience having been taking it for about 8 years now. I think the easiest of the three questions for me to answer is the last one. The only side effect I noticed from taking the drug was that I seemed to get a little light headed, especially when I would stand up from a chair. The doctor told me that could be related to perhaps not enough sodium in my diet. Since Spironolactone is also a diuretic you do loose extra electrolytes since you go to the bathroom more frequently. I found that eating a pickle or sucking on a ketchup packet would instantly make me feel better. Actually as I am typing this I do remember being tired a lot as well, but taking in that extra sodium seemed to always do the trick and bring me back to life again. I speak in the past tense because I no longer experience any of these side effects and haven’t for many years. [click to continue…]

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Hair Loss And Medication- Vicky's Hair Loss StoryI’ve just discovered your site and I must say that i,m glad that it exists. This is my dilemma, I’m a 39 year old woman who is experiencing hair loss/shedding and thinning for the last year and a half. I’ve always had long thick hair so this hair loss is a BIG adjusment for me and a lot of people have noticed the change in my hair which of course is adding to my stress and my depression. What I would like to know is this, I took aldactone for a little over 2 months and had some side effects, but only really stopped it because I had an infection elsewhere and I had to get onto medication that contained potassium. The infecton has now cleared up and I’m thinking of going on aldactone again as my shedding has increased again and also I’m also having my period and its seems I shed even more during my cycle than any other time (or at least i think i do). Is it worth going on aldactone again? Is the increased shedding due to the stopping of aldactone? I was also prescribed Diane 35 and Androcur- but have read up on them and the side effects scare me. I’m also trying chinese herbs and a regrow lotion for the last 4 months which has slowed my shedding but not stopped it. I would like to keep what I have left and not take medication that in in long run will do more harm than good. Do you know anything about soya products and hair?Thanks, awaiting your reply.

Dear Vicky -

Thanks for writing. I think a huge consideration is exactly what side effects you were having from the Aldactone and that should definitely be discussed with your physician. You were on Aldactone for such a short period of time that I don’t even know if that is long enough for it to have really have had enough effect to cause shedding from getting off it. Please remember I am not a doctor and cannot give medical advice, this is just my opinion, but it makes more sense to me that the shedding at the 2 month mark could have occurred from actually getting on the pill. Most medication used to treat hair loss all have the possibility of causing increased shedding in the beginning, it can get worse before it gets better type thing and it occurs around that time frame.

When it comes to taking any medication side effects can be pretty scary, but all meds have them. For myself I try to weigh out the possibility of one of the potential side effects to the degree of distress the ailment is causing me, in this case hair loss. Hair loss for me 8 years ago was probably the worst thing in the world, no one thinks they are going to lose their hair at 21. So I was very willing to try anything I could to save it, even knowing that some trouble could occur down the line. [click to continue…]

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Disorders of Hair: Androgenetic Alopecia

by admin on November 8, 2007

Disorders of Hair: Androgenetic AlopeciaI came across this article today while doing some hair loss research on the internet, and I thought it covered a lot of questions that women have about hair loss. The article is about both male and female pattern hair loss and provides a good overview. It was published on medscape from ACP Medicine Online. Here it is:

David A. Whiting, M.D.

Androgenetic alopecia is the common type of nonscarring hair loss affecting the crown. It results from a genetically determined end-organ sensitivity to androgens. It is often referred to as common baldness, male-pattern alopecia, and female-pattern alopecia.

Epidemiology and Pathogenesis

Androgenetic alopecia affects at least 50% of men by 50 years of age and 50% of women by 60 years of age.6,7 Males have more androgen than females and therefore are usually affected earlier and more severely. Male-pattern alopecia often starts between 15 and 25 years of age. Male-pattern alopecia has two characteristic components, bitemporal recession and vertex balding [see Figure 1 -- omitted], which in pronounced cases can progress to complete balding of the crown.6,7 Female-pattern alopecia is more likely to start between 25 and 30 years of age (or sometimes later, after menopause). It is characterized by an intact frontal hairline and an oval area of diffuse thinning over the crown [see Figure 2 -- omitted]. Bitemporal recession in women is much less obvious than it typically is in men, or it can be nonexistent. In general, androgenetic alopecia in women progresses to mild, moderate, or severe thinning but not to complete baldness. The best predictor of outcome is the degree of progression in affected relatives.

Androgenetic alopecia is an autosomal dominant disorder with variable penetrance. Susceptible hairs on the crown are predisposed to miniaturize under the influence of androgens, notably dihydrotestosterone. In both sexes, miniaturization results from a shortening of the anagen cycle, from years to months or weeks. Miniaturized hairs are characterized by reduced length and diameter; this accounts for the appearance of hair loss.8 Androgenetic alopecia largely spares the back and sides of the scalp.

Diagnosis

The diagnosis of androgenetic alopecia is usually obvious from the clinical pattern of hair loss from the top of the head.9 In some men, a female pattern of alopecia (see above) causes diagnostic confusion but has no other significance. In women, a male pattern of alopecia (i.e., bitemporal recession and vertex balding) occurring with menstrual irregularities, acne, hirsutism, and a deep voice is significant. The virilism indicates significant hyperandrogenism, the cause of which must be identified and treated [see 3:IV The Adrenal -- omitted].

Scalp biopsies are rarely necessary to diagnose androgenetic alopecia. Biopsies cut horizontally are sometimes useful, however, in differentiating female-pattern alopecia from chronic telogen effluvium (see below). [click to continue…]

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Treatment of Female Pattern Hair Loss With A Combination of Spironolactone and Minoxidil I want to thank Kate for emailing me this Case Report about the use of spironolactone and minoxidil in treating female pattern hair loss. The Case Report appeared in the Australasian Journal of Dermatology Volume 48 Issue 1 Page 43-45, February 2007

CASE REPORT

Treatment of female pattern hair loss with a combination of spironolactone and minoxidil

Carlijn Hoedemaker, Sylvia van Egmond and Rodney Sinclair

Department of Dermatology, St Vincent’s Hospital, University of Melbourne, and Department of Medicine and Skin and Cancer Foundation, Melbourne, Victoria, Australia

Summary

A 53-year-old woman with clinical evidence of female pattern hair loss and histological evidence of androgenetic alopecia was initially treated with the oral antiandrogen spironolactone 200 mg daily. Serial scalp photography documented hair regrowth at 12 months; however, the hair regrowth plateaued, and at 24 months there had been no further improvement in hair density. Twice daily therapy with topical minoxidil 5% solution was then introduced and further regrowth documented, confirming the additive effect of combination therapy.

Introduction

Female pattern hair loss is a common, psychologically distressing, age-related, androgen-mediated condition that presents with increased hair shedding and reduction in hair volume over the mid-frontal scalp.1

Binding of dihydrotestosterone to cellular androgen receptors induces susceptible scalp hairs to undergo a progressive and orderly transition from terminal to vellus hairs to produce patterned baldness. Antiandrogen therapy with either spironolactone or cyproterone acetate is commonly used to treat FPHL, as is topical minoxidil.2 The mechanism of action of minoxidil is unknown, but does not involve androgen pathways.3 The use of topical minoxidil together with an oral antiandrogen might have an additive effect; however, combination therapy has not been previously reported. [click to continue…]

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Hair Loss At The Age Of 20 - Veronica's Hair Loss StoryWow, I’m so happy I just found this site…I’m 20 years old, have had been genetic hair loss for four years now. About 2 years ago I had a biopsy done and my derm told me it was probably genetic, he put me on Rogaine, Spiro and Yasmin. I was on those meds for about a year… and they did absolutely nothing. Last year in the fall my hair loss was getting really bad and I was getting so desperate for something, so I spent over $1000 on getting Invisible Hair extensions. I was assured by so many people that they would be safe, and definitely the perfect solution. The extensions were great! I loved having so much hair and planned on having the extensions put back in. Well when I got them removed for the first time I was SO devastated, more than half of my already thin hair was gone.

Its been since January now since I’ve had them out and I feel like I’ve hit the bottom. I’m in college and can’t concentrate on anything. I’m always way too focused on everyone else’s hair and I feel like I’ll never feel normal again…I haven’t been able to wear my hair down since I got the extensions taken out. My poor hair is
still falling out like crazy… it’s so thin I can’t even wear it in a ponytail, I feel like I will be bald soon.

I’m so scared, nobody seems to understand. My best friend and my family just tells me to cope with it like its no big deal. I feel like I have no where to turn. That’s why I was so glad I found this forum…I really sometimes feel like I’m the only one experiencing this and it’s comforting to hear everyone’s story. I’m not sure what to do with myself, I hate going out, even going to school because I just feel so ashamed…I don’t even know where to start looking for a wig around here (I’m from Portland, OR). And I feel like seeing another doctor would also be pointless. Anyways, Thanks a lot for listening to my story.

~Veronica

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Dear Veronica,

Thank you for writing and sharing your story, I’m so sorry you are having to go through this. It probably is of mild comfort, but know you definitely are not alone and there are A LOT of women who start to lose their hair at young age. Who knew? I definitely didn’t until I started going through it. Here comes my usual disclaimer I provide on every question I respond to. I am not a doctor and cannot provide medical advice or treatment, this is just my opinion. Ok…

After reading your story I have so many questions. Did your dermatologist put you on Rogaine, Spiro and Yasmin all at the same time? You said you are 20 and have been experiencing hair loss for 4 years, so you started losing your hair at 16 and saw your doctor at 18. Did he provide any explanation as to what might have trigged your hair loss at such a young age? You stated that after a year the medications did nothing, but you didn’t say whether or not you stayed on them or took yourself off. I’m curious because if you took yourself off after a year and the following year noticed a rapid decline in your hair, then perhaps the drugs were doing more than you thought. Sometimes all the drugs can do is slow the hair loss process down and help you maintain the hair you have,. Not all women experience a phenomenal regrowth after treatment. Even after I started treatment, I never regained the hair I had and was pretty convinced the treatments weren’t working so I eventually took myself off of aldactone around 2003… I think. The dates get fuzzy. Anyways, my hair loss increased dramatically. That could have just been from getting off the drug and it may have re-stablized eventually, but that scared me enough to get back on. Not only did I get back on aldactone, but when I got back on, I had my dose increased from 100mg to 200mg a day.

If you would have asked me then about my hair, I would have complained about the hair I once had and that it was so thin and continuing to fall out. But looking back it was doing fairly well after the 200mg increase. [click to continue…]

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Spironolactone – Hair Loss Story Question

by admin on October 6, 2007

Spironolactone - Hair Loss Story & QuestionHi! First of all I want to say that this is a GREAT forum/blog and I give you a lot of credit for starting it, sharing your stories, and wanting to help others. THANK YOU, and I really appreciate all you’ve done and gone through. Stay strong, continue helping others and you will get through this!

I want to ask you about your thoughts on Spirinolactone, but should provide you some context first. I am 28 years old and started losing my hair around August of 2006. I was under a lot of stress with my job and not taking very good care of myself nutritionally either. So, I started with a family physician and had blood work done. Everything came back fine. She recommended I take a daily multivitamin. She also recommended me to a dermatologist. I finally saw a derm in January of 2007 (it takes FOREVER to get in) and they did some additional blood work and told me to start taking biotin as well as the daily multivitamin. Again everything was “normal” and that was it. In March of 2007 my excessive shedding stopped and my hair felt better again. So I thought the vitamins and biotin were helping and
thought stress had a lot to do with it, too.

THEN, in August of 2007 I started losing a lot of my hair again and am continuing to shed excessively. This time around the hair loss is more noticeable and my scalp is much more noticeable than the first episode. I did just move to a new state, change jobs, sell our house, etc., etc. I thought maybe it was stress again but knew I needed to see a derm to be sure. I live in Winston-Salem, NC and they have an excellent dermatology practice at Wake Forest University School of Medicine and Medical Center. They have doctors that specialize in female hair loss!! So, I finally went early this week (after getting an earlier appointment because of a cancellation). I saw 2 doctors that were fantastic. They spent a lot of time talking through everything and came to the conclusion that it’s likely androgenic alopecia. BUT, they had me take every blood test possible in case it’s related to low iron, thyroid, etc. I’m still awaiting those test results. They also think some stress could be involved, but when they performed the hair pull test on me it was positive in some areas and not in others, likely female pattern hair loss (androgenic alopecia). I am supposed to start using Rogaine for men and they will prescribe Spirinolactone if all of my blood work comes back “normal.”

So, do you know much about this drug? Does anyone else on the site know? [click to continue…]

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Will I Ever Have The Strength To Shave My Head?I talk so much more now about shaving my head with my fiance, he is all for it. If you are wondering why I would want to do that, please read my hair loss story. I cannot treat it anymore, my medications have stopped working, but yet I still am a prisoner to them. I fear if I remove myself from them I will experience greater shedding from a hormone shift. Shaving my head would free me. It would allow me to get off my medication now and not have to “see” the shedding. It is the shedding that tears me up inside, a constant reminder that very soon I’ll just have thin patches of hair around my head.

Talking isn’t doing, but that fact I am talking about shaving my head is really healthy. I am getting more comfortable with the idea each time I really try to envision it. I’m starting to believe that I will eventually be able to make that choice. Thinking about it makes me sigh a breath of relief… I’d be able to finally get off the aldactone and orthotricyclen I’ve been using to treat my hair loss. In my post titled “Regretting Past Decisions on My Hair Loss” I relay my regret about ever getting back on the pill to treat my hair loss, knowing it was the very cause of it. I didn’t really think it through. I didn’t realize that even if it worked I would have to be on it forever to maintain the hair that it saved. But what about children? I haven’t had kids and have felt that that option has been ripped away from me. How can I have kids on the pill? I can’t. But how can I get off knowing that I could have even more increased shedding that would depress me so much I couldn’t get out of bed. How would I be able to be a mother then? I wouldn’t. Not to mention who knows the damage of taking birth control pills and aldactone, an antiandrogen which is essentially a blood pressure pill, long term? I don’t have high blood pressure yet I agreed to take Aldactone for it’s antiandrogen properties, I didn’t think it all through.

I suppose my feelings would be all different if the treatments continued to work warding off impending hair loss, but it isn’t. Not after 8 years it isn’t. It did help me before (I think) although I never will really know what would have happened if I just decided to let be what would be 8 years ago. Would my hair loss have stopped on it’s own? Would my hormones or whatever was causing the extreme loss after getting off the pill rectify by itself? Maybe. Maybe not.

Part of healing will be accepting the decisions I made. Accepting myself. Once I’ve done that, I think I’ll be ready to shave my head and start living again. I look forward to that day.

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My Hair Loss Story – How Did I Get Here?

by admin on August 30, 2007

So how did I get here? I find myself asking myself that very same question on a daily basis. The year 1999 was the year that forever changed my life. My hair loss began after having stopped taking the birth control pill Loestrin FE. Later I found out that it is or at least was, an extremely high androgen index pill. Who knew? Certainly not me and certainly not my gynecologist who prescribed it to me.

So the following months after I stopped the pill my hair began to shed and shed like crazy. It was all over the place and coming out what seemed to be by the handfuls. I tried to find answers online, but I found nothing. I went to so-called “hair experts” also known as dermatologists who aren’t any wiser than the other dermatologists, but just know how to capitalize on the vulnerability of women. They were of no help either. Blood work… within normal levels. I felt frustrated that I couldn’t point to it on a paper and say “ah ha that’s it, my estrogen is low” or “there it is, I need more iron.” There simply was no explanation. I should point out that I also saw very expensive “hair experts” who told me I wasn’t losing my hair. What? Like they would know better than me, I’ve only live in this body… umm forever. Of course if I revisited those same doctors today they wouldn’t be telling me that now. This certainly isn’t one of those instances where you want to be right and say “I told you so.”
[click to continue…]

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