Does Spironolactone Lower Libido? A Dermatologist Explains

If you take spironolactone for acne, hair loss, or unwanted facial hair, you may have wondered whether it can affect your sex drive. In this video, dermatologist Dr. Dray takes a closer look at what we actually know about spironolactone, antiandrogens, and libido in women, including what the research tells us and where the evidence is still limited. Spironolactone is a commonly used antiandrogen in dermatology, particularly for adult female acne. While decreased libido is a recognized potential side effect, studies have not given us a reliable estimate of how frequently this occurs in women. Libido is also influenced by many factors beyond testosterone and androgen signaling, including stress, sleep, medications, relationships, pain, vaginal dryness, menopause, and overall health. We also discuss newer research that examined sexual dysfunction diagnoses among hundreds of thousands of premenopausal women with acne. Interestingly, this observational study did not find an increased rate of coded sexual dysfunction among spironolactone users. However, this does not prove that spironolactone improves libido or that it cannot cause sexual side effects. The study relied on medical coding and highlights the need for prospective research using validated measures of sexual function. This video also covers dose-related side effects of spironolactone, potassium and medication interactions, menstrual changes, breast tenderness, pregnancy considerations, finasteride, dutasteride, and te