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Anyone Know If You Need Spironolactone If You Are Taking Dutasteride?

Discussion in 'Treatments for Androgenetic Alopecia' started by NancyDC, Jun 20, 2017.

  1. NancyDC

    NancyDC New Member

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    I was diagnosed with Androgenetic Alopecia last summer. I've been taking 200mg of Spironolactone and using a topical compound with minoxidil for a little under a year. Haven't noticed too much change in my hair, but I'm happy with that since it means that I'm not losing more. (I notice shedding hair in the shower and elsewhere, but I don't notice my scalp being more visible, so I guess I'm hanging in there.)

    In April, I went to see a hair loss specialist because I wanted a recommendation about what drug would be best for my high blood pressure. (The answer was that it's best to use trial and error since more than one class of blood pressure medicines can cause hair loss and everyone reacts differently. I switch to a different beta blocker; I think it's working better for the blood pressure, and I notice no difference in my hair.)

    He recommended adding .5 Dutasteride. I've been taking it about three months. Again, I haven't noticed much of a change.

    Does anyone have a sense about whether I need to continue taking Spironolactone if I'm taking Dutasteride?

    (I'll ask the Dr. also next time I see him; I just wondered what you thought too. I really get the feeling that everyone treating female hair loss is just winging it anyway.)

    I'm experiencing menstrual irregularities and some other sex related side effects that pre-date the Dutasteride and that I'd prefer not to experience if it makes no difference to the hair situation. On the other hand, these side effects are tolerable if they are facilitating keeping my hair.

    Anyone want to speculate?
     
  2. valentinab00

    valentinab00 Established Member

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    Spironolactone and Dutasteride work in different ways. Spironolactone is an anti-androgen and Dutasteride curtails the 5 alpha enzyme, i.e. DHT. Most doctors prescribe Spironolactone for women as it can cause feminizing side-effects in men -- it's an anti-androgen. It essentially downplays testosterone. It seems to be more helpful to women who have high levels of testosterone, particularly free testosterone. Some would say Spironolactone is more effective because it prevents testosterone at the androgen receptor while Dustasteride and Finasteride simply curtain DHT, in the latter free testosterone may increase and/or convert (aromatase) to estrogen.

    Spironolactone can cause menstrual irregularities, which is why it is commonly prescribed with birth control pills. Dustasteride and Finasteride seem to not cause these issues; however, are usually prescribed with birth control since they are category X drugs.

    If you are experiencing menstrual irregularities, you may check into correcting those -- estrogen, progesterone, testosterone, shbh, and your hair loss issues may improve. Usually hair loss is a result of a hormonal imbalance, though it isn't guaranteed that "correcting" the imbalance restores hair growth.
     
  3. mcat11

    mcat11 Established Member

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    IF the dutasteride is working for you IF you are responding to dutasteride (not everyone does I don't think) then its probably safe to give up the Spironolactone--But i think you have to make sure the dutasteride is working on you first.

    I was using topical Spironolactone (the pills messed me up) for about a year and it definitely slowed down my hair loss, then i added topical finasteride (which works similar to dutasteride I believe although dutasteride is stronger in some manner more potent).
    The topical finasteride has stopped the hair loss and definitely given me good regrowth.
    BUT I am not stopping the topical Spironolactone because I am scared to change anything.
    That being said I am not getting any side effects so I cant say what I would do or not do in your place..other than i would want to make sure the dutasteride was doing its job.

    My understanding (and I can be wrong) if dutasteride or finasteride are doing their job correctly or if you are a good responder to these drugs then the Spironolactone becomes unnecessary.
     

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