PCOS-MEDICATION Messages for August, 2002: Should I try Spironolactone or switch pills?

Should I try Spironolactone or switch pills?

From: Maria (anonymous@obgyn.net)
Sat, 31 Aug 2002 15:29:13 -0500 (CDT)

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Hi all,

Sorry this is a bit long, but please bear with me:-)

I talked to my ob/gyn yesterday about my hair loss. I've been losing hair since last August or so, after starting Ovcon-35 birth control pills in June 2001. I started with a high TE-like shed of about 300 hairs or more a day, then trickled down from December on to about 20 -100 hairs in the shower. I lose short hairs too and have had no regrowth to speak of.

However, when I thought about it, i remembered that I'd had another huge shed 3 years back, around the same time I put on 45-60 pounds very quickly and suddenly developed acne, and started having irregular periods (why I went on the pill) and some slight increased facial hair. I thought i might have PCOS, so that's why I went to the ob/gyn (that, and the fact she's a woman and more likely to care about the hair loss than my male internist, who wasn't that concerned).

Anyway, after discussing my symptoms with me, the Ob/gyn said it's quite possible I have PCOS, but there's no way to tell until I get off the pill,as the pill would throw off lab results. IS THIS TRUE?

I've lost most of the weight now, and Ovcon-35 has controlled my acne, so the hair loss is the main issue for me. The doc said in her experience, the pill really can change hair growth patterns, so it's possible that going off for 3-6 months will help my hair. If my hair stays better, I should consider staying off the pill or switching to a new brand, she said.

She also said I can switch birth control pill brands right away if I want -- I was thinking Desogen. However, she did mention that some women respond poorly to all pills, or even to pills labeled non-androgenic (she said our bodies can convert the progestin to a more androgenic form sometimes).

Finally, she said I could try SPIRONOLACTONE. The decision, she said, is up to me.

Well, that's the support I've wanted, but I am afraid of making the wrong call. I'm tempted just to go with Spironolactone and see if it helps, as it is likely to clear my face even further. However, I worry about going on more drugs than I need. But if I go off the pill, I worry my acne will come back, and -- if i have some kind of androgen-promoted AGA -- my hair loss will worsen.

Since you guys have so much experience with this, I'd really appreciate your advice. Would it be worth it to go off the pill for 3-6 months and see how my hair does? Should I go ahead and switch to Desogen? Or should I go ahead and try Spironolactone? I'm torn between my desire to take action now with drugs and my fear of being tied to meds -- ones I may not actually need -- for the rest of my life.

Sorry for the long whine. Thanks for all your input.

--
Maria

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