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Evidence reviews. Spironolactone versus placebo or in combination with steroids for hirsutism and/or acne. The evidence suggests a lack of evidence to show whether spironolactone can reduce hirsutism and acne. Hirsutism in women (excessive hair growth) is most often caused by an increased production of male hormones.
It is also used for hormone therapy in transgender women. Spironolactone is taken by mouth. Common side effects include electrolyte abnormalities, particularly high blood potassium, nausea, vomiting, headache, rashes, and a decreased desire for sex. In those with liver or kidney problems, extra care should be taken.