JAMA Netw Open

Spironolactone use in young women is rising despite limited safety data

March 20, 2025

Study details: This cohort study analyzed trends in spironolactone prescriptions among 38 million insured females aged 12 to 40 years from 2000 to 2020 using the Merative MarketScan Commercial Claims and Encounters Database. The study focused on new prescriptions, stratified by age and indication, and standardized monthly incidence rates.

Results: The proportion of young women and girls initiating spironolactone increased from 17 per 100,000 in 2000 to 88 per 100,000 in 2020, with the highest rise among those aged 19 to 25 years. Of the 451,234 new spironolactone initiators, 55.5% were prescribed for acne, 8.3% for hirsutism, and 8.1% for polycystic ovary syndrome. Only 4.0% and 0.8% were for hypertension and heart failure, respectively.

Clinical impact: The significant rise in spironolactone use among young females, particularly for androgen-related conditions, highlights the need for safety studies on higher doses used in this population.

Source:

Soppe SE, et al. (2025, March 3). JAMA Netw Open. Trends in the Proportion of Young Women and Girls Prescribed Spironolactone. https://pubmed.ncbi.nlm.nih.gov/40094669/