Affiliation:
1. Postgraduate Program in Endocrinology, Medicine School Universidade Federal do Rio Grande do Sul Porto Alegre Rio Grande do Sul Brazil
2. Gynecological Endocrinology Unit, Division of Endocrinology Hospital de Clínicas de Porto Alegre Porto Alegre Rio Grande do Sul Brazil
3. Department of Physiology Universidade Federal do Rio Grande do Sul Porto Alegre Rio Grande do Sul Brazil
Abstract
AbstractObjectiveSpironolactone (SPL) has been used to manage hyperandrogenic manifestations in women with polycystic ovary syndrome (PCOS), but data on the risk of hyperkalemia in this population are scarce. The aim of this study was to evaluate the incidence of hyperkalemia in women with PCOS using SPL in the long term.DesignSingle‐centre retrospective study.PatientsInclusion and analysis of 98 treatment periods in 78 women with PCOS (20 of whom were duplicates, returning after treatment interruption for a mean of 38 months) who received SPL for a minimum of 12 months and had at least three measurements of potassium levels over time.MeasurementsClinical and hormonal profiles before and during SPL treatment.ResultsMean age was 29.1 (SD: 9.6) years, and body mass index was 32.2 (SD: 8.1) kg/m². Nine patients had diabetes, and 22 had prediabetes. SPL was used in combination with combined oral contraceptive pills in 55 participants and progestin‐only pills/long‐acting reversible contraception in 28; metformin was added in 35, and angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers in 15. Median SPL dose was 100 (range: 50–150) mg. A total of 327 serum potassium measurements were obtained (84 pre‐exposure and 243 postexposure). Four potassium measurements were above the reference range before exposure and 19 during exposure. All potassium measurements above the reference range during follow‐up were classified as mild hyperkalemia (5.1–5.5 mEq/L).ConclusionsThe present findings suggest that women with PCOS, without kidney or heart disease, using SPL combined with hormonal contraception for managing clinical hyperandrogenism have a low incidence of hyperkalemia and well‐tolerated minor adverse effects.
Subject
Endocrinology, Diabetes and Metabolism,Endocrinology