03/30/2026
Scalp hair loss Minoxidil vs Spironolactone: Part 3
While it’s available over the counter, remember that both minoxidil and spironolactone were originally blood pressure medications. They were later repurposed as androgen blockers, which is why they’re commonly used for women with PCOS, hormonal disorders, acne, excess facial hair, and scalp hair thinning.
If you’re taking oral minoxidil—especially combined with oral spironolactone—you may experience fatigue, dizziness, and drops in blood pressure because they still act on those blood pressure pathways. This is a common reason patients feel “off” while treating hair loss. For hormonal hair loss, spironolactone is often the better option and tends to cause less dizziness and fatigue at appropriate doses. Minoxidil is best kept topical, and the two should not be combined in oral form unless you actually need blood pressure management.
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