Could long-term spironolactone use be contributing to my infertility? (25F, TTC for 2 years, lab results included)

[u/aryannaxarana]

Hi everyone! I’m posting because I’m trying to understand whether long-term spironolactone use could have contributed to my fertility struggles, and I’d really appreciate hearing from anyone who has experienced something similar.
I’m a 25-year-old female, generally healthy, and my husband and I have been trying to conceive for about 2 years without ever having a positive pregnancy test.
My spironolactone history:
I stopped taking birth control in January 2025 because I wanted to let my natural cycle return and eventually get pregnant. However, I continued taking spironolactone for acne.
I’ve been taking spironolactone for almost 3 years total. I was taking 100 mg daily, and at one point I tried increasing my dose to 200 mg. My menstrual cycles seemed to become more irregular after stopping birth control while still taking spironolactone, and increasing the dose seemed to make things worse. I eventually went back to 100 mg daily.
My cycles are currently around 21–35 days, with a normal flow lasting several days. I do get periods, and I haven’t gone an entire month without one, but I don’t know for certain whether I’ve been ovulating consistently.
I recently started investigating my fertility and had hormone testing done. I also have ultrasounds that reportedly haven’t shown cysts or anything else concerning.
My lab results:
Total testosterone: less than 12.0 ng/dL (lab reference range: 8.4–48.1)
SHBG: 66.2 nmol/L (lab reference range: 24.6–122.0)
AMH: 3.49 ng/mL
TSH: 0.668
Prolactin: 23.9
FSH: 3.0
Estradiol: 75 pg/mL
My bloodwork was drawn on cycle day 23, and I’m not sure how much the timing affects the interpretation of these results.
I’m especially concerned about my testosterone being at the very low end of the lab’s range. I’ve read that spironolactone blocks androgen activity, and I’m wondering whether taking it for so long could have affected my hormones, ovulation, or ability to conceive.
I just stopped taking spironolactone a few days ago because we want to get pregnant, and I’m hoping my hormones and ovulation will return to their natural patterns.
I understand that nobody here can diagnose me, but I have a few questions:
Has anyone struggled to conceive while taking spironolactone and then gotten pregnant after stopping it?
Could long-term spironolactone use have affected my ovulation or fertility, even though I still get regular-ish periods?
Does my low-end testosterone result mean anything concerning for fertility, especially alongside my SHBG result?
Do my AMH, FSH, estradiol, TSH, and prolactin results look reassuring, or is there anything I should follow up on?
If you’ve been through something similar, how long did it take for your cycles or ovulation to normalize after stopping spironolactone?
I know there could be other explanations for infertility, and I’m planning to continue investigating this with my doctor. Since we’ve been trying for about two years, I’m just hoping to understand whether this medication could have played a role.
Thank you so much to anyone willing to share their experience or insight! ❤️

IMPORTANT TO NOTE: Although we have been trying for 2 years, my doctor told me to continue Spiro for skin purposed and stop as soon as we got a positive…

[u/Helpful-Magician2611]

I think it’s entirely possible that spironolactone affected your ability to conceive while you were on it given how it affects your hormones. I doubt it will have had a permanent effect. I am not a doctor but as someone who discontinued spironolactone I saw how my cycle and body went back to normal after I discontinued it. Given that you have been trying to conceive for 2 years it may also be worthwhile for your husband to get his sperm tested just to make sure there are no issues on that end. All the best!

[u/aryannaxarana → u/Helpful-Magician2611]

Thank you so much for reading all of this and responding! I do think now that I have discontinued Spiro, that my cycle will start to regulate. How long until you noticed your cycle go back to normal? And yes my husband is in the process of also getting testing, hope all is well with him!

[u/Helpful-Magician2611 → u/aryannaxarana]

Maybe a couple months? I don’t recall. I was on a low dose (25 mg) but even that shortened my cycle, caused me insomnia, increased my a1c levels and made me less toned. Hormones can have a huge effect on one’s body.

[u/aryannaxarana → u/Helpful-Magician2611]

Okay thank you! I definitely like it’s played a big part on my hormones and overall cycle.

[u/pebblenooo → u/aryannaxarana]

Spiro pretty much stopped my cycles for several months, and like you I’d been trying for a year and never got a positive pregnancy test. I came off it and got pregnant literally the next cycle, so I think anecdotally it definitely can interfere with cycles. I told my dermatologist I had her to thank for me getting pregnant 🤣 Best of luck to you!

[u/Current_Blueberry839]

Bonjour. Je suis pas dans ta situation donc je peux pas témoigner à ce sujet. En revanche, C’est quand même un traitement hormonal. Je le prends depuis 8 ans, j’ai tenté plus ou moins de l’arrêter à un moment (baisse de dose) et j’ai eu les mêmes symptômes qu’à l’arrêt de ma pilule et je dois encore gérer ça même après avoir réaugmenté la dose. Donc je veux bien croire que ça perturbe les cycles. Il est aussi prouvé que la spironolactone change l’équilibre entre œstrogènes progestérone et testostérone. Ça veut absolument pas dire que tu es stérile. Tu as bien fait de l’arrêter. En règle générale de ce que j’ai pu lire, les femmes l’arrêtent avant d’essayer d’avoir un bébé. Renseigne toi sur le myo-inositol et parles en à ton médecin. C’est censé rééquilibrer les hormones et beaucoup de femmes le prennent à l’arrêt d’une pilule et/ou pour essayer de concevoir. Cela ne marche pas chez tous le monde mais ça peut valoir le coup d’essayer.