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Spironolactone is a medication that patients can utilize for a number of patient conditions ranging from excessive acne in teenagers to hirsutism in those suffering from sex organ dysfunction and even high blood pressure when high aldosterone levels are thought to be present. The question, however, is there any inherent danger in women continuing this medication when trying to conceive or even during their pregnancy. 

There may be some merit to doubters concerned about spironolactone during pregnancies. It has a significant effect on the renin-angiotensin pathway that can help regulate blood pressure and women during pregnancies already have a lower blood pressure compared to non-gestational females. This medication can cause blood pressures to drop even further and lead to women fainting or having vascular insufficiency which can significantly impact the fetus. 

Studies also suggest that spironolactone is a medication that is possibly tetratogenic yet it was prescribed in over 10 percent of patients who were pregnant [1]. In one particular study, spironolactone was administered to pregnant rats and it was found that fetuses that were originally male underwent feminization and were partially male and partially female by the conclusion of the pregnancy. Although animal studies do not represent complete comparability to human counterparts, the sexual alteration of spironolactone may be extremely risky when used on human subjects. [2]

Another possible complication with the use of spironolactone that was observed in women was the increased likelihood of developing breast and uterine cancer. In a cohort of Danish women, it was found that patients who had routinely used spironolactone has a 10 to 30 percent increased chance of developing breast and uterine cancer compared to normal Danes who had not used this medication. These studies also show, however, that once spironolactone is stopped, the adjusted risk for cancer one year after the medication is stopped is not any higher in the spironolactone-exposed group compared to the control population. [3]

During pregnancies, there are times where doctors may consider spironolactone as a medication that can help manage hypertension that may develop as the fetus grows. This is a decision that should shoot off an immediate red flag if you are sitting in the examination room because of spironolactone directly linked to the fetus. Spironolactone is a medication that is capable of traveling through the mother's blood and entering the fetal bloodstream.

This spironolactone is capable of affecting androgen levels in the fetus and lead to gender abnormalities similar to what was reported in the rat population. [4] 

Needless to say, the risks of taking spironolactone during a pregnancy are not worth the potential benefits that may help during a pregnancy so it should be substituted for other medications capable of lower aldosterone levels without the same complications seen during pregnancy. Not only can it lead to gender disparities during the pregnancy, but the mother may also be unnecessarily subjecting herself to developing breast and uterine cancer when alternative options are available. There are a few studies showing how women accidentally continuing to take spironolactone during the course of their pregnancy were able to successfully give birth to healthy babies but why take the risk. If you are taking spironolactone and wish to have children, consult with your physician in order to find an alternative medication that does not carry the same pregnancy risks. 

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