If you're taking spironolactone as part of your gender-affirming hormone care, we might recommend switching to finasteride in some cases – especially if you have low blood pressure.
What Spironolactone Does
Spironolactone is a medicine that helps block testosterone. It also acts as a diuretic, which means it helps your body get rid of extra salt and water by urinating more frequently. Because of that, it can sometimes lower blood pressure.
Read more about Spironolactone here.
Why Low Blood Pressure Matters
If your blood pressure is already low, spironolactone can make you feel:
Dizzy or lightheaded
Faint when standing up
Weak or tired
In those cases, continuing spironolactone might not be safe or comfortable.
Read about blood pressure reference ranges here.
How Finasteride Is Different
Finasteride also helps reduce the effects of testosterone, but it doesn't lower blood pressure. Instead, it works by blocking a specific form of testosterone (called DHT). That makes it a good alternative for people who can't tolerate spironolactone because of low blood pressure or dizziness.
Read more about Finasteride here.
What to Expect
If we recommend a switch:
Your blood pressure should stay more stable.
You might notice fewer side effects like dizziness or fatigue.
So long as you keep providing us with your blood test results, we will keep monitoring your hormone levels and adjust your treatment as needed.