Women with PCOS have frequently a hyperaldosteronism (30% of the cases). In a previous study, we found that both the aldosterone to renin ratio and blood pressure values are normal in PCOS but significantly higher compared with healthy controls, comparable in age and BMI. Moreover, PCOS is characterized by an increased prevalence of different pathological conditions associated with hyperaldosteronism and/or increased aldosterone activity, like hypertension, Hashimoto’s thyroiditis, diabetes, obesity, and preeclampsia, particularly after menopause. Spironolactone is the only antiandrogen approved for hirsutism in the United States and has been in use for this reason for more than three decades with close to 300 entries in Pub Med. The weakness of research in this field is the small sample of women enrolled in each study and a meta-analysis of all these studies should be performed. In this editorial, we aim to focus on the importance of the associated antiandrogen and antiinflammatory effects of Spironolactone in the treatment of PCOS.
