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Concerned over 'Spironolactone' Rx for acne as a maleHello, (30y/o male).I was recently seen by an NP at a Urology center and during my visit my acne was brought up. She just got done some time working in dermatology. I had stated I was not comfortable with something like Acutane since I am trying to have kids and honestly that medication seems very scary to me from a health standpoint. She Rx me something called 'spironolactone'. Coincidentally I was seeing a male health specialist (an NP) the next day and he also brought up my acne and suggested 'spironolactone' out of the blue..Before I picked this up from the Pharmacy I googled it, because I like to know about medications and nowhere does it say this medication is safe or FDA approved for men. It's apparently outstanding for female acne, but as an androgen blocker, is not intended for use in men, and in fact a clinical study showed 100mg of daily use for 3 months in a group of 18 men, 8 of them developed significant gynecomastia..I called and canceled my Rx for spironolactone. I wanted to get an MDs opinion on this. I am a lay person so maybe I was just dramatic here. I am quite confused why two entirely different NPs, practicing in different states, would both suggest spironolactone (100mg a day) for acne in men..Patient History:Pituitary tumor which impacts my testosterone levels (sub 100) so am on 100mg of T a week. I have cut this down and am weaning completely off of it because I am currently 0.00 10x6 for sperm. NP just started me on 5mg of 'finasteride' (for acne due to DHT conversion maybe?) and HCG (0.75mg a week) to try and get that up. Another NP started me on Clomid and suggested I finished off the HCG (*I know, its not ideal to have two providers dictating care for the same thing - but NP #1 didnt know I was at a 0 and wanted to determine if I needed something like Clomid after the analysis came back but I dont see her again for 2 months).*I will say the IM testosterone has changed my life. I cannot explain how much better I feel. Its so profound I almost want to cry. Its like seeing in color for the first time in 20 years. I am sad / nervous to get off of it, but its for a purpose so I can handle that.
gpt
I have never heard of spironolactone being used for men's acne. Without good evidence, I use it frequently in women.
Child urology: Double kidney, megaurether, uretheroceleFemale, 10 months old, 70 cm, 7.5 kgHi all,I am searching for second opinions and experiences for my 10 months old daughter.She was born with a double kidney whose upper part is polycystic and thus not working properly. The urether of this part became a megaureter, probably because it ends in an ureterocele in the bladder.Her first surgery was when she was 1 month old. They cut into the ureterocele so the urine can flow into the bladder. However, at this point they thought she had only one urether for both systems and thus there had been enough urine to guarantee sufficient flow. When she had a persistent infection with Klebsiella pneumonia, we were referred to specialists who saw the second urether and, 2 weeks later, her second surgery was done to make a urostoma, so the basically standing urine from the megaureter could flow directly outside. The ureter is smaller now and except that she receives prophylactic treatment with antibiotics, everything is normal. But the stoma has to be closed of course. Now there are 2 options:connect the ureter from the dysplastic part of the double system with the healthy ureter from the healthy partcut out the dysplastic part of the double system and part of its ureter, leaving the other part and the ureterocele where they are, as there is no refluxOur doctors recommend option 1), as the surgery is shorter (90 minutes vs 3 hrs) and less invasive (opening up the existing hole from the stoma a bit more vs making an additional cut close to the lungs) and the healthy kidney part is not damaged (vs certain loss of at least 7% function). The only risk is that the connection of the two ureters leaks, which is rare and easily fixed they say.These are all compelling arguments, but we were also told that option 2) is the more common one. Does anyone have experience with similar cases? What's her best option in your opinion?Thank you very much for any feedback!
!redditsilver