| Interaction type | None known. Spearmint has a mild anti-androgen effect in short trials; spironolactone is a prescription anti-androgen. In theory the effects add up; in practice nobody has measured the combination. |
| How serious | Low. Two cups of spearmint tea a day is food-level exposure. Concentrated spearmint capsules have no trial data at all. |
| What to do | Keep taking your spironolactone as prescribed. If you want to add spearmint, use tea (two cups a day, the studied amount), give it six months, and judge by hair, not by hope. Tell your prescriber it's on your list. |
| Who this matters most for | Women with PCOS taking spironolactone for hair growth, acne or hair thinning who are tempted to replace it with something "natural." |
Medically reviewed by Dr Zainab Ajmal · Last reviewed September 2026 · Next review due September 2027 · MyStaq interaction record: spironolactone-spearmint
Why you are probably reading this
You have PCOS (now renamed PMOS) and you're on spironolactone for coarse hair, acne or thinning at the crown. Spearmint tea is the one PCOS remedy that shows up in every list with the word "study" next to it, and you want to know whether it's safe with spironolactone and whether it's worth the kettle.
What each one does
Spironolactone blocks the androgen receptor and reduces androgen production, on top of its original job as a potassium-sparing diuretic. It's the anti-androgen the international PCOS guideline names for hirsutism when the pill alone isn't enough after six months, or when the pill can't be used, and it must be paired with reliable contraception because it can affect a developing baby [1], [2].
Spearmint (Mentha spicata) lowers androgen levels in the two trials that exist. In 21 women with hirsutism, two cups a day for five days lowered free testosterone and raised LH and FSH [3]. In 42 women with PCOS, two cups a day for 30 days lowered free and total testosterone, raised LH and FSH, and improved women's own rating of their hair growth, but the objective hirsutism score did not change significantly in that window [4]. The mechanism isn't settled; rosmarinic acid and flavonoids are the usual suspects.
That's the whole evidence base: 63 women, 35 days at most, hormone changes in both, objective hair change in neither. The reason the hair score didn't move is not mysterious; hair follicles cycle over months, and every hirsutism guideline says to judge any treatment at six months, not one [1].
What happens when you combine them
No interaction has been described. Spearmint doesn't affect the liver enzymes or kidney transporters that handle spironolactone, and it has no meaningful potassium content, so it doesn't touch the one thing spironolactone users need to watch [5].
The effects may add, or may not. Two anti-androgens acting on different steps could plausibly do more together than either alone. Nobody has tested it. If you're already on a working dose of spironolactone, the honest expectation for adding spearmint is a small extra effect or none.
Side effects don't overlap. Spironolactone's are menstrual irregularity, breast tenderness, dizziness and the potassium issue. Spearmint tea's, at two cups a day, are essentially none.
Why this matters more if you have PCOS
The trap is substitution, not combination. The risk with spearmint isn't taking it alongside spironolactone; it's reading "spearmint lowers testosterone" and stopping the spironolactone. A 30-day hormone shift in 42 women is not the same evidence as decades of prescription use, and spearmint has never been shown to reduce hair growth on an objective score [4].
Capsules are a different product. "Spearmint extract" supplements at several hundred milligrams have no trials in PCOS. The studied preparation is brewed tea from leaves. High doses of spearmint in animal studies produced liver and kidney changes, which is a reason to stay at tea strength rather than a reason to fear tea [6].
Trying to conceive changes the whole picture. Spironolactone is stopped before trying because of its effect on a developing baby [1]. Spearmint's safety in pregnancy is unknown; food amounts are presumably fine, but deliberately dosing an anti-androgen herb while trying is not a good idea either. Have one conversation about both.
It won't touch the other half of PCOS. Spearmint has no effect on insulin resistance, cycles or fertility in any trial. It's a hair-and-acne question only.
What to actually do
Keep the spironolactone. It's the treatment; spearmint is the garnish.
If you add spearmint: two cups of brewed spearmint tea a day, the amount used in both trials. Plain spearmint, not peppermint (different plant, no androgen data) and not a flavoured blend.
Give it six months. Take a photo of the area on day one. Judge by the photo, not by how you feel about it, and not by a blood test.
Tell your prescriber. It won't change their plan, but it belongs on the list, and if your cycle changes they'll want the full picture.
Keep the potassium rules. Spearmint doesn't add potassium, but if you're mixing herbal teas, check that nothing else in the cupboard is a potassium-based salt substitute or electrolyte product [5].
What we do not recommend
- Stopping spironolactone for spearmint. Different evidence, different effect size [1], [4].
- Spearmint extract capsules as a "stronger" option. No trial data; animal toxicity at high doses [6].
- Judging results at 30 days. The hair score didn't move in 30 days in the trial that measured it [4].
- Taking spearmint for anything except androgen symptoms. No evidence for cycles, insulin or fertility.
- Assuming "herbal" means pregnancy-safe. Unknown [1].
How confident are we
| Claim | Evidence strength | Basis |
|---|---|---|
| Spearmint tea lowers testosterone over days to weeks | Moderate (small trials) | Two randomized trials, n=21 and n=42 [3], [4] |
| Spearmint tea reduces hair growth on an objective score | Not shown | Ferriman-Gallwey score unchanged at 30 days [4] |
| Spearmint interacts with spironolactone | No interaction described | No pharmacokinetic overlap; no potassium content [5] |
| The combination works better than spironolactone alone | Unknown | No trial |
| Two cups of tea a day is safe | Strong (food-level exposure) | Trial tolerability; long culinary use [3], [4] |
| High-dose extracts are safe | Unknown | Animal toxicity at high doses [6] |
When to talk to a clinician rather than read further
- You're thinking of stopping spironolactone
- You're trying to conceive
- Your periods have become irregular since starting either
- You're using spearmint extract capsules rather than tea
- Six months in, nothing has changed on the photo
None of this replaces your doctor. It is meant to make the conversation with them faster and better.
Quick questions
Can I drink spearmint tea while taking spironolactone? Yes. No interaction is known, spearmint tea has no meaningful potassium, and two cups a day is food-level exposure. Tell your prescriber it's on your list, and don't expect it to do the spironolactone's job.
Does spearmint tea work for PCOS hair growth? It lowers testosterone in two small trials, but the one that measured hair growth objectively found no significant change in 30 days. Hair takes months to respond, so a fair trial is six months. It's a low-risk extra, not a proven treatment.
Can spearmint replace spironolactone? No. Spironolactone is the guideline-named anti-androgen for hirsutism, with decades of use behind it. Spearmint has 63 women and 35 days of data, none of it showing objective hair change.
Sources
- Teede HJ, Tay CT, Laven J, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (hirsutism; anti-androgens; assessment period). J Clin Endocrinol Metab. 2023;108(10):2447-2469.
- U.S. Food and Drug Administration. ALDACTONE (spironolactone) prescribing information, 2025 (Use in Specific Populations 8.1; Warnings 5.1).
- Akdoğan M, Tamer MN, Cüre E, Cüre MC, Köroğlu BK, Delibaş N. Effect of spearmint (Mentha spicata Labiatae) teas on androgen levels in women with hirsutism. Phytother Res. 2007;21(5):444-447.
- Grant P. Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. A randomized controlled trial. Phytother Res. 2010;24(2):186-188.
- MyStaq Health. Spironolactone and Potassium: What You Need to Avoid.
- Akdoğan M, Kılınç İ, Öncü M, Karaöz E, Delibaş N. Investigation of biochemical and histopathological effects of Mentha piperita L. and Mentha spicata L. on kidney tissue in rats. Hum Exp Toxicol. 2003;22(4):213-219.
Related guides: Spironolactone and Potassium
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Always consult your physician before starting any supplement, especially if pregnant, nursing, or taking medication.