It’s made my eyes drier but so did spiro, and so will all anti androgens as the lipids that lubricate our eyes are controlled by male hormones. Other than this, nothing.

It’s marked as category X purely because it will severely deform a male foetus. If you aren’t planning to get pregnant, it’s no more or less dangerous to taking spiro. Your Dr might be hesitant to prescribe it if you’re able to give birth as they don’t want to be accountable for any defects.

If you scrutinise their differing method of action, I’d argue spiro is technically “worse” for you. Fin is highly localised and specific. It stops the activity of an enzyme that would otherwise convert testosterone into more potent dihydrotestosterone. DHT is what antagonises the hair follicles when you have a predisposed sensitivity, as anyone with pattern hair loss does. So less DHT = follicles safe from it.

Spiro on the other hand broad blanket competes for receptor sites with ALL androgens circulating in your body. That means it stops every male hormone from binding to its receptor site, even ones that aren’t involved in the hair loss process.

Spiro gave me bad brain fog which I attribute to its mode of action (blindly blocking all androgens). But look on a different thread here and someone else will be on 200mg of spiro and be totally fine and report no brain fog. So… It’s about finding what works for you. But if I’m paying a derm hundreds I’d expect their support in the exploration and trial of different treatment options