Administration of spironolactone in standard dosage to nine women with mild renal disease resulted in amenorrhea in six and marked menstrual irregularity in a seventh. Discontinuation of therapy resulted in normal menstrual periods within two months in every patient. The drug action causing this side effect may be responsible for previously reported gynecomastia, but this action is unknown. The high incidence of amenorrhea in this group may be due to increased drug susceptibility or decreased drug elimination in patients with kidney disease.