NR3C2 and Gynecomastia: The ability of spironolactone to mitigate hypokalemia should be noted because the risk of hypokalemia is reduced by 50% with MRAs, with only 7% of patients on spironolactone experiencing hypokalemia compared to 14% in the placebo group [15]. Because spironolactone has a high affinity for the mineralocorticoid receptor but is not specific for it, it also binds to progesterone and androgen receptors, which explains some of its well-known side effects, including gynecomastia and breast pain, erectile dysfunction in men, and irregular menstruation in women who are not yet menopausal.