Author Topic: estrogen without Spiro or other anti-Androgen??  (Read 474 times)

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Offline iskra

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estrogen without Spiro or other anti-Androgen??
« on: May 03, 2021, 02:20:10 pm »
Got a script today  for estrogen(pills) but without Spiro. Anyone heard of such an approach? I don't like it. I'd rather experience some of the androgenizing effects of Spiro before I jump headlong into estrogen. It suites my approach to gender transformation better but the person prescribing it was not sensitive to this and simply didn't care. Maybe I need a different clinician. She seems a bit frosty. Also she named taken aback when I said I wanted smaller breast development rather than larger if my genetics allows that. She seems very narrow minded. My sense is that she is not a specialist in this field.

Offline Northern Star Girl

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Re: estrogen without Spiro or other anti-Androgen??
« Reply #1 on: May 03, 2021, 02:24:57 pm »
Got a script today  for estrogen(pills) but without Spiro. Anyone heard of such an approach? I don't like it. I'd rather experience some of the androgenizing effects of Spiro before I jump headlong into estrogen. It suites my approach to gender transformation better but the person prescribing it was not sensitive to this and simply didn't care. Maybe I need a different clinician. She seems a bit frosty. Also she named taken aback when I said I wanted smaller breast development rather than larger if my genetics allows that. She seems very narrow minded. My sense is that she is not a specialist in this field.
@iskra
Dear Iskra:
I have gone to other doctors in the past to be able to obtain 2nd opinions... hopefully you can find another nearby doctor to either confirm what your present doctor is prescribing or to come up with something different.
 
Doctors make their medication prescriptions based on your blood test results and labs so perhaps there is a factor that you are not aware of.

 ... in addition, if you are not happy with your present doctor's demeanor and how she reacts with you then that perhaps would be a good reason to look for a change of physicians.
HUGS,
Danielle
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Offline Rakel

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Re: estrogen without Spiro or other anti-Androgen??
« Reply #2 on: May 03, 2021, 07:03:01 pm »
Got a script today  for estrogen(pills) but without Spiro. Anyone heard of such an approach?

This was quite common many years ago. Today we commonly use an anti-androgen does speed up the feminization process. This is not absolutely necessary, though. Estradiol alone will decrease your natural Testosterone production. It just takes a few months before this will show on your blood tests.

Spironolactone is not without it's own issues. There are a number of people like us who just cannot tolerate the side effects of Spironolactone.





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Offline iskra

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Re: estrogen without Spiro or other anti-Androgen??
« Reply #3 on: May 04, 2021, 11:27:00 am »
I am going to get a second opinion since there is nothing in my blood tests to justify that approach. My labs were basically perfect. She said that that was just her way of doing it. Well, my way of doing it is to get a second opinion from someone who isn't dismissive of my concerns. My gender therapist, with whom I spoke yesterday, also told me to get another doctor, don't even bother with someone who dismisses you like that.  I Also note, she's an NP  not a physician, let alone an endo.

Offline Allie Jayne

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Re: estrogen without Spiro or other anti-Androgen??
« Reply #4 on: May 04, 2021, 09:36:23 pm »
Search for Transgender Estrogen Monotherapy and you will find lots of information on this and a lot of support among doctors. I’ve never taken anti androgens, and my pre op blood T was adequately suppressed by estrogen alone, and my endo was very happy with this.

Hugs,

Allie

Offline iskra

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Re: estrogen without Spiro or other anti-Androgen??
« Reply #5 on: May 05, 2021, 09:09:16 am »
Search for Transgender Estrogen Monotherapy and you will find lots of information on this and a lot of support among doctors. I’ve never taken anti androgens, and my pre op blood T was adequately suppressed by estrogen alone, and my endo was very happy with this.

Hugs,

Allie
Fine, but what if you don't WANT estrogen monotherapy? Some people prefer not to start with E alone, and you will find support for that on the UCSF guidance statement. We could do this all day: you find a source for your desired approach, I find a source for mine. We then have a battle of the publications. Since my approach is more common, starting with S alone, you seem to be missing the big picture. The question isn't whether you can find support for your approach but how typical it is. estrogen monotherapy is not typical . Why on earth should I be forced to do the atypical.  I should need to need to justify the atypical, not the typical! It's crazy logic.The Mayo Clinic states that starting with S  alone is the typical approach.

Offline Allie Jayne

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Re: estrogen without Spiro or other anti-Androgen??
« Reply #6 on: May 05, 2021, 01:17:41 pm »
Fine, but what if you don't WANT estrogen monotherapy? Some people prefer not to start with E alone, and you will find support for that on the UCSF guidance statement. We could do this all day: you find a source for your desired approach, I find a source for mine. We then have a battle of the publications. Since my approach is more common, starting with S alone, you seem to be missing the big picture. The question isn't whether you can find support for your approach but how typical it is. estrogen monotherapy is not typical . Why on earth should I be forced to do the atypical.  I should need to need to justify the atypical, not the typical! It's crazy logic.The Mayo Clinic states that starting with S  alone is the typical approach.

Iskra, I’m not forcing you to do anything, you asked if anybody had heard of that approach, and I answered you. If you don’t like the treatment you are getting, look for other options!

Allie

Offline iskra

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Re: estrogen without Spiro or other anti-Androgen??
« Reply #7 on: May 06, 2021, 10:47:02 am »
Search for Transgender Estrogen Monotherapy and you will find lots of information on this and a lot of support among doctors. I’ve never taken anti androgens, and my pre op blood T was adequately suppressed by estrogen alone, and my endo was very happy with this.

Hugs,

Allie
Sorry I didn't mean to snap at you. I'm just disappointed that my first practitioner, after this whole journey, turned out to be so unsuitable and basically mean. The word I have in mind  rhymes with witch. Maybe she enjoys the gatekeeper role.There are such people unfortunately.

Offline Myranda

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Re: estrogen without Spiro or other anti-Androgen??
« Reply #8 on: May 06, 2021, 03:43:51 pm »
Sorry I didn't mean to snap at you. I'm just disappointed that my first practitioner, after this whole journey, turned out to be so unsuitable and basically mean. The word I have in mind  rhymes with witch. Maybe she enjoys the gatekeeper role.There are such people unfortunately.

Yes people have heard of it, and some have started off with just E alone.  Others have opted to go just E alone.

I';m not sure what the problem was with the earlier replies, but it sounds like your doctor is not listening to your needs.  So 1 of 2 things must happen:

1) talk to your doctor about your concerns with the approach they are taking, and what exactly you are looking to accomplish with your transition, and why they are prescribing what they are and what they are hoping to accomplish, specifically as it relates to your lab work/hormone levels.

2) seek a second opinion and find another doctor who will listen to you and your desires and concerns, and work with you.




Offline iskra

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Re: estrogen without Spiro or other anti-Androgen??
« Reply #9 on: May 06, 2021, 06:19:23 pm »
Yes people have heard of it, and some have started off with just E alone.  Others have opted to go just E alone.

I';m not sure what the problem was with the earlier replies, but it sounds like your doctor is not listening to your needs.  So 1 of 2 things must happen:

1) talk to your doctor about your concerns with the approach they are taking, and what exactly you are looking to accomplish with your transition, and why they are prescribing what they are and what they are hoping to accomplish, specifically as it relates to your lab work/hormone levels.

2) seek a second opinion and find another doctor who will listen to you and your desires and concerns, and work with you.
'talk to your doctor...she has made herself unavailable and doesn't listen anyway. I have a new appt. with a new doctor.what a miserable first experience.

Offline AnonyMs

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Re: estrogen without Spiro or other anti-Androgen??
« Reply #10 on: May 07, 2021, 04:08:03 am »
There’s tons of HRT resources online if you want to understand this subject better, which considering the number of bad doctors around would be a good idea.

Estrogen suppresses testesterone, but the amount required and how much suppression you get varies among individuals. Not everyone can suppress testosterone with pills and there’s a limit to how much you can safely take with pills. Injections can be stronger and suppress testosterone in more of us, but not all. The remainder will required another means, but the only way to find out is to try. And there’s plenty of doctors around who won’t follow this approach and just hand out antiandrogens to everyone.

Offline Myranda

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Re: estrogen without Spiro or other anti-Androgen??
« Reply #11 on: May 07, 2021, 06:43:39 am »
'talk to your doctor...she has made herself unavailable and doesn't listen anyway. I have a new appt. with a new doctor.what a miserable first experience.

Well the good news is that you will be seeing a different doctor, and I for one am wishing you better luck with the second.  You are most assuredly better off without the first.

this is an incredibly personal journey, and the only way it can succeed is if you feel comfortable.



Offline iskra

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Re: estrogen without Spiro or other anti-Androgen??
« Reply #12 on: May 07, 2021, 09:34:16 am »
There’s tons of HRT resources online if you want to understand this subject better, which considering the number of bad doctors around would be a good idea.

Estrogen suppresses testesterone, but the amount required and how much suppression you get varies among individuals. Not everyone can suppress testosterone with pills and there’s a limit to how much you can safely take with pills. Injections can be stronger and suppress testosterone in more of us, but not all. The remainder will required another means, but the only way to find out is to try. And there’s plenty of doctors around who won’t follow this approach and just hand out antiandrogens to everyone.
I want the anti-androgen. That's the whole point. I want to explore life without T for a month or whatever, so that I can ease into feminization before I start estradiol, which I do indeed intend to use. Psychologically this would be better for me. Too bad I didn't just get a normal doctor, or least one who is not so inflexible. To preempt what you'll likely say, there is nothing in my labs contraindicating Spiro. No, the doctor isn't always right. Only a simpleton could believe that, not that you're claiming it, but many are indeed biased in favor of the opinion of those overworked, under informed people in the white coats.they make an astonishing number of errors.

Offline AnonyMs

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Re: estrogen without Spiro or other anti-Androgen??
« Reply #13 on: May 07, 2021, 06:36:43 pm »
Usually when you go on estrogen and antiandrogens you don’t start both at the same time just in case there’s problems. You want to know which one causes it. I’m surprised a doctor who prescribes both would refuse to start you on whichever one you chose, and personally I’d change doctor. It’s not a good sign for the future.

Personally I think it’s better to start with estrogen as it’s the one that’s going to make you feel good, and it’s possible you won’t need the antiandrogens at all. Spiro is not without its side effects and some people believe that it can have some very negative long term side effects.

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