Is there a difference US HRT vs the rest of the world

[Emily Ray]

After spending the day reviewing online information about different drugs used around the world for HRT I have questions. This is how I usually end my day in much of the world some form of 17b estradiol is used with cyproterone acetate. Here in the US the regime is again some form of 17b estradiol and spironolactone. In some instances there is the addition of progesterone of some form. My question arises because I have read that cyproterone acetate has some progestin like qualities. For those of on the US style of HRT are we getting all we need without the addition of progesterone. It must make for a confusing picture for retroactive review when comparing the outcomes of the european HRT and assuming no progesterin was used when in fact that is not entirerly the truth.

Are our american doctors really doing all they can to help us feminize our bodies? How much of a difference does the antiandrogenic drug used effect that feminization? When I first started my HRT I used Aldactone-D availabile in Mexico. It included flutamide with the spironolactone and was effective at 1/3 the typical spironolactone dose. Considering my recent trouble with testosterone I might try it again.

Huggs

Emily

[Flan]

alot of it is simply because the FDA is lazy and doesn't care about niche meds. other part is known side effects, interactions with surgery and liver health especially.

We have observed that patients who undergo an operation exceeding three hours tend to have more bleeding and the INR is reduced–possibly due to prior antiandrogenic medication with the antiandrogen cyproteroneacetate–so that such a prophylactic measure is not necessary and might introduce a risk intraoperatively.

ninja edit: most of the antiandrogen effects are, IMHO, 80% psychological as some T is needed to keep SHGB in line and things happy, but not enough T for effects (morning erections). if that makes sense