.

[XchristineX]

I am getting used to my Spiro now. Can almost sleep the whole night.

But still wake up around 5 6 in the morning and have to Run to
Pee ...4 months its taken to get used to it

[FrancisAnn]

I want all T gone, breasts, all other nice pleasant changes with HRT however this pee, pee, pee every 10 minutes is going to take a while to get used to. Do natural women have to pee so often?

[kelly_aus]

I want all T gone, breasts, all other nice pleasant changes with HRT however this pee, pee, pee every 10 minutes is going to take a while to get used to. Do natural women have to pee so often?

Some T is actually required..

[Tammy Hope]

on a somewhat related note, I've been given to understand, since I started looking into HRT, that once you take Spiro in high dosage for a certain period of time (9 months? 12? 18? Not sure which) that the effects are permanent and it can be discontinued.

anything to that?

[kyh]

Well maybe HRT can do that but like I said spiro didn't even make any difference for me so what would there be to reverse?

More and more I think E is the only thing actually useful in an HRT regimen... it lowers the T and it feminizes and yeah unless I am a special case, I don't know if spiro actually does either.

But yes they do say once you stop producing T long enough it becomes permanent...

Guess that's what people mean when they say chemical castration.

[kyh]

They use androcur for that

Androcur is a type of anti androgen right? Is it really different from what spiro does?

[Tessa James]

Thanks all for the great discussion, detailed pharmacology and personal experience.  Now on Spio and Estradiol for almost two months the pee and pee diuretic effect is too real while my happy little breasts feel thrilling if constantly achy.  Spiro is tough on our livers while the patches are kind of annoying for placement and adhesives.  Gives me reasons to consider an orchi over the long term.  This is transition and along with our name we get to tailor our journey---what a ride!

[Tessa James]

Significant hepatic (liver) damage and problems associated with spironolactone are "rare" but alcohol may be a concern relative to the metabolic demands on the liver from the combination.  No personal judgement, I drink too;-)

[Dawn Heart]

The things that make me really nervous about Spiro at this point (I already have it on hand, but waiting to start my HRT until better weather so I can be active and avoid problems from lack of exercise):

1. The potential potassium and resultant kidney problems

2. The long list of drug interactions and the fact that I NEED to take certain drugs that Spiro interacts with, or could need them in an emergency. I don't need emergency personnel between a rock and a hard place if I have a medical emergency because of Spiro.

3. I know the racehorse effect well, having once taken Lithium and the Lithium had me running to the bathroom. I also have a metabolism that has a history of sudden changes, and that could really be a problem with Spiro.

The more research I do on this drug, the more I start asking myself if Spiro is necessary or even worth the potential problems. E seems to be THE drug that does most of the work according to most people and according to the posts here. As someone else said above my post, there are alternatives.   

[Alainaluvsu]

I am surprised everyone sees such a diff. on spiro, I did not think anything of it or notice I had to go to the bathroom more (but yeah again... long used to having to pee all the time lol)

There's one factor I think a bunch of us are overlooking in your "chart"... You're young, as in puberty age, correct? If so, this may explain why Spiro alone does nothing for you. Completely theoretical: but if I had to guess, since biologically you are suppose to be going through male puberty, I'd be willing to bet your brain doesn't CARE that there is tons of free T in the blood. It only wants your testes to produce more T because you're at the age where "that's what they're suppose to do".

If I remember correctly from reading your past posts, you claim that you have no trouble passing despite the high T levels. Since T isn't binding to the AR, then this would explain why you have only minimally masculinized instead of masculinizing at a rate most teenage males would. However you are correct, I believe, in your comments claiming that E is a better inhibitor of T.  But only if the T doesn't block the E from doing its job.

Spiro DEFINITELY inhibits the effects of testosterone, and over time nukes it. Go on any hair loss forum or body builder forum and you will see men talk about how Spiro is almost like a death sentence to your masculinity. That's all the anecdotal evidence you'll need IMO.

[Alainaluvsu]

I think Spiro may be useless after some time of fully suppressing T, but I'm not sure. I've been in for tests where my E was as low as 72 and my T was as low as 7, which either means Spiro IS suppressing T (as these were total T levels from serum), or that being on HRT for 18 months has completely castrated me. I think for many of us, Spiro is needed. But my question I guess is for how long? Lifetime? 2 years? 1 year?

Honestly I think it'd be smarter and would produce better results to start on a full dose of both E and T blocks. When you see levels, adjust accordingly. If T stays suppressed after a year, ween off of Spiro. I understand that doctors don't want to start you out on a full dose to protect themselves, but I really think the first 6 months or so that HRT levels are so critical to feminizing. I think they should be highly elevated so the cells in your body can create estrogen based fat before it learns to metabolize the excess chemical more effectively.

I'd love to see a study done on this, where 100 MtFs are put on a HRT regimen where 40 are given a full dose at start, 40 are given a "careful dose" of some kind, and 20 are given a placebo of some kind. Then, over a 3-5 year period, record things like HRT levels, breast growth, epidermal layer thickness, thigh hip and butt fat, emotional stability, and the patients overall impression of feminization effects after the given time is over. I'm willing to bet the ones who start out full blow full dose everything get better results with easier suppression of hormones.

[Alainaluvsu]

When you talk about the body getting used to metabolizing the E, you don't mean it like slowly gets less effective over time right??? 

Long post incoming (I'm usually short and sweet)

Keep in mind what I'm saying is almost completely theoretical on my part as far as the body learning to get rid of E quicker. I think the body simply learns how to get rid of the E in a faster, more effective way over time. However, I think in the first few months, it is very crucial to make sure the cells have enough estrogen so they can learn how to utilize the E before it gets flushed out by your system. From what I've read, when you start taking E, it goes into your cells and the amount of estrogen receptors in each individual cell determine your progress. I've also read that when you start, your body starts developing NEW cells that are more responsive to estrogen (perhaps in the breast tissue, hips, thighs, buttocks, subcutaneous fat?). I think the amount of initial flooding determines the amount of new cell growth with more affinity to estrogen. However, maybe if you don't initially flood, the body learns to flush it quickly enough to not build these cells, or even supply all the current cells it has with the amount of E they need for maximum feminization.

Again, purely theoretical... the only evidence I have is anecdotal...

I've met a bunch of trans people. The most passable ones that have started between their 20s and 40s are usually the ones who started out on a pretty high dose from what I've seen. For me, I started out high, 5 months in my E was ridiculously high. My E dose alone was cut by 33%, and my E levels plummeted. I have since went back to my starting dose and they rebounded, but nowhere NEAR my 5 month mark. However, staying on a high dose has turned me from a no-way-are-you-anything-but-a-guy to not even being clocked by some at trans support groups.

This leads me to believe, at least, that the body either learns to get rid of the E more effectively, or that the body has used that high E level to build many new cells and it takes more E to "feed" them. The only thing is... post ops and cis women don't need to take a high dose like me to get the levels up... so something doesn't fit? What's weird is my T has been suppressed the entire time (never tested above 25) even when my E was low (once at 112, with T of 7 and another E= 72 T = 9). Which leads me to believe that the E is attaching very well to something and I have just enough free E to have "Elevated" E for men in the serum.

Others, however... Well a friend of mine for example. She started on a low dose and she's having trouble suppressing her T 7 months in even when she ups her dose. She doesn't do tests (can't afford them) but she smells like a male. Her first few months, she was developing wonderfully. Her face was rounding QUICKLY and her skin was clearing up and softening too. However, the past 3 months she has been starting to revert. She upped her dose a month ago, and while the smell is getting less manly, she's not really developing much at all anymore.

Another one of my friends, she was on a fairly low dose at first. 3 months in, her E was in the 300s, her T was in the 40s or so. 6 months, E was in the low 200s, T was still suppressed (don't remember the number). She was developing really well at first. Her breasts were on the slow side to develop but her skin was REALLY clearing up and her face was softening, with her body fat distributing fairly quickly. After about the 8 month mark, she just hit a dead end and stopped any development.

There's also a documentary about trans women in prison called "Cruel and Unusual" that's been posted on YouTube. In it, a girl that is CLEARLY unpassable (poor gal) claims that before going to prison, she was more feminine looking. However, after coming out of prison, she never really developed back. Which leads me to believe the body DOES get used to the E and learns to flush it. Almost as if the E is a pathogen in a way, and the body develops an immunity of sorts if you go off. Or maybe it's because the body rids itself of the E cells and they do NOT grow back... who knows?

The women over 50 however get a different result. I've found almost all of them have really good results when they start late. I think this is because the T is easier to suppress since their body makes less of it as you age (1% less every year over 35 if I'm not mistaken). Starter dose or no... didn't matter. They almost always develop very well.

This leads me to believe that T suppression is ABSOLUTELY CRITICAL in the entire scheme. And the earlier into HRT you get it down and keep it down, the better results you will get.

[Alainaluvsu]

Obviously every bodies biochemistry is different, so maybe you just don't react to Spiro that well. Also, maybe 2 pills isn't enough for you. Maybe you need 3 or 4. If you've been swallowing the pills, I'd suggest going sublingual until you can get another form (injection, topical, etc). Swallowing the pill outright IS going to go through the digestive system before reaching the blood. Perhaps your liver is breaking down the E way too much to be effective by swallowing the pill. With sublingual administration, it reaches the blood first. As far as non-oral Spiro, from what I understand it is not as potent. However, who knows... idk if any analysis has been done when topical Spiro has been used in conjunction with estradiol administration.

Either way, your E is way too low to initially suppress the T IMO. IDK why your doctor is satisfied with the levels being <100. Most literature I've seen calls for our levels to be constantly above 150. Honestly, I'd look for a new doctor or take things into my own hands.

A girl sent me a message on here today, actually, saying she had satisfactory results in breast growth using a cyclical method, using progesterone every so many days in combination with the patch. In this method, the E has a natural rise and fall like that of a cis womans. If this is something that interests you, maybe you can do some research into it...

[Theo]

Hm. My E was up at 165 pg/ml after 6 weeks (the first 3 of which were on a lower starting dose), and that was without any sort of T blocker. My endo added low dose andro at that point, as my T levels were still too high. Breast growth, rather than just a tingling feeling with my gynecomastia simply getting more "fleshy", has since started. It also sped up the process of my skin becoming a lot smoother. According to instructions, I simply swallow all my pills in the morning.

I guess that, at least for me, it is really the combination of a decent E level combined with my T being clobbered down that does the trick; which seems very much in line with what Alaina is saying.