Spironolactone and Breast bud fusing

[Tessa James]

Thank you all for this informative discussion and issues to discuss at my next endo appointment.

Our very personal development and safety are reasonable issues to discuss with you who are there and our clinicians.

[Violet Bloom]

  I will be very interested to hear the feedback any of you receive when raising this issue with your health care provider.  Hopefully there will be some discussion about the various up and down-sides to the various AAs.

[KelsieJ]

I hope nobody ever puts a pill in their mouth, but I know it takes time.

Curious, Jenny - what's your reasoning behind that?

Kelsie

[Jennygirl]

Curious, Jenny - what's your reasoning behind that?

Kelsie

When you eat estradiol, it passes through the liver and much of it is converted to estrone- an estrogen that does exist naturally in the body but in very small doses. It is the primary reason people get bad side effects from oral hrt / birth control because the level becomes much higher due to the liver conversion. Estradiol is what you want, it is 10s of times more effective for feminization compared to estrone (by weight) and actually extremely good for you. Estradiol will actually extend your life expectancy if you start it before testosterone related health problems arise. Estrone does not have these natural healthy benefits, and high levels of it in your blood stream is flat out bad for you. Quite the opposite of what we want.

By adding estradiol straight into the bloodstream, it avoids the initial phase of liver conversion- which means lower doses, higher feminization, and vastly lower risk of health complications like bloot clots / weight gain / mood effects.

Our bodies are not designed to EAT hormones. Actually the liver is set up to protect against it, hence why a healthy liver is so drastically important for oral HRT and why eating plant estrogens simply does not work. It puts a lot of load on your body in all the wrong ways. Endocrinologists should do away with all forms of oral completely when treating trans people especially because of the high dose that is needed due to estrone conversion. It is less of a problem for cis females who need a much smaller dose, but it's still not good- just less bad.

[Ms Grace]

I've been on Spiro about four months and was on Androcur and some other AA (and two Es) during my first transition. I've had considerably better breast development and growth this time than I had after 26 months on HRT last time so I'll be interested to hear back from Cindy.

BTW, just what exactly does "breast bud fusing" mean? Sounds very nasty!

[Ashey]

When you eat estradiol, it passes through the liver and much of it is converted to estrone- an estrogen that does exist naturally in the body but in very small doses. It is the primary reason people get bad side effects from oral hrt / birth control because the level becomes much higher due to the liver conversion. Estradiol is what you want, it is 10s of times more effective for feminization compared to estrone (by weight) and actually extremely good for you. Estradiol will actually extend your life expectancy if you start it before testosterone related health problems arise. Estrone does not have these natural healthy benefits, and high levels of it in your blood stream is flat out bad for you. Quite the opposite of what we want.

I may be misremembering this, but doesn't spiro help keep estradiol from converting to estrone? Something about blocking receptors of some sort and leaving free estradiol.

[Bardoux]

Spiro has many medical uses but in the transgender field is used as a AA and very weak Progestin (not the same as Progesterone) to my knowledge. It doesn't actually shut down the production of T like the GnRH injection (Decapeptyl) but prevents cells from utilising the T. I don't think it has any impact on the conversion process Ashey but i could be wrong.

Ms Grace, YES! that term scared the heck out of me!! I assume he meant it's the breast bud under the nipple fuses and prevents further growth/rounding out of the breast.

[Sammy]

So does this research essentially recommend switching to Androcure? My endo initially wanted to place me on Andro, but we decided to switch to Spiro for the beginning. I will be seeing her soon, so maybe it is time for little experimenting? And yes, I have experienced slow but steady growth, though I think the progesterone had a lot of saying into that. Apparently, I might probably end with B cup (which should be fine for me), but if I might get stuck with A.. then its not cool (I have A cup, Tanner III/IV at six months of the HRT).

[Bardoux]

No, from what i recall he didn't recommend Cyprotene Acetate either, i mean if he was just singling out Spiro i probably would have started to consider thinking about Androcur, but ultimately it seems like the hugely expensive Decapeptyl 3 monthly injection is the most effective and safest AA he uses.

[Keroppi]

So does this research essentially recommend switching to Androcure? My endo initially wanted to place me on Andro, but we decided to switch to Spiro for the beginning. I will be seeing her soon, so maybe it is time for little experimenting? And yes, I have experienced slow but steady growth, though I think the progesterone had a lot of saying into that. Apparently, I might probably end with B cup (which should be fine for me), but if I might get stuck with A.. then its not cool (I have A cup, Tanner III/IV at six months of the HRT).

I don't have a copy of the handout with me at the moment, and I haven't managed to get my hand on a copy of the article itself yet, but from what I recall the percentages for the other is even higher. Will have to check to make sure.

[MariaMx]

Same with my endo, he never prescribes the stuff and scoffed at me when I asked him about it during my second appointment 10 months ago.

I hit a full B tanner stage III at around 7-8 months of HRT , very little fat despite gaining some weight and nearly all breast tissue. Now at Tanner stage IV and still at a full B even after losing about 15lbs. For sure, all breast tissue.

Spiro is not necessary, and I'm not surprised he was lecturing about it. Estrogen and progestins seem to be the most important from my own experience. I've never put a single tablet of estrogen, progesterone, or spiro into my mouth and I never will (it's all been pellets with a few booster injections). I hope nobody ever puts a pill in their mouth, but I know it takes time.

Come on modern medicine, wise up for us! This isn't the stone ages. You don't treat gender dysphoria with prostate medicine and horse hormones.

Sorry if my rant is a little brash. It frustrates me to know that people aren't getting the care they deserve.

I've always wanted to try injections or implant, but I live in a nanny state and we are only allowed Progynova pills here because that is what "mommy" has decided is right for us

[Sammy]

I've always wanted to try injections or implant, but I live in a nanny state and we are only allowed Progynova pills here because that is what "mommy" has decided is right for us

Same story here, except it is not even a nanny state so I can at least choose between Progynova and Estrofem (which is 2 x cheaper than Progynova). But yeah, no injections here... I can only get the stuff which You can buy in pharmacies and which is intended for "normal" people, because nobody knows that transgender people exist here too .

[Mariah]

Let's see...

Augmentation vs none
Antiandrogen 72 vs 92
Cyproterone acetate 45 vs 39
Finasteride 25 vs 23
Spironolactone 16 vs 6
Dutasteride 5 Vs 3
GnRH 51 vs 40

[Keroppi]

You need to give some context to those number I'm afraid....

[KabitTarah]

You need to give some context to those number I'm afraid....

WOW yes!



So... I'm hearing that those of us in the USA are a bit screwed for options? GnRH costs a fortune... Finasteride isn't recommended as a primary AA... and Spiro is all that's left.

Which means... get that Spiro and forget about the rest... or just have an orchi and be done with it.

[Bardoux]

Also, the sample size is pretty darn small with those numbers so you couldn't draw any real conclusive conclusions from that tbh.

Thanks for posting them up Mariah!

[Keroppi]

Sample size are always small in trans research, there's not many of us (in terms of % of population). What's important is statistical confidence. Again, access to the article would help here.

[KabitTarah]

Sample size are always small in trans research, there's not many of us (in terms of % of population). What's important is statistical confidence. Again, access to the article would help here.

...but a low sample size gives a low confidence interval unless all samples showed exactly the same results... that rarely happens with anything medical and breast size in MTF transgender patients seems to be all over the board (just as it is with cis women).

[Heather]

I'm no doctor so I can't say what spiro does or does not do. But I do know that after 11 months on hrt I'm pushing a D cup and I was easily a C by 6 months so I don't think it has hurt my development one bit. But as they say your Mileage may vary and I've been very lucky so far that my body has responded so well to hrt.

[MadelineB]

Sounds like the study is using a very odd measure for determining success. Spiro is the drug of choice in a country (the US) that is culturally obsessed with large breasts, where androcur isn't avail, and where people's health coverage won't pay for g blockers except in children. So using BA surgery as the measure makes no sense.
18 months on Spiro, from A to D, fully formed, Tanner IV-V, and still growing. No P.
BA is a question of money and personal taste, which is shaped by culture.