Switching antiandrogens, what can i expect?

[Amy1988]

Hello...my first post! yay! OK, so i went the not so okay way and done it myself. I was on cyproterone acetate and estradiol for over a year before going to a doctor. i know it's bad but i was desperate. Here's the deal, i finally went to a doctor...He's really nice and gives a darn about me.  i checked out as fine. He kept me on the same dose of estradiol but is "making" me switch to spironolactone as my antiandrogen.  Has anybody here made that switch? Any difference in how you felt afterwards? i'm just scared i'll feel different.

I self medicated too for about a year out of desperation.  I finally found a doctor who would help me.  It's a dam shame that people have to resort to self medicating in the 21st century.

[KayXo]

According to studies, bicalutamide appears safer, more convenient and more effective than flutamide.

http://www.ncbi.nlm.nih.gov/pubmed/16845534

"There are no direct comparisons between the three non-steroidal antiandrogens in terms of quality of life, but available evidence suggests that bicalutamide has a more favorable safety and tolerability profile than nilutamide and flutamide."

Urology. 1996 Jan;47(1A Suppl):70-9; discussion 80-4.
Worldwide activity and safety of bicalutamide: a summary review.

"Bicalutamide is a new antiandrogen that offers the convenience of once-daily administration, demonstrated activity in prostate cancer, and an excellent safety profile. Because it is effective and offers better tolerability than flutamide, bicalutamide represents a valid first choice for antiandrogen therapy in combination with castration for the treatment of patients with advanced prostate cancer."

http://www.ncbi.nlm.nih.gov/pubmed/10587288

"Three non-steroidal anti-androgens are available in the US, i.e. flutamide (Eulexin), bicalutamide (Casodex) and nilutamide (Nilandron). Nilutamide offers patients no benefit over flutamide or bicalutamide and has the least favorable safety profile. Because of its short half-life, flutamide must be administered 3 times a day. Furthermore, flutamide therapy is associated with a relatively high incidence of diarrhea, often intolerable for some patients. Bicalutamide is available in a convenient one tablet, once-a-day dosing regimen, is at least as effective as flutamide and is better tolerated in terms of diarrhea."

Arch Ital Urol Androl. 1999 Dec;71(5):293-302.
Antiandrogens: a summary review of pharmacodynamic properties and tolerability in prostate cancer therapy.

"As regard as pure antiandrogens clinically important adverse events including gastrointestinal events, particularly diarrhea and occasional disturbances of liver function related to flutamide treatment and antabuse effect, problems with light-dark adaptation and rare interstitial pneumonitis related to nilutamide indicates the bicalutamide, due to its better tolerability profile, together with its once-daily oral administration regimen, could be considered the antiandrogen of first choice in the treatment of prostatic cancer."

[Kaley]

I too am currently self medicating (for about 5-6 months now) on cyproterone acetate and estradiol and have not seen any negative side effects at all.  Compared to back when I was on spironolactone, the AA effect of cyproterone is much more powerful and caused quicker changes.  I also disliked spironolactone due having to pee a lot more often! 

Anyways, I have been taking the appropriate steps to doing HRT the right way and according to my initial consult, the dr will switch me to spironolactone (due to being in the US) and estrogen injections.  I am kind of looking forward to trying the estrogen injections, but my feelings about spironolactone are somewhat mixed.

[KayXo]

Since you will be on injections, you should be fine since E should strongly suppress your T and will be quite effective at feminizing. On injections, some don't even need anti-androgens at all. Really, no worries!

[Kaley]

Since you will be on injections, you should be fine since E should strongly suppress your T and will be quite effective at feminizing. On injections, some don't even need anti-androgens at all. Really, no worries!

Wow, really!??  I did not know that!  Are estrogen injections really that much more effective than the pill form??  I guess I will have to see then, but I will still most likely add on the spironolactone just to make sure the nasty T goes away and stays away!!

[Sammy]

Maintaining funcionality is a necessary evil if you are planning to go for SRS, specially if it is going to take several years.

Right now I can't get it to work, but that's because my body only allows one weight hanging from my wiener, and that's androcur. Add another thing such as lorazepam / ativan, or being really anxious or depressed, and it won't raise. I just do it once a week just for maintenance purposes.

Is Lorazepam considered to have antia-androgenic properties or it is just anti-anxiety drug only? /curious, cause I was on it during my childhood alongside other "interesting" drugs (haloperidol etc), because of ADHS/hyperactivity/

[Aquarelle]

I've been on Spironolactone and I personally find it almost ineffective in doses, that do not cause nasty side effects. I had got far better results with Androcur...

[KayXo]

Are estrogen injections really that much more effective than the pill form??

It does depend on the dose prescribed but usually, at typical doses prescribed, injections appear to, at least give much higher levels with a better ratio of the strongest estrogen (estradiol) to weaker estrogens such as estrone with transwomen usually doing better on injections vs pills. But, no guarantee. Just wait and see.

[Hikari]

I've been on Spironolactone and I personally find it almost ineffective in doses, that do not cause nasty side effects. I had got far better results with Androcur...

I think it makes sense really, not like Spiro is designed as an antiandrogen. I switched to Bicalutamide because of Spiro's side effects, I considered Androcur, but since it isn't FDA approved it would be a bit of a hassle to deal with, even though I know I can still get my hands on it here in the states. I have yet to really find any downside to Bicalutamide outside of cost.

I just don't get why doctors seem to love Spiro so much, for me Spiro had a real quality of life reduction and the dizzy spells were incredibly unsafe.

[KayXo]

Of all the anti-androgens, I have a personal preference for bicalutamide and LhRh agonists (or antagonists). These seem to have, overall, much less side-effects while effectively inhibiting androgens at doses typically prescribed for us. 

[VaneTS]

Of all the anti-androgens, I have a personal preference for bicalutamide and LhRh agonists (or antagonists). These seem to have, overall, much less side-effects while effectively inhibiting androgens at doses typically prescribed for us.

Hi kay, im vanessa, from Peru.Ive been reading your posts about bicalutamide.I started 3 weeks ago and in one week ill start with estradiol in GEL(its also a very good option  like injections).Early in this year i was using cyproterone  but my prolactin got too high.

I know bicalutamide is a very strong antiandrogen,but after 3 weeks i still have an oily face, oily hair.I have to wait for estrogen to reduce testosterone production(L.H) to see that?(dry face, less body hair,dry skin)?
Or maybe bicalutamide is not being effective in blocking testosterone in my body?



edited for dosages.

[KayXo]

3 weeks is too early to judge effects especially if you just stopped Androcur, I think. Hopefully, you got your bicalutamide with a prescription and you are taking enough, under the supervision of a doctor.