Anti-Androgen in Cis-male? Testicular pain? Hate Your Penis?

[Mara]

I have a bunch of questions that I need to ask.

Question 1: If a cis-gendered man were to take/use an anti-androgen for several months without knowing that it is an anti-androgen, could that cause him to question his gender identity?

I just found out that I was using an anti-androgen for several months around the time that I started to seriously question my gender, and I did not know that it was an anti-androgen. Specifically, I was using prescription strength ketoconazole cream applied directly to my penis and scrotum in an attempt to treat a fungal infection that was resistant to everything they had over-the-counter. I'm worried that it might have also damaged my liver because my blood tests for starting HRT weren't so good, and I did not know that you should not drink alcohol while using that medication. I can't ask a doctor about it because I didn't get it from any doctor.

Question 2: Is it normal for spironolactone to cause testicular pain? I'd think it is normal considering what it does to them, but I just wanted to check and hear other people's experiences.

Question 3: As a followup, did you hate your penis and really want to be rid of it when you first began HRT? I feel like it is pretty much a requirement to go through with MtF HRT considering what the medications do to it. I felt a lot of pain in my testicles every time not long after taking spiro, and I don't really want the pain. I don't hate my penis. I was under the impression that I could maybe still be transgender without completely hating my penis, but now I'm not so sure. It seems like a lot of the MtF's on this site would want SRS even if they couldn't take hormones.

I've stopped HRT for now and am going to sort this all out before starting again (or giving up entirely). Any help is appreciated.

[LordKAT]

First, self medicating is dangerous, please see a doctor. You can ask about medication you have used even if it wasn't prescribed. Second, try to find a gender therapist. They can do wonders when it comes to answering your questions as well as pointing you to appropriate doctors and such. The help in sorting out your feelings can be invaluable.


I can't do much to answer your questions directly as I have no experience with them.

[Mara]

First, self medicating is dangerous, please see a doctor. You can ask about medication you have used even if it wasn't prescribed. Second, try to find a gender therapist. They can do wonders when it comes to answering your questions as well as pointing you to appropriate doctors and such. The help in sorting out your feelings can be invaluable.


I can't do much to answer your questions directly as I have no experience with them.

I know its dangerous. Can't change the past. I was sort of pressured into it and didn't realize just how strong of a medicine it was, and I doubt a doctor would know how it works in regard to gender identity anyway. I want to know from people who have put hormones into their body whether or not the act of taking the hormones can alter one's gender related feelings and self-perception or not. Did anyone feel more feminine or more masculine after taking hormones, or did their dysphoria increase for a time? Before I started questioning my gender and used that medication, I was mildly interested in cross-dressing, but I never even guessed that I might be transgender.

I've been seeing a gender therapist for months. Still can't sort out my feelings. I go to therapy every week, and I always leave just as confused as when I started. I don't think therapists are all that they're cracked up to be. I saw one for a couple of years in high school, and I'm not sure it helped much. Maybe psychotherapy just doesn't work very well. Anyway, whatever sort of magic is supposed to happen at the gender therapist's office is not happening for me, and the one I'm seeing is very experienced with trans people.

[Cindy]

HRT does not change your gender. It allows  you to live in your affirmed gender.

The AA spiro is used to treat cismales for heart issues. It doesn't change their gender.

[Dee Marshall]

In my case, well, let me give you an analogy...

For perfectly normal (but uncommon) medical reasons my body began reducing testosterone about 15 years ago.

Imagine that estrogen and testosterone are two radio stations close together. In men the estrogen station broadcasts nothing in particular, in trans women it broadcasts "you're a girl", the testosterone often, but not in all cases, broadcasts "you're a guy" or something else that drowns out the weaker estrogen station.

Then something happens that begins to degrade the testosterone signal. You get the estrogen signal clearly. If you're not trans you get something innocuous, maybe easy listening or farm reports, who knows.

Trans women get stronger and stronger "you're female" propaganda from Radio Free Female.... And that's how I became a defector in the war between the sexes.


Wow, that was a really clumsy analogy, but I hope it gets the point across.

[suzifrommd]

Question 3: As a followup, did you hate your penis and really want to be rid of it when you first began HRT? I feel like it is pretty much a requirement to go through with MtF HRT considering what the medications do to it. I felt a lot of pain in my testicles every time not long after taking spiro, and I don't really want the pain. I don't hate my penis. I was under the impression that I could maybe still be transgender without completely hating my penis, but now I'm not so sure. It seems like a lot of the MtF's on this site would want SRS even if they couldn't take hormones.

I've been on HRT for years and completed SRS last summer.

I never hated my penis, right up until surgery. I'm still thrilled that I went through with it all.

A LOT of trans women don't hate their penises.

However I did hate not having a vagina, if that makes any sense.

[Jenna Marie]

(Never took spiro, so I'm no help there, but I'll second the fact that its legal/FDA-approved use is as a blood pressure medication which is given to cis men as well.  In lower doses, but the amount absorbed by topical application of a cream is probably consistent with the amount of AA a cis guy gets from blood pressure treatment, and they don't decide they're women because of it.)

I started HRT without hating my penis, and I continued to not hate it for years thereafter. I admit I did *come* to hate it, but that wasn't a prerequisite for being trans or transitioning, it was the result of seeing my body otherwise become more and more correct. Anyway, the "you must be/feel/know X to be trans" thing is a myth that I wish would DIE, because it almost talked me out of transitioning... and it turns out that even though I didn't know since I was a child, and I wasn't suicidal or desperate, and I didn't hate my penis, and I wasn't sure transition would do anything but make me happ*ier,* I was and am "really trans."

[Cindy Stephens]

Spironolactone doesn't cause damage to your testicles.  Think of a hormone like this.  The hormone molecule has a particular shape, like the key to a lock.  You (and Women also) have receptors that are like the lock. 
A Testosterone molecule goes into the lock and opens it.  That causes your voice to deepen, facial hair to grow, and all the other symptoms of testosterone poisoning.   Spironolactone is shaped so it fits into the lock, but CANNOT activate it!  Now, when a molecule of testosterone comes around, it finds the lock already filled.  That causes your free testosterone levels to go up, because it has no place to go.  THEN your body senses this and tells your testicles to "kick back." Over time, you just produce less of it because of this feedback loop.  Therefore it never really attacked your body in any way, leaving it undamaged.

[Mara]

In my case, well, let me give you an analogy...

For perfectly normal (but uncommon) medical reasons my body began reducing testosterone about 15 years ago.

Imagine that estrogen and testosterone are two radio stations close together. In men the estrogen station broadcasts nothing in particular, in trans women it broadcasts "you're a girl", the testosterone often, but not in all cases, broadcasts "you're a guy" or something else that drowns out the weaker estrogen station.

Then something happens that begins to degrade the testosterone signal. You get the estrogen signal clearly. If you're not trans you get something innocuous, maybe easy listening or farm reports, who knows.

Trans women get stronger and stronger "you're female" propaganda from Radio Free Female.... And that's how I became a defector in the war between the sexes.


Wow, that was a really clumsy analogy, but I hope it gets the point across.

I get it. Thank you for that analogy!



I found a study that suggests cis-men using sprio rarely experience testicular pain, so maybe its not surprising I'm experiencing such awful pain given how high my dosage is. It is still probably a fairly rare occurrence though.

[ImagineKate]

My GD only spiked and the bell rang after I started taking statins, at least that is my theory and the timeline makes sense. I had low T before though but statins do lower it. Dee's analogy makes perfect sense to me as a broadcast eng and a ham radio operator. But I must stress that it was always "there" with me since I was 4. I just was able to stuff it down and bury it. But I have had bad episodes in the past if dysphoria.  So if whatever I was taking had an effect, it did not cause anything. Maybe it just revealed what was there and made it clearer to me.

I do take spiro for blood pressure in addition to it being an anti androgen. It is a potassium sparing diuretic and my other medications were adjusted appropriately. It works. The doctor and nurse practitioner know what they're doing and they test me and follow up regularly.

[Mara]

So the spiro is causing me unbearable pain in my left testicle. The tube connected to the ball feels swollen. I'm pretty sure its my fault for damaging it with binding. Otherwise, it is a cyst or something else bad. I really hate myself.

I'm going to have to stop HRT. A half dose might work, but the pain is so bad that I'm afraid of the medication now. I suppose I could try to see a urologist, but they probably wont be able to do anything, and an appointment could take months.

[Leila]

If as you say you've been binding, then it could have caused a varicocele, so you probably want to see your GP/urologist to get the pain checked out. One of the issues with having an untreated varicocele aside from any pain is infertility, but I doubt you'd be too concerned with that.

[Mara]

If as you say you've been binding, then it could have caused a varicocele, so you probably want to see your GP/urologist to get the pain checked out. One of the issues with having an untreated varicocele aside from any pain is infertility, but I doubt you'd be too concerned with that.

Thank you very much for suggesting that. That is almost certainly what the issue is. There was no pain or noticeable swelling prior to HRT, and since I didn't take spiro this morning, the swelling has gone down considerably and the pain is almost entirely gone.

From what I'm reading about it, this wouldn't be an issue if I weren't trying to start HRT since it was causing no pain, no noticeable swelling, and no decrease in sperm production or testicle volume prior to starting HRT. It says that they usually do nothing unless its an issue like that, and then it seems the recourse is surgery?