Dangers of spiro vs cypro?

[Ruth Ruthless]

I've been 8 months on estrofem and androcur.

Been vegan for two years and lately became low fat vegan and it has successfully kept my belly fat in check which started going wild on hrt.

As I wrote in other threads I lost my sexual drive. People here suggested I take progesteron but the endo said it has too many side effects and wants me to switch to spiro instead.

I'm concerned about the side effects of spiro I read about including peeing a lot and lowering blood pressure. She assures me these are rare and the risk is minimal but I think she isn't taking into account several factors:

- most people don't eat like me and tend to have higher blood pressure so losing some wouldn't bring them down to low range
- my blood pressure is regularly 90/60 which is bottom of optimal range. If it gets any lower though...
- I fainted twice during childhood
- My mom has low blood pressure issues
- When I get up abruptly after sitting for a long time I sometimes get dizzy for a few seconds

Generally I got lots of energy. I eat 2500 calories a day and get all rda of all vitamins, minerals and proteins.

So I'm thinking spiro would be dangerous for me specifically though for most it would be no problem. What do you think?

Also about the peeing issue I already pee many times a day and wake up 3 times at night to pee so tending to pee even more would not be fun for me. Again, remember I'm eating lots of fruits and vegetables so I have lots of high water content food unlike perhaps people who eat more cooked food. I'm not completely raw but two thirds of my intake weight wise is raw fruits and vegetables.

Anyone else here eating mostly fruits, vegetables, rice, potatoes, sweet potatoes and legumes or something similar who is on spiro and ok with it or am I the only low fat vegan who happens to be a trans woman in the world?

[Spicy]

Hey another person with low blood pressure! You have me beat in pressure - I'm usually in the 105-110 range. I get a warm tingly dizzyness with a vision fade for about 5-10 seconds if I stand up too quickly.

I eased on spiro with a lower than usual starting dose to see how well I'd tolerate it. My body had a short adjustment time of increased dizziness when I started and when I bumped up in dose, but that decreased quickly both times.

I can compare this to another drug that lowered my bp to the 90 range: anafranil. I was dizzy ALL the time. Spiro has been nothing like that (and what a terrible experience that drug was!). 

I've never tried androcur, so I can't compare them.

[antonia]

I'm on Androcur and my blood pressure is on the lower side but I'm pretty active as well, most days I keep to vegetables/nuts with the occasional fish/white meat thrown in.

I don't know how much Androcur you are on but in my (somewhat limited) experience it's a very powerful anti-androgen and it's easy to bring your Testosterone levels to zero which really isn't good, perhaps you can reduce your Androcur dosage and still keep your Testosterone within the female range?

I have some friends on Spiro, one of which did not have any history of fainting but after a couple of days on Spiro she fainted at work, another one of my friends got horrible stomach cramps but I think these are exceptions, most people only notice the diuretic effects for the first while and then are fine.

[Ruth Ruthless]

Thank you for your responses. I started on a dosage of Androcur that was considered the beginner's dosage by my endo. Then I cut it in half two times, so now I am taking 4 times less of it than I started with and my endo says there is no point in reducing it more. Only switching to spiro. Pretty much I get the impression from her that she is only open to the option of staying with what I have or switching to spiro.

No registered change in testosterone or libido levels, but then again the test only registers values above 1.5 nmol/L and all my tests show I am somewhere below that.

[Ruth Ruthless]

I also tend to believe there is a connection between diet and estrogen levels. When I ate more fat, I had higher estrogen levels in my blood tests.

But my belly grew and I tended to have depressions that were a lot harder to cope with and drove me close to suicide. The exercise and low fat diet kept the belly fat and more importantly my depression in check. We raised the estrofem dosage but the estrogen levels in the blood tests still stayed at the same levels, in female range but not peak levels. I get the impression that now my dosage of estrofem is the highest normally permitted. I still cry and feel horrible sometimes but I don't want to kill myself anymore as long as I keep eating low fat and exercising. Whenever I go for a fatty treat the depression worsens but doesn't get as bad as before because it's just a treat here and there and not what I'm eating all the time like I did before.

But the endo says there is no known connection between diet and estrogen levels, but then again how many people are low fat vegans who also happen to be trans women for anyone to notice the difference?

Personally, I feel there is, and that fat in my diet raises my estrogen levels, and that at those levels they have an emotional effect that is very hard for me to cope with.

[antonia]

There might not be a direct relationship between measured blood levels but consider that CIS females will go through some drastic changes if their diet does not include enough fat/carbs including menstruation stopping so clearly there is some relationship.

I also tend to believe there is a connection between diet and estrogen levels. When I ate more fat, I had higher estrogen levels in my blood tests.

But my belly grew and I tended to have depressions that were a lot harder to cope with and drove me close to suicide. The exercise and low fat diet kept the belly fat and more importantly my depression in check. We raised the estrofem dosage but the estrogen levels in the blood tests still stayed at the same levels, in female range but not peak levels. I get the impression that now my dosage of estrofem is the highest normally permitted. I still cry and feel horrible sometimes but I don't want to kill myself anymore as long as I keep eating low fat and exercising. Whenever I go for a fatty treat the depression worsens but doesn't get as bad as before because it's just a treat here and there and not what I'm eating all the time like I did before.

But the endo says there is no known connection between diet and estrogen levels, but then again how many people are low fat vegans who also happen to be trans women for anyone to notice the difference?

Personally, I feel there is, and that fat in my diet raises my estrogen levels, and that at those levels they have an emotional effect that is very hard for me to cope with.

[KayXo]

People here suggested I take progesteron but the endo said it has too many side effects

What side-effects did he say? By the way, Androcur is a progestogen.

What do you think?

I think that this should be discussed with your endo, your concerns and all and decide together. Perhaps starting low? Or suggest instead bicalutamide which would increase your sex drive somewhat? And doesn't have these side-effects? There are are also LhRH analogues and also the possibility of taking estrogen by injection so that you don't need anti-androgen. Discuss these options with the endo and see what they say.

I'm not completely raw but two thirds of my intake weight wise is raw fruits and vegetables.

Interestingly, there is a diet close to yours where everything is eaten raw and consists of fruit, nuts and a little bit of egg yolk/fish daily. It is supposed to slim you down, make you feel good and eliminate any cellulite you might have. The Wai diet.

Anyone else here eating mostly fruits, vegetables, rice, potatoes, sweet potatoes and legumes or something similar who is on spiro and ok with it or am I the only low fat vegan who happens to be a trans woman in the world?

From what I remember, it not so much the potassium in natural foods that is the problem but that in processed foods/drinks. Also, it's important to eat enough salt and drink enough plain water on spiro.

it's easy to bring your Testosterone levels to zero which really isn't good

Why not? Who says testosterone is absolutely necessary if enough estradiol is taken? There are women who are born completely insensitive to androgen and do quite alright.

perhaps you can reduce your Androcur dosage and still keep your Testosterone within the female range?

Measuring levels while taking Androcur does not give a complete and accurate picture as what is measured might be inactive (bound to SHBG), if total testosterone is measured and Androcur also blocks some of it.

fat in my diet raises my estrogen levels

Adipose tissue (fat) contains a significant amount of an enzyme called aromatase which converts androgens to estrogens. More fat, more conversion.

There might not be a direct relationship between measured blood levels but consider that CIS females will go through some drastic changes if their diet does not include enough fat/carbs including menstruation stopping so clearly there is some relationship.

Could it be due to the lack of cholesterol as cholesterol is a precursor to all hormones or from increased stress on the body thus causing changes hormonally? I don't know, just asking and speculating...