So I am concerned that my Testosterone Levels are still High

[Shawn Sunshine]

So if my Doctor prescribes GnRH agonist, should I be then given no Spiro at all or a combo still?

[Steph34]

A GnRH agonist plus estrogen should be enough to reduce testosterone to a female level and render spironolactone unnecessary, but for me it was not. It would probably be best to have your testosterone level tested again after 3 or 4 weeks on the GnRH agonist, and to continue the spiro during that time to prevent an androgenic 'flare' caused by spiking testosterone. (GnRH agonists may cause T to rise temporarily before drastically reducing it and keeping it down for the duration of treatment.) You should discuss it with your doctor because the time frame and results may vary depending on your dosage and responsiveness to the treatment.

[EllieM]

I'm not an endocrinologist (I don't even play one on TV) and I can only tell you what I have seen here. The endo I see has been treating the trans community here for decades. All of his MTF patients (pre-op) use nasally administered Suprefact and no other anti-androgen agents. We started with a median dose and adjustments were made, lessening the dose. You are changing protocols, so there may be some crossover, but I can't say for sure. The important thing is that you are retested to find an optimal dose for you (we are all different). Ultimately, the effect of a GnRH agonist is to stop your gonads from producing T, and in my case it has done just that Of course, post-ops don't need this, but that's a ways off for me...