Prometrium and Bicalutamide

[Richenda]

Hi Kiera,

As a matter of interest why did you come off the Bic? Sorry I don't know you: did you have the GRS?

[Chloe]

. . . did you have the GRS?

No. The main reason I stopped was financial but then realized no ill reversing effects other than the positives. Having watched someone get an 'orchi' I would not recommend it feel Casodex, for me at least, was far more effective and obviously less invasive. Am sterile (still no fluid at all) but functional, not Impotent, and after years of tucking my 'junk' has become very diminutive.

The lack of hair thing continues to be a surprising bonus.

Upon my father's death am told WAS(?) high risk for prostrate cancer?

Being older and again working up to 60hrs/week with two new grandbabies in the house it feels nice to be in permanent 'nominal girl mode' without having to take or do anything!! LOL If people want to start noticing my A breasts then I'll start dressing more "en femme"

[Richenda]

Hi Kiera,

Wow that's brilliant news. I've just pm'd you. xx

[KayXo]

I think it's important to point out for anyone searching and finding this thread that the above statement may be factually incorrect. It would be wise for anyone embarking on this to look at the following links and above all to speak carefully with their physician:

http://medlibrary.org/lib/rx/meds/casodex-2/

http://www.macmillan.org.uk/cancerinformation/cancertreatment/treatmenttypes/hormonaltherapies/individualhormonaltherapies/bicalutamide.aspx

Once again, I repeat, these side-effects were noted at much higher doses. Transsexual women will usually take much lower doses, one cannot assume those side-effects will take place at these lower doses.

[AbiDrew]

Once again, I repeat, these side-effects were noted at much higher doses. Transsexual women will usually take much lower doses, one cannot assume those side-effects will take place at these lower doses.

This doesn't actually make any sense.  The idea of bicalutamide is to block the receptors, which actually increases serum testosterone.  Unless taking some kind of combination therapy with some other antiandrogen, you WANT a complete saturation of bicalutamide so that NONE of that extra T finds a free receptor.  If using combination therapy, spiro/cypro with dutasteride is a more effective combo than any combo with low dose bicalutamide could be.  High dose bicalutamide, on the other hand, makes combination therapy useless and unnecessary.  It's actually the folks using it on-label that require only a lower dose, in combination with drugs that prevent any potential for feminization.

[Richenda]

Abi you sound like you know what you're talking about. What would be your advice about post-GRS anti androgens for someone who has been taking them for c.18 months? Would you cold turkey on the grounds that 95% of T is cut off from its source? Or would gradually withdraw as a few people suggest? There doesn't seem to be clear guidance about this.

[AbiDrew]

Abi you sound like you know what you're talking about. What would be your advice about post-GRS anti androgens for someone who has been taking them for c.18 months? Would you cold turkey on the grounds that 95% of T is cut off from its source? Or would gradually withdraw as a few people suggest? There doesn't seem to be clear guidance about this.

There isn't clear guidance because experiences differ so greatly.  Some people if they stop aa's immediately after GRS will experience some reversion before all the androgens are truly flushed.  Some can cold turkey and have no problem.  Honestly, this is something you'll have to discuss personally with your doctor and figure out what's best for you individually.

[Richenda]

Okay thanks. That does sound wise. I will talk it through very carefully with my clinic this week.

[KayXo]

Unless taking some kind of combination therapy with some other antiandrogen, you WANT a complete saturation of bicalutamide so that NONE of that extra T finds a free receptor.

Combination, high or low, I very much doubt one will be able to block all receptors.

If using combination therapy, spiro/cypro with dutasteride is a more effective combo than any combo with low dose bicalutamide could be.

One must also consider risks and side-effects. I have personally read good results from using low doses of bicalutamide in combination with estradiol in transwomen.

Some people if they stop aa's immediately after GRS will experience some reversion before all the androgens are truly flushed.

Androgens are flushed quite rapidly after the op.

Urol Oncol. 2014 Jan;32(1):38.

"In men with prostate cancer, bilateral orchiectomy reduces serum testosterone to castrate levels within 12 hours [6]."

"Persistent levels of serum testosterone after castration are mainly derived from adrenal androgens."

And...

Prog Brain Res. 2010;182:321-41.

"after castration, the 95-97% fall in serum testosterone does not reflect the 40-50% testosterone (testo) and dihydrotestosterone (DHT) made locally in the prostate from DHEA of adrenal origin"

Perhaps, to optimize breast growth, some form of anti-androgen can be used until final size is reached, post-op but this must be discussed with doctor, and risks vs. benefits weighed. In some, there is apparently a temporary increase in adrenal androgen output post-op (could perhaps be due to stress) and as such, an anti-androgen could help counter this for a few months. Or the post-op androgenization could be the result of stopping hormones pre-GRS and post-GRS.