On Spiro, you definitely need to eat ENOUGH salt and DRINK enough water. Androcur (cyproterone acetate) has its own set of problems and that is why it is not FDA approved or used any longer in the UK for transsexual women. It can increase the risk of meningioma ( 8 of the 9 cases in transwomen associated with Androcur ), raise prolactin levels and has been associated with prolactinomas in transwomen (5 of 8 cases), can lead to depression, especially in predisposed individuals, lead to abdominal weight gain, slightly increase the risk of blood clots, may oppose estradiol's beneficial vasodilating effects on arteries and can mess with adrenal gland function due to its glucocorticoid actions, in the same manner as corticosteroids (i.e. prednisone) do. In higher doses, it can cause extreme fatigue and liver problems.
Other safer anti-androgens, according to the scientific literature, include LhRh agonists like goserelin, leuprolide, buserelin acetate and bicalutamide. Yes, these also may have side-effects but they appear to be much less as compared to the above and this is why the UK now uses LhRh agonists for their transgendered clients. Paid out of your pocket though, these may be cost-prohibitive.
One last approach is sticking with estrogen only, bio-identical estradiol, preferably non-orally, to keep T levels down.
These issues need to be discussed at length with a doctor who is familiar with these matters.
