Switched to injections - Dr stopped Spiro

[LShipley]

I have asked this question somewhere else but i barely received a reply and I am still unable to find anything written that answers or explains this so your input is greatly appreciated!

Recently my doctor switched me from pills to injections and at the same time stopped my spiro prescription. I was too nervous from the injection training and i forgot completely they did that until i went to fill my scrips.

They kept me on finasteride as well as progesterone, but it was a complete shock to stop the main blocker and now i am very anxious.

Is there a good explanation for this? My T was like 28 3 months ago and 3 months before that but they didnt check it this time.

[kelly_aus]

I have asked this question somewhere else but i barely received a reply and I am still unable to find anything written that answers or explains this so your input is greatly appreciated!

Recently my doctor switched me from pills to injections and at the same time stopped my spiro prescription. I was too nervous from the injection training and i forgot completely they did that until i went to fill my scrips.

They kept me on finasteride as well as progesterone, but it was a complete shock to stop the main blocker and now i am very anxious.

Is there a good explanation for this? My T was like 28 3 months ago and 3 months before that but they didnt check it this time.

There's a growing number of trans women and their prescribers who are moving away from the use of anti-androgens. T is suppressed quite happily by E at quite moderate levels in most people, making spiro or similar unneeded.

And yes, I'm sure there are going to be those who read this and say "But your E levels need to be dangerously high" and I'm going to suggest you all do some further research.. The levels needed are not "high", and most would probably find their current levels are sufficient.

TL;DR: You don't need spiro when your E level is sufficient.

[Devlyn]

The only thing I miss about Spiro is the salt cravings! 

Hugs, Devlyn

[LShipley]

Thank you Kelly!

The other thing I had seen rumored is that when injecting hormones it stops the bodies natural production of hormones which is why the blocker wasn't needed specifically with injections. However I never could find anything concrete that backed this up other than other posters commenting about it.

I wish I just asked my doctor and I am still half leaning to asking for a callback to help explain their reasoning to me since I had forgotten to ask

[Cindy]

Calling your Dr and asking is a very good idea. It is the duty of your medics to explain to you what they are doing and why. We should always keep ourselves informed on what and why treatment is being done to us.

Thank you Kelly!

The other thing I had seen rumored is that when injecting hormones it stops the bodies natural production of hormones which is why the blocker wasn't needed specifically with injections. However I never could find anything concrete that backed this up other than other posters commenting about it.

I wish I just asked my doctor and I am still half leaning to asking for a callback to help explain their reasoning to me since I had forgotten to ask

[LShipley]

The only thing I miss about Spiro is the salt cravings! 

Hugs, Devlyn

I am in day 2 and I already lost the dizzy spells so I def agree

Calling your Dr and asking is a very good idea. It is the duty of your medics to explain to you what they are doing and why. We should always keep ourselves informed on what and why treatment is being done to us.

I 100% agree. My particular doctor consults out to another doctor who oversees a lot of the transgender care + training in nearby cities so it is just a bit of a process sometimes. For instance I was given the email sent from said doctor advising the change in medication.

tbh it felt a little like Dr. House lol. Never met this guy (the consulted dr) but he hasn't messed me up so far

[KayXo]

The other thing I had seen rumored is that when injecting hormones it stops the bodies natural production of hormones which is why the blocker wasn't needed specifically with injections. However I never could find anything concrete that backed this up other than other posters commenting about it.

J Clin Endocrinol Metab. 1991 Sep;73(3):621-8.

"These results provide direct evidence that E2 inhibits gonadotropin secretion at the pituitary level in men"

In other words, E2 stops gonads (testicles) from producing T, whether it be taken orally, or non-orally. How much gonads stop depends on how much estradiol there is in the blood. The more E there is, the weaker the signal (LH and FSH) to the gonads.

[Ellement_of_Freedom]

Calling your Dr and asking is a very good idea. It is the duty of your medics to explain to you what they are doing and why. We should always keep ourselves informed on what and why treatment is being done to us.

I was gonna say... isn't this naturally the first thing you would do? Your doctor should have explained why there is a change to your regime at the time.

For instance I was given the email sent from said doctor advising the change in medication.

With no explanation? :/

J Clin Endocrinol Metab. 1991 Sep;73(3):621-8.

"These results provide direct evidence that E2 inhibits gonadotropin secretion at the pituitary level in men"

In other words, E2 stops gonads (testicles) from producing T, whether it be taken orally, or non-orally. How much gonads stop depends on how much estradiol there is in the blood. The more E there is, the weaker the signal (LH and FSH) to the gonads.

That journal article is older than me! Also where did you access it from? Do you have a doi or anything? You only underlined the title. Is it even peer reviewed?

[kelly_aus]

That journal article is older than me! Also where did you access it from? Do you have a doi or anything? You only underlined the title. Is it even peer reviewed?

It's available on PubMed and was published in the Journal of Clinical Endocrinology and Metabolism. Yes, it was peer reviewed.

[KayXo]

That journal article is older than me!

And so what? Are men today any different from those studied in 1991? Older studies have their place and can be quite informative.

The Journal of Clinical Endocrinology & Metabolism, Volume 85, Issue 9, 1 September 2000, Pages 3027–3035

"From these data, we conclude that in the human male, estrogen has dual sites of negative feedback, acting at the hypothalamus to decrease GnRH pulse frequency and at the pituitary to decrease responsiveness to GnRH."

[I Am Jess]

I was on IM injections from day 1 in my transition.  I've never taken Spiro.  I was on Dutasteride (Avodart) for BHP prior to transition and just continued taking that once I started HRT.  My T level at 6 months was 11.  I know everyone is different but I was very thankful I never had to be on Spiro.  You should be fine.  Good luck!!

[nola]

I have asked this question somewhere else but i barely received a reply and I am still unable to find anything written that answers or explains this so your input is greatly appreciated!

Recently my doctor switched me from pills to injections and at the same time stopped my spiro prescription. I was too nervous from the injection training and i forgot completely they did that until i went to fill my scrips.

They kept me on finasteride as well as progesterone, but it was a complete shock to stop the main blocker and now i am very anxious.

Is there a good explanation for this? My T was like 28 3 months ago and 3 months before that but they didnt check it this time.

Prob because with injections you are on a higher e dose, and higher e doses reduce t to female levels in most people, so you wouldnt need a blocker

[LShipley]

Thanks to everyone that replied so far

After speaking with my doctor yesterday she confirmed what everyone here is saying

Their plan is to watch the next 3 months and see how I react to the change of intake + increase of E and then potentially either raise the dose again or change to weekly instead of every other week.

I went from 7 pills a day to 2 pills a day so I'm happy as long as it works lol