Yay, good news! I went for my annual HRT checkup and prescription refill. All my levels are good, including my cholesterol, which is still the best the doctor has ever seen.

I complained about the effects of spiro: the constant dehydration, trying to balance drinking enough water to function with having to pee inconveniently often, the low blood pressure (110/55). I also asked about progesterone, since I have had no breast growth for over a year.
Well, it seems that, in the two years since I started going there, they have become a lot less risk-averse. It used to be only estradiol and spiro, take it or leave it. Today, my doctor decided to switch me to androcur (cyproterone) as a blocker for the (hopefully) few months until my GRS. She isn't going to prescribe progesterone yet, since that would involve two changes simultaneously, but in a couple of months when I go back to get a followup on the cypro, we will talk about it. Yay!
And she filled in the remaining paperwork for Dr. Brassard's clinic, so I will be able to sent all their forms off as soon as I can get a printout from the pharmacy of my new prescriptions.
I don't mind driving in to the city when it is that productive!