I've gone the estradiol injection only route out of concerns about spiro. While my numbers have looked "good" all this time, with really low T and high E, at 8 months I can only describe utter disappointment over my non-results to date. So, at least in my case, E and T levels weren't the whole story... I'm now left wondering where I'd be if I had started spiro too, but who knows, maybe the same place with a lot more bladder emergencies. 😂 In my case, age and an overly masculine appearance were not helping.
If I had it to do over again, I'd go the spiro route, it's the more typical path. If you don't like it, you can wean off of it at a later time.