Spiro

[Stephanie]

I have been reading that Spiro's much vaunted anti-androgen effect is actually a minor side-effect.
Apparently Spiro is a diuretic used for high blood pressure, and that the alleged anti-androgen effect does not happen to everyone taking it.  Also Spiro is meant to be taken as a short term medication only.  I don't think that Spiro's manufacturers have carried out any clinical tests to assess its suitability for transsexuals.

[Ms.Behavin]

Yes Spiro is primary a drug to help control blood pressure and a diuretic.  The Anti-Androgen is more a secondary effect as it does also prevents the absorbsion of T on males.   It's alleged anti-androgen effect does work for most though.

Gee has any drug been clinically tests for suitability for transexuals.........

I'm pretty sure estrogen therapy is contra-indicated for males too.  But that ever stopped me either.

Beni

[iminadaze]

I have been reading that Spiro's much vaunted anti-androgen effect is actually a minor side-effect.

Yeah....well....explain that to my girlfriend 

all I can say is the stuff worked for me....big time! 

[Vexing]

Hmm. Spiro isn't used by many over here in NZ, most endos put you on Cyproterone Acetate (Siterone) - which is generally used for hirsutism in women or for testicular problems of the cancerous sort.

[Rachael]

I heard most of the people for who it doesnt work, are intollerant to it, or alergic... so its more thier biology than the drug...

[vanna]

Yes
my bloodwork always showed it working just fine

Androcur did not agree with me so i prefer spiro too.

[Sandy]

I have been reading that Spiro's much vaunted anti-androgen effect is actually a minor side-effect.
Apparently Spiro is a diuretic used for high blood pressure, and that the alleged anti-androgen effect does not happen to everyone taking it.  Also Spiro is meant to be taken as a short term medication only.  I don't think that Spiro's manufacturers have carried out any clinical tests to assess its suitability for transsexuals.

You are absolutely right.  Spironlactone was developed precisely as a blood pressure medicine through the diuretic effect.  It is also a raises potassium level in the body.  And if not closely monitored can be fatal.

At sufficiently high doses (as demonstrated through clinical testing) it also blocks the absorption of testosterone and reduced sexual ability and can cause breast swelling and tenderness.

Physicians who deal with transsexual patients are aware of these side effects and use them to help MTF transsexuals feminize their bodies.  This is actually much safer and less stressful on the body rather than using a overwhelming amount of estrogenic compounds.

Testosterone is a very powerful sex steroid and requires quite a bit of estrogen relative to testosterone in order to overcome it's effects.  By using Spiro and other anti-androgen drugs, less amounts of estrogens can be used to achieve the same effect, thus reducing the stress on the liver.

And as others have stated, no drugs have been approved through clinical testing for exclusive use with MTF or FTM transsexuals.  But then again there is quite a bit of medicine used for it's side effects rather than it's primary diagnosis.  For example minoxidil was originally developed as a anti-depression drug, but it's side effects of being able to reduce DHT topically also allows it to be used in its more well known form of a hair restorer.

-Sandy

[Rachael]

A huge quantity of drugs are used in this way... its the nature of 'ooh what does this drug we made do' 'oh i didnt expect that, well we can treat that too!'

[Stephanie]

I have always been suspicious of Spiro.  Last year I started taking it, and developed depression and daily headaches. I never saw any sign of any anti-androgen effect.  When I started oestrogen without spiro my headaches vanished along with my depression.  I also noticed a slowing down of body hair regrowth.
I think that while Spiro does work well with some people, with others it has either no effect or it causes negative effects.

[Rachael]

This could be as i said... your reaction, not the drug... As it works fine for the majority... i dont belive it  is a 'bad drug' that a number of transwomen make it out to be... they are perhaps just intollerant or alergic to it... why cry? swap aa and live happily ever after!



That or i have two bricks lieing around here somewhere...

[HelenW]

I had my orchiectomy done because the spiro was damaging my kidneys.  It's an option, albeit an expensive one.

hugs & smiles
Emelye

[Annwyn]

By using Spiro and other anti-androgen drugs, less amounts of estrogens can be used to achieve the same effect, thus reducing the stress on the liver.

I can't discuss clinical dosing common for MtF hormone therapy, but I can discuss common clinical dosing for the same medicines for their on label uses.  So, let's get some college education in here and some common sense as well.

I find it amusing that you would make a statement regarding higher doses of estrogen needing to be used.  Not specifying the dose, I can tell you that the dosing for menopausal women in ratio to that of MtF hormone therapy is at exactly four times the previous.
That is to say, if clinical dosing of generic Estrace were x.xxmg-x.xxmg, common dose for MtFs, REGARDLESS of Spironolactone therapy or no, is four times the unmentioned doses.

Common dose of aldactone in hypertensive patients is 25mg.  That is merely a fraction of the effective dose used for the off label use of lowering androgens in male to female transsexuals.

The difference being?

You're simply trading a high dose of one medication for a high dose of another one, both sharing in their risks and benefits, both hopelessly overdosed in MtF's to achieve noticeable effects.

[Rachael]

rather on the spot...

Menopausal hrt is maintenance... m2f hrt involves a lot of work to change the subject. And it also depends on what is the 'agreed' dosage for m2fs we are working off here as '4x' Its rather annoying we cant use figures, but hey.

Admitedly, most of the 'antispiro' drama in here is suposition and rumour. I've yet to come accross one in that camp with a medical degree or pharmacologists degree either...

[Annwyn]

I've yet to come accross one in that camp with a medical degree or pharmacologists degree either...

4 years in and 2 away from my PharmD.

Agreed doses for MtF patients as well as the few studies accompanying those are part of the curriculum in both pharmacy school and for doctors specializing as OBGYNs/endocrinologists.  Yes, even in South Carolina, home of the racist rebels.

Medical professionals are expected to deal with every possible issue, especially one this sensitive.  It's more sensitive than an old, married man going to pick up his Viagra to run down the road and get a prostitute, IMO.

In every single psychology, endocrinology, and anatomy class I've taken transsexuals have been discussed.

We're really not anywhere near on our own as we pretend to be.  There's just not enough of us out there for most to make a good living off of, that's why it's hard to find health care with our particular stamp on it.

[Sheeba]

I took spiro for a little while, a long time ago. I didn't like it. It made me feel dizzy and dehydrated and I think it made my hair feel dry and a little frizzy.

[Annwyn]

I took spiro for a little while, a long time ago. I didn't like it. It made me feel dizzy and dehydrated and I think it made my hair feel dry and a little frizzy.

I think you missed the part where spironolactone DEHYDRATES you