What is the strongest antiandrogen?

[love88]

Hi ppl =)

I'm not transgender so I hope I'm allowed here.. if not just say and I'll go away =P I have similar problems though.. well I've been reading this site for a cpl of days I just made an account.. I'm an XX female with PCOS (polycystic ovaries) which means I have excess androgenic activity in my body.  My testosterone levels are very low even for a woman but my body is just very sensitive to it.  Most of my symptoms are mild.. I don't have facial hair or body hair.. But I'm losing my head hair =( "female pattern baldness" which is the worst symptom for me..its not socially acceptable for a woman to be bald.. I'm only 19 too and this started when I was 16 and I've lost 10% of my hair all over my head.  My endo put me on the highest dose of spironolactone but I couldnt take it because of the bitter taste .. Now I'm on flutamide twice a day & yasmin (a contraceptive pill).

It says here that flutamide is a weaker anti androgen than spiro:
https://www.susans.org/wiki/AA
But my endo said it was the strongest and similar to cyproterone, so now I'm confused, maybe she meant it was more effective than spiro in XX women because of different physiology?  I read some studies on pubmed and it says flutamide is the strongest too. What do you think?

[Mischa]

Love88,
This is very interesting. As for the answer I have no Idea, but I do know an XX female with Pcos. She on spiro, but she gets facial hair, and her hair is falling out as well. From what I hear ther isn't a whole lot they can do for it. But a suggestion, mabe you could talk to your pharmasist, because they should know the different active compounds in each medication....

Just a thought...good luck!
~M

[Hannah]

Spironolactone isn't exactly fun to take at first. It's a diuretic so you have to really watch staying hydrated, there's the potassium thing, and in my case I got horrible migraines for about a week after upping the dose to full supression levels. On the bright side it smells wonderful! I love the little minty kiss every morning and night. Anyway maybe your endorconologist doesn't think you need it's power, and therefore don't need to deal with it's side effects. It is really cheap though, practically free at smaller doses, if that's a factor it might be worth talking to her about it again.

[GinaDouglas]

Aromatase converts testosterone to estrogen, so this natural enzyme would be the strongest antiandrogen.  Too bad nobody cares enough to figure out how to synthesize Aromatase.

[Steffi]

Dutasteride is a blocker of testosterone and a very potent anti-androgen that gets good reports on many sites dealing with male-pattern hair loss, so would seem worth checking out in your own case..

[Mari]

Andorcur (Cyproterone acetate) is probably the strongest, but should be taken under doctor supervision only as it is hepatotoxic, and liver tests must be done while taking this medication

[Shelina]

To what I have heard, Cyproterone Acetate is officially the most potent and strongest but the most dangerous as well.

In your case particularly, you'd rather urgently need more of a DHT blocker (that thing which converts testosterone and make you bald) than testosterone blocker. DUTASTERIDE (Brand Avodart) works the best for those losing hair. Gliding in the archives I have seen some people claiming to regain their hair growth quickly with Avodart/Dutas but the side effect it makes men not hard sexually anymore but it does not apply to you as you're a woman.

[Naturally Blonde]

To what I have heard, Cyproterone Acetate is officially the most potent and strongest but the most dangerous as well.

In your case particularly, you'd rather urgently need more of a DHT blocker (that thing which converts testosterone and make you bald) than testosterone blocker. DUTASTERIDE (Brand Avodart) works the best for those losing hair. Gliding in the archives I have seen some people claiming to regain their hair growth quickly with Avodart/Dutas but the side effect it makes men not hard sexually anymore but it does not apply to you as you're a woman.

I'm on cypretone acetate and I've found it's works best for me. Spiro is far more potent and is not widely used in the U.K.

[BridgetBby]

my endo has me on Lupron, it shuts down all pituitary hormone function, so requires one to be taking some form of estrogen while on it. My mother and many gg women i have spoken to take Lupron also for ovarian problems such as cysts and other gg female area problems.

[Autumn]

Dutas doesn't break your willie.

Sexual arousal is a function primarily of the mind. If you are absolutely disgusted by having an erection, then the knowledge that there can be sexual side effects from medication is probably going to all mesh together nicely. For me, after I got on dutas, I actually for the first time in over a year had sexual fantasies about women and was much hornier. Straight men do take it for hair loss, and it's an anti-cancer med so it's not exactly trans only. You can experience varying levels of breast development from it, but for me a year on avodart did nothing compared to a month on spiro.

[Naturally Blonde]

Dutas doesn't break your willie.

Sexual arousal is a function primarily of the mind. If you are absolutely disgusted by having an erection, then the knowledge that there can be sexual side effects from medication is probably going to all mesh together nicely. For me, after I got on dutas, I actually for the first time in over a year had sexual fantasies about women and was much hornier. Straight men do take it for hair loss, and it's an anti-cancer med so it's not exactly trans only. You can experience varying levels of breast development from it, but for me a year on avodart did nothing compared to a month on spiro.

I was put on Goserelin acetate (Zoladex) by a gender clinic at the NHS and hated it. It's also a form of Dutasteride. It was a bad experience for me and I got endless erections when I didn't want them. It was a real reversal of everything and for me it was truly horrendous. These days I now choose my own medication.

[Hannah]

I experienced this with dutasteride as well, and it turns out it can apparently raise general testosterone levels a little bit while blocking more dht. The change isn't extreme in most of it's consumers, but for us it's huge. Funky. Anyway it was nothing a lil extra spiro couldn't handle. It does make me wonder though, if finasteride might be a better option. I know it supresses about 25% less dht, but we are talking about such tiny percentages that the difference is negligible. I guess the question is if the testosterone boost from dutas is permanent or just a short term side effect.

[taru]

I experienced this with dutasteride as well, and it turns out it can apparently raise general testosterone levels a little bit while blocking more dht. The change isn't extreme in most of it's consumers, but for us it's huge. Funky. Anyway it was nothing a lil extra spiro couldn't handle. It does make me wonder though, if finasteride might be a better option. I know it supresses about 25% less dht, but we are talking about such tiny percentages that the difference is negligible. I guess the question is if the testosterone boost from dutas is permanent or just a short term side effect.

The testosterone boost is not something you should be worried about. To illustrate this look at some very simle made up numbers.

Nothing: testosterone: 80 units, DHT 20 units
Finasteride: testosterone 90 units, DHT 10 units
Dutasteride: testosterone 95 units, DHT 5 units

Now take into account that DHT is about 3 times stronger androgen than testosterone is. Clearly the androgenic effects are *smaller* with the higher testosterone in this case.

[Caroline]

I was put on Goserelin acetate (Zoladex) by a gender clinic at the NHS and hated it. It's also a form of Dutasteride. It was a bad experience for me and I got endless erections when I didn't want them. It was a real reversal of everything and for me it was truly horrendous. These days I now choose my own medication.

Zoladex is not a form of dutasteride.  Zoladex is a gonadotropin releasing hormone super-agonist whereas dutasteride is a 5-alpha-reductase inhibitor.  Their mechanism of action is totally different.  One inhibits the release of lutenizing hormone thereby stopping the gonads pumping out hormones, the other prevents testosterone being converted to DHT.

Zoladex does tend to cause a testosterone spike when the first injection is given and for some people a smaller spike whenever subsequent injections are given (and sometimes the 12 week depot seems to only work well enough for about 11 weeks).  I've been on a GnRH agonist and the initial T spike can be horrid, but it then suppressed my testosterone very well (I took it for a couple of months before surgery when I had to be off spiro and estrogen).

[Naturally Blonde]

Zoladex is not a form of dutasteride.  Zoladex is a gonadotropin releasing hormone super-agonist whereas dutasteride is a 5-alpha-reductase inhibitor.  Their mechanism of action is totally different.  One inhibits the release of lutenizing hormone thereby stopping the gonads pumping out hormones, the other prevents testosterone being converted to DHT.

Zoladex does tend to cause a testosterone spike when the first injection is given and for some people a smaller spike whenever subsequent injections are given (and sometimes the 12 week depot seems to only work well enough for about 11 weeks).  I've been on a GnRH agonist and the initial T spike can be horrid, but it then suppressed my testosterone very well (I took it for a couple of months before surgery when I had to be off spiro and estrogen).

Thanks for the  corrections.  Zoladex (goserelin) was a pretty horrible experience. I tried it about 3 times and I still kept getting the same negative results with erections and other unwanted side effects. It's primarily a cancer drug but is widely used at Charing Cross GIC, London, U.K for male to female gender dysphoria patients.

[gothique11]

The strongest anti-androgen is getting rid of those two poison factories (via SRS or orchi).   

[Myself]

Probably Avodart and Androcur,
I think it's mostly DHT which affects scalp hair.
Estrogen protects the hair from DHT/Androgens effects, increasing estrogen if it's low could help.

[love88]

Thank you so much everyone for your replies.

Mischa & Becca - I was on spiro for 2 months but yuck it tasted sooo bad =/ the minty smell is nice though i think they add that in to mask the taste. i talked to my endo about going back on spiro and she said i should probably stay on flutamide bcoz its supposed to be the best for PCOS. my grandpa takes spiro.. its commonly used as a blood pressure lowering drug. he hasn't had any side effects from it. so thats why i assumed it wasn't a very effective anti androgen, bcoz its so widely prescribed?

Steffi - Dutasteride is supposed to be a good DHT blocker but unforunately it isn't approved yet in australia & nz

Mari -  yea thats what I heard too. I get liver tests done every month bcoz flutamide is hepatoxic.. a lot of these antiandrogens seem to have dangerous side effects.

Shelina - I know, sux but Dutasteride isn't available here... we only have finasteride which blocks alpha reductase I (one of the enzymes which converts testosterone to DHT). Dutasteride blocks alpha reductase I & II.  I havent' tried finasteride yet.

Naturally blonde - congrats on finding one which works for you =) i guess it really does depend on the person's own biochemistry.. im still trying different antiandrogens.. If flutamide doesn't work, i want to try cyproterone

Myself - wow I've never thought about it that way.  I've always had low estrogen levels on my blood tests so maybe thats whats causing my hair loss rather than high androgen levels bcoz my testosterone is borderline low. I'm on yasmin it has 30 mcg ethinyl estradiol in it so I hope it works.

Nichole -
I hope you get this msg,  I couldn't work out how to reply to emails here (if anyone knows, please let me know!)
Thank you for your email & kind words =) It helped a lot.  I'm on a low glycemic index diet too and my face is less oiler and I don't get so much breakouts anymore..  I'll read up on the zone diet. It sounds good. Exercise is like Glucophage bcoz it makes your body more sensitive to insulin . Insulin stimulates the ovaries to make more testosterone. so more insulin sensitivity = need less insulin = less insulin produced = less testosterone !! 

[Jet Alexis Armstrong]

Hiya Ladies , ive been on  Spironolactone per day for 5 years now , my personal experience is that it is a very effective Anti Androgen . It is generally accepted as one of the ( if not the ) most widely used Anti androgens , and generaly has a good safety record , however as one of the respondents has already pointed out it is a Potassium sparing Diuretic and therefore special attention must be paid to your potassium intake , as I gather it prevents the cells from releasing excess potassium and therefore you must pay particular attention to this dangerous side effect . I began taking Spiro some months before I started Estrogen and I did notice some small changes ( only small but noticeable swelling of breast tissue etc ) so it clearly has an Estrogenic effect too . I contacted the manufacturers of Spiro and contacted the American Drug Administration in order to check it thoroughly before I began it . Just as a side note my feet have shrunk by over two sizes and when I brought this up I was informed that this is an effect of Spiro fairly rare but not unknown . so overall from a purely personal stand point I would recommend it ...



Mod Edit- No dosages please TOS 8

[KayXo]

I began taking Spiro some months before I started Estrogen and I did notice some small changes ( only small but noticeable swelling of breast tissue etc ) so it clearly has an Estrogenic effect too .

Androgens inhibit breast growth so when androgens are inhibited, it is not surprising to notice breast growth or gynecomastia. This isn't because it is estrogenic; spiro doesn't trigger estrogen receptors. However, a small increase in estrogen levels is sometimes seen with this drug due to increased peripheral conversion of testosterone to estradiol.

Just as a side note my feet have shrunk by over two sizes and when I brought this up I was informed that this is an effect of Spiro fairly rare but not unknown.

Water loss? Spiro increases water loss, it is a diuretic.