Is it necessary to continue taking anti-androgens & DHT blockers post-op SRS?

[Shelina]

Why do some still take anti-androgen and DHT blockers despite they already have undergone sex reassignment surgery? If the testicles are no more there to produce testosterone/androgen and the adrenals do not produce that much, what's this non-sense of taking anti-androgen & DHT blockers post-operation? Why do still some do it, can someone explain please?

[Sandy]

That is usually something that you would want to discuss with your endocrinologist post-operatively or while preparing for surgery.

About 90% of the testosterone comes from the testicles and either orchiectomy or SRS will remove them.  About 10% of the testosterone (as well as some of the estrogen hormones) are also produced by the adrenal gland.

Depending on your post-op blood tests, your doctor may choose to keep you on anti-androgens to suppress this testosterone as well if your testosterone levels are above the minimum for a woman.  You do need some amount of testosterone for proper health and sexual function so having no testosterone can be an issue as well.  It is a balancing act that we have to do for the rest of our lives.

I stopped my spironolactone just before my SRS and I have not needed it since according to my blood tests.

-Sandy

[Shelina]

Your doctor may choose to keep you on anti-androgens to suppress this testosterone as well if your testosterone levels are above the minimum.

But are the testosterone production not suppose to be automatically stopped after SRS? I don't think the adrenal could produce that much to cause an issue.

[Sandy]

The amount of testosterone produced by the adrenal gland is not affected by the removal of the testes by SRS or orchiectomy.  It is produced regardless.

As I mentioned it is appropriate for a healthy female to have about a tenth of the testosterone in her system as a healthy male at the same age/development.  It usually does not cause any masculinization such as beard hair, upper body muscle development or other secondary sexual characteristics normally associated with a male.

-Sandy