Susan's Place Transgender Resources

Hi. I'm a little confused about something and would appreciate a bit of clarification from those in the know. From what I understand, AA practices differ a bit between Canada and the US. If I understand correctly, while virtually all American MTFs are prescribed Spiro, Canadian providers have more options at their disposal.

My questions are as follows:

1) Is this true or am I misunderstanding?

2) If this IS true, how is this being handled in practice? Is Spiro the go-to AA for Canadians, as well?

Thank you in advance for clarifying this,

Maddy

I ended up finding someone in Alberta to talk to who has been through it all and could help me out.  They didn't mention anything about any options just that Spiro would be prescribed, then later Estrogen from a different doctor.  Could vary by province, city, or even by doctor though.

Cyproterone acetate (brand name Androcur) is not approved for use in the United States.

Sorry, I left my thought unfinished.  That's why spironolactone is so prevalent in the US.  I was not able to use spiro because of an adverse drug interaction.  So I was on bicalutamide for a while.

That was the other drug I'd seen reference to. To this point, all of my reading has been Spiro. I'd like to know if there is a reasonable chance that I'll be pxd something else so that I can get reading.

Maddy

Quote from: Jamie D on August 07, 2013, 12:46:16 AM
Cyproterone acetate (brand name Androcur) is not approved for use in the United States.

Yes, but it is approved by Health Canada and covered under my provincial drug formulary. This raises the possibility that it's a drug I might find myself prescribed. I'm hoping to get a handle on to what degree it is being used in the treatment of Canadian transsexuals. I'd just rather not be surprised.

Maddy

I plan to. That being said, it's nice to know the relevance of what you're reading.

Maddy likes to know what she's getting herself into!

The thing about Androcur is that it used to be prescribed at rather ... interesting ... doses; literally about 10-20 times what doctors will usually give you today. While it can cause depression, the very low dose thrown out there these days rarely suffices to bring that down on you. As for liver etc. effects, again the whole dosage discussion comes into play, with the expectation being that at current levels you really need to be punching your liver via other means to see much effect.

If you find a good Endo that knows TG issues you will most likely be on androcur over spiro. It works way better even at very low dose (i took a normal low dose a day then changed to half that after a year) then spiro does. Androcur is a super t blocker my t level was about 1 point higher then what my post GRS levels are. It is harder on your liver so that needs to be checked more often.
In the states on spiro i was on a extra high dose that took us 5 years of adjustments to make it in a level that worked.

Most depends on the Doctor i feel?

Izzy

In Korea, too, spiro and androcur are avail, as well as the dreaded diane. I was on spiro for 3 or 4 months starting out, but wasn't really blocking my T that much. Doc switched me to androcur and that kicked it down significantly, and fast. Hasn't come up with the small dose. When researching on the internet, in Seoul, this doctor is 1 of the very few that will help transfolk. Others are plastic surgeons that prescribe meds. I think the effects of spiro are better, and you don't have to watch what you eat, except for alcohol...of course.

I'm in Ontario and I had no issues getting prescribed Spiro.  If you discuss things with your GP or endo, they'd most likely be willing to accommodate you with the meds you would prefer to take.  They are usually concerned with making sure you're aware of all the different options available before writing a prescription.