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Hello...my first post! yay! OK, so i went the not so okay way and done it myself. I was on cyproterone acetate and estradiol for over a year before going to a doctor. i know it's bad but i was desperate. Here's the deal, i finally went to a doctor...He's really nice and gives a darn about me.  i checked out as fine. He kept me on the same dose of estradiol but is "making" me switch to spironolactone as my antiandrogen.  Has anybody here made that switch? Any difference in how you felt afterwards? i'm just scared i'll feel different.

Hey Sammie

I'm glad to hear you have decided to stop self medicating, it's important to have these matters looked after by a proper medical person. As to the change between the two I can't offer much I'm afraid as I have been on Spiro since the start. Depending on where your T levels are it might help to lower them further, certainly my T levels are close to zero. Spiro is also a blood pressure medication and may be one of the reasons the doc has switched you if your BP is up a bit. It is also a diuretic, so expect to pee a bit more, probably better to take in the morning not before bedtime!

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Thank you! He's switching me because cypro isn't FDA approved so he also has zero experience with it. Personally i wish i could stay on it. But he's the boss now.

Cypro is usually a stronger anti-androgen but I'm sure the doctor will know what to do to keep T at bay and allow for adequate feminization. If you notice returning androgenization symptoms (increase in libido, erections, oily skin, acne, faster body hair growth, body odor, skin less soft, etc.) or/and regression in feminization (reduced breast growth, more angular face, etc.), advise the doctor immediately.

Thanks! Usually when i missed a dose of cypro or had to cut back because i was waiting on a new shipment (another reason doing it yourself is a bad thing) the first symptom i noticed was being aggressive...angry. >:-)  i didn't like it all. That scares me more than body hair or something. Well, the morning surprise too...well that usually made me cry. Have i mentioned i'm just really nervous about switching?  :embarrassed:

I'm spiro - wonderful! CA does have a side effect of causing or triggering depression, doesn't happen to everyone but if you are susceptible to depression it can be a no no.

I'm so glad I got switched from spiro to cyproterone acetate. Spiro gave me one of the worst possible side effects: Messing with my digestive system to unknown extentes. I spend months unable to gain weight and having to go to the bathroom several times per day (and not exactly to pee).

Anyways, I had to convince the endo since he wanted to put me on flutamide. He did not have a great opinion about spiro.

My doctor proposed Flutamide too! But the cost is outrageous and it has even worse risks to the liver than cypro.  I really wish i could just stick with it. i was a very depressed person before i started taking cypro and estrogen. i seem more grounded and easy going now. Maybe just because i am happy to be out. :)  But i do remember reading about all the possible side effects.

Surprising that flutamide is still being proposed because there is a newer anti-androgen of the same class now available, bicalutamide (Casodex, Calutide) which is much less toxic to the liver, has fewer side-effects overall, has stronger anti-androgenic activity and only needs to be taken once daily (or even once every 2 -3 days, as it has a long half-life of 5.6 days) versus three times daily for flutamide.

I think flutamide is no longer used in men with advanced prostate cancer and has been replaced with bicalutamide for side-effects, ease of taking and more favorable anti-androgenic activity.

I just switched from spiro to cyproterone a few days ago.

I'm in the UK though.

I think I was massively resistant to Spiro.

Nothing to report from the swap as of yet.

Mod edit: no dosages please.

Quote from: KayXo on May 16, 2014, 06:53:28 PM
Surprising that flutamide is still being proposed because there is a newer anti-androgen of the same class now available, bicalutamide (Casodex, Calutide) which is much less toxic to the liver, has fewer side-effects overall, has stronger anti-androgenic activity and only needs to be taken once daily (or even once every 2 -3 days, as it has a long half-life of 5.6 days) versus three times daily for flutamide.

I think flutamide is no longer used in men with advanced prostate cancer and has been replaced with bicalutamide for side-effects, ease of taking and more favorable anti-androgenic activity.

I only know of a sure market for flutamide, and it's sex workers, and transgirls that are ok with the dick and like penetrating. Flutamide does not affect a lot brain, erections and even sperm production is still possible. Originally I asked cyproterone acetate intead of flutamide with the excuse of more side effects on flutamide (I actually wanted the most powerful and feminising thing I could get my hands on.). The good thing on flutamide is that genital atrophy would be minor compared to other treatments.

Wow. It sounds like i went with cypro for pretty much the same reasons as you. i am certainly NOT ok with erections. i lived way too long with that. i won't say i hate that part of me, but i do not want it functional at all. That is one of my big worries with spiro. 

Maintaining funcionality is a necessary evil if you are planning to go for SRS, specially if it is going to take several years.

Right now I can't get it to work, but that's because my body only allows one weight hanging from my wiener, and that's androcur. Add another thing such as lorazepam / ativan, or being really anxious or depressed, and it won't raise. I just do it once a week just for maintenance purposes.

i really don't care for "functionality" and i doubt i will ever be able to afford SRS/GRS since face surgery is what i am really after. i just can't see me ever being able to get both.  i'm not exactly young. So i have my priority list.  i must admit, switching seems more like a bad idea every day.   :(

SRS for me despite being unpassable. Some bad issues (taxes, paying for exams, etc) have drained my savings account so much that I don't think I will meet the money requirements for FFS (and I had the money already), so if FFS ends being unaffordable for me until I am working again, at least I won't have to care about using an antiandrogen.


Going back to an AA, I have a friend that was one year on spiro before the endo switched her to Androcur. She keeps insisting that she did not started seing changes until the switch. She also keeps saying the same about me (8 months spiro, nearly six on androcur), that I look more female since I started taking androcur. And it may be true, I probed to be fairly resistant to spiro, and the equivalent amount of androcur gave me better results. On the other side, my libido worked worse on spiro than androcur.

Quote from: Julia (Apple-Whatever) on May 17, 2014, 06:00:30 AM
Flutamide does not affect a lot brain, erections and even sperm production is still possible.

The same is true of bicalutamide except that bicalutamide is safer, only needs once daily dosing and is more potent. It makes no sense to take flutamide if a better, safer alternative is available.

i'm just really nervous. i am happy with how i have reacted to cypro. Switching scares me a lot. Then againm most everything does anymore. :p i read that flutamide should also be used with leuprolide acetate for best results. But i haven't really heard of that being used in the USA. idk. There aren't many doctors where i live that want to deal with gender stuff anywayz.

Quote from: sammielicious on May 17, 2014, 09:51:14 PM
i read that flutamide should also be used with leuprolide acetate for best results.

In men afflicted with advanced prostate cancer whose life depends on degree of androgen inhibition so they need to cover all bases. Either one or the other should be sufficient for us but, if leuprolide is taken, best to combine with flutamide/bicalutamide for the first 2-3 weeks to prevent testosterone flare-up. 

All i know now is that i was better off on my own.

Ive been with flutamide / estradiol one year... and im OK.. my doctor knows and she recommended to continue like that, but i want to change it because maybe i am OK now, but who knows in another year, I wolud like to let my liver a rest a little of flutamide, so i want to tell my doctor to make that change  to spiro or cyproterate, i really dont know.. what to do .... :'(

Quote from: sammielicious on May 14, 2014, 06:21:57 PM
Hello...my first post! yay! OK, so i went the not so okay way and done it myself. I was on cyproterone acetate and estradiol for over a year before going to a doctor. i know it's bad but i was desperate. Here's the deal, i finally went to a doctor...He's really nice and gives a darn about me.  i checked out as fine. He kept me on the same dose of estradiol but is "making" me switch to spironolactone as my antiandrogen.  Has anybody here made that switch? Any difference in how you felt afterwards? i'm just scared i'll feel different.

I self medicated too for about a year out of desperation.  I finally found a doctor who would help me.  It's a dam shame that people have to resort to self medicating in the 21st century.

According to studies, bicalutamide appears safer, more convenient and more effective than flutamide.

http://www.ncbi.nlm.nih.gov/pubmed/16845534

"There are no direct comparisons between the three non-steroidal antiandrogens in terms of quality of life, but available evidence suggests that bicalutamide has a more favorable safety and tolerability profile than nilutamide and flutamide."

Urology. 1996 Jan;47(1A Suppl):70-9; discussion 80-4.
Worldwide activity and safety of bicalutamide: a summary review.

"Bicalutamide is a new antiandrogen that offers the convenience of once-daily administration, demonstrated activity in prostate cancer, and an excellent safety profile. Because it is effective and offers better tolerability than flutamide, bicalutamide represents a valid first choice for antiandrogen therapy in combination with castration for the treatment of patients with advanced prostate cancer."

http://www.ncbi.nlm.nih.gov/pubmed/10587288

"Three non-steroidal anti-androgens are available in the US, i.e. flutamide (Eulexin), bicalutamide (Casodex) and nilutamide (Nilandron). Nilutamide offers patients no benefit over flutamide or bicalutamide and has the least favorable safety profile. Because of its short half-life, flutamide must be administered 3 times a day. Furthermore, flutamide therapy is associated with a relatively high incidence of diarrhea, often intolerable for some patients. Bicalutamide is available in a convenient one tablet, once-a-day dosing regimen, is at least as effective as flutamide and is better tolerated in terms of diarrhea."

Arch Ital Urol Androl. 1999 Dec;71(5):293-302.
Antiandrogens: a summary review of pharmacodynamic properties and tolerability in prostate cancer therapy.

"As regard as pure antiandrogens clinically important adverse events including gastrointestinal events, particularly diarrhea and occasional disturbances of liver function related to flutamide treatment and antabuse effect, problems with light-dark adaptation and rare interstitial pneumonitis related to nilutamide indicates the bicalutamide, due to its better tolerability profile, together with its once-daily oral administration regimen, could be considered the antiandrogen of first choice in the treatment of prostatic cancer."

I too am currently self medicating (for about 5-6 months now) on cyproterone acetate and estradiol and have not seen any negative side effects at all.  Compared to back when I was on spironolactone, the AA effect of cyproterone is much more powerful and caused quicker changes.  I also disliked spironolactone due having to pee a lot more often! 

Anyways, I have been taking the appropriate steps to doing HRT the right way and according to my initial consult, the dr will switch me to spironolactone (due to being in the US) and estrogen injections.  I am kind of looking forward to trying the estrogen injections, but my feelings about spironolactone are somewhat mixed.

Since you will be on injections, you should be fine since E should strongly suppress your T and will be quite effective at feminizing. On injections, some don't even need anti-androgens at all. Really, no worries! ;)

Quote from: KayXo on June 11, 2014, 10:11:36 PM
Since you will be on injections, you should be fine since E should strongly suppress your T and will be quite effective at feminizing. On injections, some don't even need anti-androgens at all. Really, no worries! ;)

Wow, really!??  I did not know that!  Are estrogen injections really that much more effective than the pill form??  I guess I will have to see then, but I will still most likely add on the spironolactone just to make sure the nasty T goes away and stays away!!

Quote from: Julia (Apple-Whatever) on May 17, 2014, 10:51:37 AM
Maintaining funcionality is a necessary evil if you are planning to go for SRS, specially if it is going to take several years.

Right now I can't get it to work, but that's because my body only allows one weight hanging from my wiener, and that's androcur. Add another thing such as lorazepam / ativan, or being really anxious or depressed, and it won't raise. I just do it once a week just for maintenance purposes.

Is Lorazepam considered to have antia-androgenic properties or it is just anti-anxiety drug only? /curious, cause I was on it during my childhood alongside other "interesting" drugs (haloperidol etc), because of ADHS/hyperactivity/

I've been on Spironolactone and I personally find it almost ineffective in doses, that do not cause nasty side effects. I had got far better results with Androcur...

Quote from: Kaley on June 12, 2014, 04:17:18 AM
Are estrogen injections really that much more effective than the pill form??

It does depend on the dose prescribed but usually, at typical doses prescribed, injections appear to, at least give much higher levels with a better ratio of the strongest estrogen (estradiol) to weaker estrogens such as estrone with transwomen usually doing better on injections vs pills. But, no guarantee. Just wait and see. :)

Quote from: Aquarelle on June 12, 2014, 04:51:55 AM
I've been on Spironolactone and I personally find it almost ineffective in doses, that do not cause nasty side effects. I had got far better results with Androcur...

I think it makes sense really, not like Spiro is designed as an antiandrogen. I switched to Bicalutamide because of Spiro's side effects, I considered Androcur, but since it isn't FDA approved it would be a bit of a hassle to deal with, even though I know I can still get my hands on it here in the states. I have yet to really find any downside to Bicalutamide outside of cost.

I just don't get why doctors seem to love Spiro so much, for me Spiro had a real quality of life reduction and the dizzy spells were incredibly unsafe.

Of all the anti-androgens, I have a personal preference for bicalutamide and LhRh agonists (or antagonists). These seem to have, overall, much less side-effects while effectively inhibiting androgens at doses typically prescribed for us. 

Quote from: KayXo on June 12, 2014, 02:40:52 PM
Of all the anti-androgens, I have a personal preference for bicalutamide and LhRh agonists (or antagonists). These seem to have, overall, much less side-effects while effectively inhibiting androgens at doses typically prescribed for us.

Hi kay, im vanessa, from Peru.Ive been reading your posts about bicalutamide.I started 3 weeks ago and in one week ill start with estradiol in GEL(its also a very good option  like injections).Early in this year i was using cyproterone  but my prolactin got too high.

I know bicalutamide is a very strong antiandrogen,but after 3 weeks i still have an oily face, oily hair.I have to wait for estrogen to reduce testosterone production(L.H) to see that?(dry face, less body hair,dry skin)?
Or maybe bicalutamide is not being effective in blocking testosterone in my body?



edited for dosages.

3 weeks is too early to judge effects especially if you just stopped Androcur, I think. Hopefully, you got your bicalutamide with a prescription and you are taking enough, under the supervision of a doctor.