Susan's Place Transgender Resources

Good Morning Ladies,

I have recently switched from CPA to Spiro (it's been almost a week) due to severe mood changes and some nasty depressive symptoms which I don't really miss. However, the drawback based on the results I am seeing so far is that I have lost the glow in my skin. I hope T is not wreaking havoc within me. However, I still have no libido and the tenderness in my breast area is still there which is a a good thing. I am just afraid that some of the positive impact I got from CPA will just revert back to the way it was ugh!

Looks to me, I am responding better to CPA but the side effects are making me crazy ugh. Did anyone of you experience this? Or is this all in my head?

I couldn't mention my specific dose but I'm on full dose Spiro.

Love,

April

I would think that as long as your T levels are similar on Spiro to what they were on CPA, it shouldn't make a difference. Have you had them checked since you made the switch?

I will not see my doctor until March 26 for my next check up. By then he might request some blood work to get it checked.
Oh well I am feeling better tho and much happier.

Glow w/ Depression vs Happiness ?? Life is so complicated sometimes :)

Quote from: Sunderland on February 23, 2015, 08:33:36 AM
I would think that as long as your T levels are similar on Spiro to what they were on CPA, it shouldn't make a difference. Have you had them checked since you made the switch?

I wouldn't worry too much about it. Happiness is always the best sort of glow. I'm sure your lovely smile lights up everything around you. :)

Awww thanks beauty and I couldn't agree with you more. :-*

Big Hugs,

April

Quote from: Sunderland on February 23, 2015, 08:41:25 AM
I wouldn't worry too much about it. Happiness is always the best sort of glow. I'm sure your lovely smile lights up everything around you. :)

When I was on a standard dose of Spiro it caused me multiple trips to the toilet and although drinking copious amounts of water (hence toilet) - leg cramping. I also experienced slow development despite being on the standard dose for a number of months.

On the other hand I am on CPA now and even on a reduced dose it has affected my mood to the point that some days I feel really really low and crazy ideas pop into my head. CPA has meant the leg cramps are no more and feminisation of my body seems to be better improved; really clear and smooth facial skin (although that might be the retinoic acid helping tbh), breast and hip (fat) growth and a rapid reduction of body hair.

I don't like CPA for its negative effects, but I can't go back to Spiro either. But for only its positive effects I'll continue with CPA.

If Spiro works out for you, then continue with it. We are all different and our bodies respond differently to various types of treatment. CPA isn't 100% right for me, but at least I am seeing results from it.

Thanks Leila, I may have to speak to my doctor about this as I feel something is missing or something isn't right.
Yes my mood has improved but I know I am missing something.:)

Quote from: Leila on February 23, 2015, 08:59:16 AM
When I was on a standard dose of Spiro it caused me multiple trips to the toilet and although drinking copious amounts of water (hence toilet) - leg cramping. I also experienced slow development despite being on the standard dose for a number of months.

On the other hand I am on CPA now and even on a reduced dose it has affected my mood to the point that some days I feel really really low and crazy ideas pop into my head. CPA has meant the leg cramps are no more and feminisation of my body seems to be better improved; really clear and smooth facial skin (although that might be the retinoic acid helping tbh), breast and hip (fat) growth and a rapid reduction of body hair.

I don't like CPA for its negative effects, but I can't go back to Spiro either. But for only its positive effects I'll continue with CPA.

If Spiro works out for you, then continue with it. We are all different and our bodies respond differently to various types of treatment. CPA isn't 100% right for me, but at least I am seeing results from it.

Hi April,

Spiro will dehydrate you so that could explain some of the lost glow.

I guess you moisturize but do you also keep yourself adequately hydrated? Right now I'm battling dry skin because of the height of winter. My cis wife and daughters have it worse though. My wife's hands are torn up badly. My daughters have the rosy cheeks, while cute, hurt a lot. We battle it with moisturizer but it seems like a losing battle. I do drink a lot of water anyway though. Also I've been craving pickles, salt is bad but the salt helps with the leg cramps which I havent been having. So I eat pickles and some salty foods in moderation. Blood pressure seems to be fine though. I watch it like a hawk. My friends who I told this too said I must be pregnant lol. If only. :(

Also the spiro dose may be increased. They started me out on a smaller dose. Still transition dose but like half of what I see a lot of trans women taking. But my T levels were low-ish anyway. Two weeks in my T was around 180.

I was on Spiro for 19 months and then switched to CPA. I really dont miss those trips to toilets as well as Spiro playing tricks with my vestibular system (almost blacking out when suddently switching from sitting to standing body position). I was initially afraid of CPA's side effects, depression included (I did read that taking folic acid helps to reduce them), but I dont really think that I am experiencing them. I do have some low moods (but they did happen on Spiro as well), and perhaps I am more irritable on CPA than I was with Spiro around 20-ties each month, lol.

Quote from: carmenkate on February 23, 2015, 08:15:40 AM
I have recently switched from CPA to Spiro (it's been almost a week) due to severe mood changes and some nasty depressive symptoms which I don't really miss. However, the drawback based on the results I am seeing so far is that I have lost the glow in my skin.

My suspicion is that this is due to a decrease in progestogenic effect as cyproterone acetate is a stronger progestogen than Spiro. I had that same glow with CPA and regained that glow on bio-identical progesterone.

I've been taking CPA for 13 months now, and it generally brings my testosterone and libido down to zero even at pretty low doses. I was very depressed when I started HRT, but I was also very depressed before I started HRT. I think changes I made to exercise, i.e. from couch potato I started running several times a week, plus changes to my nutrition to whole plant foods helped my mood. Whenever I eat fatty junk food the depression hits me again, but that might be psychological, not a chemical effect.

So maybe CPA has depression effect on me, I don't know for sure.

I think I'm going to try switching to Spiro myself, though I've been very reluctant to do so because it makes people pee a lot, and I already pee a lot. I get up 3-4 times each night because of a full bladder. Part of it is perhaps due to the high water content of my food, plus I still feel thirsty for lots of water in addition to that. I also have a theory that all the fiber and nutrients in my food might give my body the conditions to remove excess materials from it, and it might also deem the hormones I am taking to be an excess that needs to be removed.

I'm probably going to switch to Spiro anyway and hopefully I won't get too "pissed off" by the result... shall I update?

Quote from: ♡ Emily ♡ on February 25, 2015, 07:41:44 AM
I was on Spiro for 19 months and then switched to CPA. I really dont miss those trips to toilets as well as Spiro playing tricks with my vestibular system (almost blacking out when suddently switching from sitting to standing body position). I was initially afraid of CPA's side effects, depression included (I did read that taking folic acid helps to reduce them), but I dont really think that I am experiencing them. I do have some low moods (but they did happen on Spiro as well), and perhaps I am more irritable on CPA than I was with Spiro around 20-ties each month, lol.

I actually have that problem of sitting and standing up suddenly with CPA, though I haven't tried Spiro yet. It's not near blackout, but it is a bit of a dizzy spell. I think it might be due to not having enough calories, so I make sure to get some more when that happens and also drink water. Only now that you mention do I remember it never happened to me before HRT. It also doesn't happen all the time. It's pretty rare, but it does happen to me and it used to never happen to me.

What you're saying about peeing a lot scares me about Spiro... I'm peeing a lot as it is. :(

About the folic acid, it's interesting what you say, because when I switched to whole plant foods everything I eat has folate in it and I get plenty of folate... but back when I ate mostly junk food I was short on folic acid. Now I get depressed pretty much only when I eat the same junk food that made me not have enough folate, and I feel great when eating whole foods with plenty of folate.

I'm on spiro and I don't pee a lot. It seems to be about normal for me. How often is too often? I go like 3x/day. I also take HCTZ which has nothing to do with HRT but is another diuretic (prescribed for blood pressure). I drink 8 glasses of water per day.

I generally pee every 1-3 hours during the day, but that doesn't bother me half as much as waking up 3-4 times at night with a full bladder.

And that's on CPA, not on Spiro.

My doctor switched me to spiro and it's literally ruined every bit of progress I made in the 18 months prior to seeing him. 
What went wrong?
1.My voice deepened CONSIDERABLY. I had a voice so good people PAID me to do voice work. Now I sound "trans."
2.Hair loss... Considerably more hair loss since switching
3. No energy now at all. None. I went from hiking 10 to 20 miles a week, sometimes more, to a person that can't stand going up and down stairs at work.
4.Peeing...Good lord. I have to carry extra clothes to work.
5.I went back to being the same aggressive angry person I was before Cyprotereone. This is honestly the most disturbing.
6.Now i do get what I call "morning issues." And I get stimulated easier so I have completely quit being sexual with my boyfriend.
7. I feel like there's more I am missing.

But i have been so depressed since my hair started falling out again that I pretty much am giving up on transition.  Honestly the switch hurt every facet of my transition as far as I can see.

He talked about switching me back. He even admitted spiro is nowhere in the league of Cyproterone. That's why he also suggested Flutamide. Not to many trans folks get that and with good reason. It does not lower T on it's own.

Quote from: Ruth Ruthless on March 17, 2015, 07:49:28 AM
I generally pee every 1-3 hours during the day, but that doesn't bother me half as much as waking up 3-4 times at night with a full bladder.

That honestly has never happened to me and I'm on spiro, HCTZ and I'm diabetic. That is really bizarre.

I'd say it's because of my whole plant foods diet that means I eat foods rich in water content, but I think it happened to me when I started hormones though happened even more on whole plant foods. I shudder to think how much more I'd pee on spiro and sammielicious' experience scares me.

Probably. It could also help explain some of your other issues too but I'm guessing.

Maybe I'm peeing out all the estrogen. :P

Quote from: sammielicious on March 17, 2015, 09:21:19 AM
That's why he also suggested Flutamide. Not to many trans folks get that and with good reason. It does not lower T on it's own.

To suggest flutamide when there is now a safer alternative, BICALUTAMIDE, on the market is STRANGE. This avoids the side-effects of diarrhea and liver impairment sometimes seen with flutamide and only needs to be taken once daily compared to three times daily with flutamide due to shorter half-life.

Flutamide, bicalutamide are non-steroidal anti-androgens that are used in prostate cancer patients to inhibit androgens. They are POTENT anti-androgens and despite not lowering androgens, they block them so effectively that androgens have little effect on the body.

This topic is funny as I recently went from Spiro to Cyproterone Acetate myself. I wish I could say I don't pee as often but I'm honestly not sure. I still have to go a fair bit in a day. Maybe just not as back to back as with the spiro. So far I've been enjoying the effects of CPA now that I got through the weird high/low crash. I take an anti-anxiety/depression med as well so that probably staves off the low periods just fine. The body hair loss has is super comforting, while the head hair growth has been quite nice, though I think Spiro was doing well in that regards. I had only switched because the dose of spiro I was on wasn't lowering the testosterone enough, especially given my estrogen levels. I've got my first bloodwork since the switch, so let's see if CPA has done it's job or not.

One thing I will say, especially if you take premarin, is I feel a bit safer with Spiro + Premarin than CPA + Premarin. If my financial situation was better I'd switch over to Estrace and pay for it but I...just don't make that kind of money to comfortably do so. I still might anyway depending on how my results go and of course, a talk with my doctor. Though if I'm talking saving money, I probably should just go straight to injections since they're covered on my drug plan (yet Estrace isn't, Ontario's Drug Benefit plan is so much nonsense sometimes XD)

Quote from: Yukihime on March 23, 2015, 09:18:00 PM
I feel a bit safer with Spiro + Premarin than CPA + Premarin.

To my knowledge, Premarin and CPA both adversely affect clotting and prolactin secretion, thereby potentially leading to certain health problems while Spiro neither affects clotting or prolactin but may affect other health parameters. Double check with your doctor/pharmacist as always and you could also read what the science has to say about it.

QuoteIf my financial situation was better I'd switch over to Estrace and pay for it but I...just don't make that kind of money to comfortably do so. I still might anyway depending on how my results go and of course, a talk with my doctor. Though if I'm talking saving money, I probably should just go straight to injections since they're covered on my drug plan (yet Estrace isn't, Ontario's Drug Benefit plan is so much nonsense sometimes XD)

It seems, according to what I've come across, that injections of bio-E or EV affect clotting much less than Premarin. Had I been in your situation, I would have ceased Premarin already and either switch to Estrace, regardless of cost, my health matters more or since you say injections are covered, then discuss this option with your doctor ASAP. This is just my position on the matter. I'm not a professional. ;) My intentions are in the right place.

Quote from: KayXo on March 23, 2015, 11:06:18 PM


To my knowledge, Premarin and CPA both adversely affect clotting and prolactin secretion, thereby potentially leading to certain health problems while Spiro neither affects clotting or prolactin but may affect other health parameters. Double check with your doctor/pharmacist as always and you could also read what the science has to say about it.

It seems, according to what I've come across, that injections of bio-E or EV affect clotting much less than Premarin. Had I been in your situation, I would have ceased Premarin already and either switch to Estrace, regardless of cost, my health matters more or since you say injections are covered, then discuss this option with your doctor ASAP. This is just my position on the matter. I'm not a professional. ;) My intentions are in the right place.

I've got my appointment later today (since it's past midnight at the time of this post). I got my bloodwork done Monday so let's see what the results are. I'm going to definitely talk with my Doctor again about my estrogen medication. To be honest, I'm not afraid of needles per say but more so of giving myself an injection. Which I totally think is childish but it is holding me back a bit from switching to that route. When I first spoke with my doctor last year about doing my HRT regimen, I was interested in doing so and she explained how it worked but I got squemish at the thought and felt like I'd be more responsible taking pills. I was supposed to avoid premarin and go for estrace based on info I'd gleaned from my lurking days but financial reasons worked in premarin's favour. In it's defense, it was quite fine health wise too. It's only in my eight month that premarin started to act up.

I find it suspicious that it did so after switching to CPA too. I paused my premarin momentarily to confirm and it was indeed premarin which was giving me issues. Therefore, I will defo be talking with my doctor and getting prepared to go the injection route, it is available to me after all. Worse case if I still find myself with a bit of cold feet, I'll switch them to Estrace and by my hrt anniversary, I'll get on injections (July 30th ^-^). Thanks for the advice Kay, your posts have always been informative for me <3

Here is the what injections were for me. The issue of the needle was 100% in my head.

After the 3rd injection I had no issue at all. The 1st one I fainted, 2nd almost fainted. Third one I had the slightest of feeling and from there on out nothing. There is a very minor pinch and a feeling as you inject, not pain, just a feeling.   I inject in bed and after put no weight on my leg and go to bed.

The benefit the next day and following week, well I look forward to injections now.

I have only done pills and IM. There were a lot of pills per day and although there was a great benefit from the pills I really enjoy the feeling of the high level of E with injections and I see and feel better results.

I still have issues with needles and passed out 3/20 from a blood draw but IM is not an issue.

Quote from: Cynthia Michelle on March 26, 2015, 07:25:34 PM
Here is the what injections were for me. The issue of the needle was 100% in my head.

After the 3rd injection I had no issue at all. The 1st one I fainted, 2nd almost fainted. Third one I had the slightest of feeling and from there on out nothing. There is a very minor pinch and a feeling as you inject, not pain, just a feeling.   I inject in bed and after put no weight on my leg and go to bed.

The benefit the next day and following week, well I look forward to injections now.

I have only done pills and IM. There were a lot of pills per day and although there was a great benefit from the pills I really enjoy the feeling of the high level of E with injections and I see and feel better results.

I still have issues with needles and passed out 3/20 from a blood draw but IM is not an issue.

Thank you for that post Cynthia and thanks again Kay. I'll be switching to injections officially, got my prescription and sent out the fax to get it covered. It's a bit of a hassle, since the pharmacy is further away for the compounding and I'll be using two different pharmacies to get my medication for the time being but my Doctor has offered to give me the injections for now until I get used to doing it on my own =)