Susan's Place Transgender Resources

I would've put this in the dead linked "Spironolactone" wiki, but it's, well... dead.

So I know it is a "how long is a piece of string" question to ask when and in what way Spiro will affect me physically (and perhaps psychologically), but something must happen, right?

Admittedly I've only been taking Spiro, twice a day, for just over two-weeks. But with all the possible effects that my endo listed, surely I should be noticing something?

All I've experienced so far is a dry mouth right at the start of the therapy, which I now no longer suffer from.

Any input most welcome.


<no doses allowed>

It takes at least a month for any physical changes.

The first on spiro is often needing to pee, drink lots of water.

Oh and don't post dosages.

Quote from: Cindy on June 12, 2015, 05:32:33 AM

Oh and don't post dosages.

Oh, cripes! Apologies.

And thanks, Cindy.

No worries honey!

At 6 weeks I had difficulty getting an erection. I think the changes started to happen at week 5 and at week 6 I really felt the changes. It takes a bit to settle in. My T crashed from the spiro and my T was I think 26 ng/dl at my 6 week blood draw.

Within the first three months of starting it I had a blood test and my T was so low my endo thought I had had my balls removed! :laugh: I'd say that's something.. I can't say for sure how quickly everything else happened or what happened as a result because I was on E and P as well. But adding Spiro certainly made a difference within the first week for me.

It's difficult to quantify which of the following is due to also taking Finasteride and becoming a vegan, but:

• A quite remarkable regrowth of hair lost to thinning
• Reduction in muscle mass
• Tiredness
• Some breakouts and acne
• Increase in anxiety when I started and every time I was put on a higher dose (had to temporarily give up coffee)
• Gynecomastia
• Loss of libido

I need to add that in addition for spironolactone. I was placed on a 2/3 dose of e from the start and I was on a very high dose of finasteride for 5 months prior to hrt, which continued when I went on hrt.

When the T dropped and E took over I panicked and reduced my spiro (reported it to my PA-C) for a few days but resumed because I started to feel the hrt was less effective.

Your doctor is starting you slow so you can adjust to the meds, I suspect. 

Thanks for the responses, people!

Yes, I think I have been put on a low (though standard) dose of Spiro, and that is all I am taking (no estrogen).

Guess it will need to be increased, as my libido is as strong as ever, as are my erections, etc. I don't even have the dry mouth or urge to frequently urinate any more.

Will be interesting to see results of bloods.

Also of note is that my Sex Hormone-Binding Globulin is very high (no underlying pathology detected), while my testosterone levels are at the very low end of normal.

Well, I naively thought that over the past month and a bit I'd track any discernible changes as a result of my taking Spiro. As it turns out, after over a month on a strong dose, I have nothing to report -- nothing!

I'm starting to think that I'm one of the percentage of people who experience no anti-androgenic effects from taking Spiro.

I guess it's possible that my T is actually quite low as a result of Spiro (bloods next week) and that E will have a far greater effect than if I hadn't taken Spiro.

Your blood test will tell how spiro is effecting you.

Will the doctor place you on E next week? E helps lower T as well.

It takes time but when your body goes from T to E you will feel it.

My libido went up he first month or so and I lost weight.

Just because you think nothing is happening doesn't mean that is the case. It takes a while for the levels of testosterone to go down and the effect to become really noticeable. It may depend also how much T your body was already producing prior to starting, the body needs time to slow that factory down. Wait until your blood tests come in before worrying too much. :)

Spiro also blocks androgens (testosterone, DHT) somewhat so blood tests don't give you the whole picture of what's going on.

Quote from: KayXo on July 04, 2015, 08:22:24 AM
Spiro also blocks androgens (testosterone, DHT) somewhat so blood tests don't give you the whole picture of what's going on.

Ah, yes, that's right. Thanks. Will keep that in mind next week. I think the bloods are really to check that you're not having any adverse reactions (liver, etc.)

Quote from: Cynthia Michelle on July 04, 2015, 07:28:31 AM

Will the doctor place you on E next week? E helps lower T as well.

It's not planned, so probably not this time around. We will no doubt discuss when to introduce E.

Quote from: Ms Grace on July 04, 2015, 07:56:56 AM
Just because you think nothing is happening doesn't mean that is the case. It takes a while for the levels of testosterone to go down and the effect to become really noticeable. It may depend also how much T your body was already producing prior to starting, the body needs time to slow that factory down. Wait until your blood tests come in before worrying too much. :)

Yes, all true.

Prior to taking Spiro my T levels were at the low end of normal, but I had very high levels of Sex Hormone Binding Globulin (SHBG).

My endo couldn't find a reason for my SHBG being high; apparently some people just have high levels. While I understand that SHBG binds androgen and estrogen (influencing the amount of free hormones) I'm not clear what this means in real terms. And while my endo didn't mention that it would affect the progress of my HRT (and I pushed him on this point), he didn't help in my understanding of SHBG.

Oh, did I also mention that a few years ago I was on two separate 5-month courses of estrogen? I'm sure I mentioned it. Didn't I? Hm, maybe not.

Lol

Anyway, I responded extremely well (and quickly) to estrogen, but I bailed at the same point each time (for numerous reasons not related to my wanting to transition). I'm sure others have been through the on-again-off-again HRT merry-go-round.

Why did I raise my estrogen history? Well, I'm currently wondering why my endo (a different endo) decided to start with Spiro. I know there are different schools of thought on this point, but I've had a number of health professionals question, in passing, my starting with Spiro. Think they thought it was an archaic approach.

So... here I am again with, if anybody's interested, an update on how I'm getting on with my course of spiro.

It's going to be a very short report because even after 6-months, well... nothing's happened. And before anyone asks, and while I can't mention doses, yes, I am on a relatively high dose (as in an endo would think twice before upping the dose, as would I).

The spiro might be doing something, but I wouldn't know, as there's been no visible changes to body, face, sexual activity or ability (if you get my meaning). 

"What about bloods?," I hear you ask. Well I have had some done, but I don't know the results, as my endo's a hard person to get hold of.

I told my psych about all of this and he kindly offered to help me change endos -- an offer I think I'll take up.

Thoughts?

6 months is not a long time to see the full effects of spiro. However, you should see some minor changes on your skin and the decrease on your libido shortly after taking it.

Also, depending if you are outside the US. You can also try using a different AA i.e. cyproterone acetate and see if you'll yield better results.

Quote from: Serverlan on December 11, 2015, 06:34:35 AM
So... here I am again with, if anybody's interested, an update on how I'm getting on with my course of spiro.

It's going to be a very short report because even after 6-months, well... nothing's happened. And before anyone asks, and while I can't mention doses, yes, I am on a relatively high dose (as in an endo would think twice before upping the dose, as would I).

The spiro might be doing something, but I wouldn't know, as there's been no visible changes to body, face, sexual activity or ability (if you get my meaning). 

"What about bloods?," I hear you ask. Well I have had some done, but I don't know the results, as my endo's a hard person to get hold of.

I told my psych about all of this and he kindly offered to help me change endos -- an offer I think I'll take up.

Thoughts?

Quote from: April_TO on December 15, 2015, 02:42:50 PM
...you should see some minor changes on your skin and the decrease on your libido shortly after taking it.

Yeah, I haven't experienced any of that. My endocrinologist was warning me about all these things that would happen, but there's been nothing.

Quote...you can also try using a different AA i.e. cyproterone acetate and see if you'll yield better results.

Might be an idea.

So just received notification that my T level has reduced from 25 to 17. However, I have no idea what that means or if it's significant. Can anyone help?

Ahh... I seem to have worked it out. The values "25" and "17" appear to be measured in nanomoles per litre (nmol/L), which is within the low but healthy range (10-42 nmol/L) for males. But I guess many of you already knew all that.

I'm in Australia, so these values may not resonate with people from the US.

So seems to be a fairly good reduction in T for a 5-month period, though I have no real frame of reference, as getting info from my medical peeps is ludicrously difficult.

17 nmol/L =  490 ng/dl. Still high. It's normal you haven't seen much. You will start seeing changes usually at under 200, and more significantly at under 100. My testosterone is around 20 ng/dl, female range between 15-90.

Adding estrogen will further reduce T as will increasing dose of current anti-androgen or adding/switching to another anti-androgen like cyproterone acetate, for instance. These need to be discussed with your doctor ASAP.

You should also know that Spiro also blocks (although not too strongly) T so that part of the T measured is blocked but probably not that much. This is why measuring levels only tells part of the story.

Thanks, Kay!

Yes, still high. My GP, who says Spiro does nothing, was mildly encouraged by the drop from 25 to 17. But she also just gave my endocrinologist a nudge, as obviously he's dragging his feet. She doesn't know why, doesn't agree with, Spiro as an effective measure on its own. Glad I have her around.