Susan's Place Transgender Resources

Sadly, I was informed by my doctors that I had to completely stop taking estrogen because of my recent blood clot and that's even if I take blood thinners, due to my predisposition to develop DVT. So now I am only taking spironolactone. Does anyone know what kind of results I can expect from spironolactone only and how long it usually takes for any effects to take place? I had only been on spironolactone and transdermal estradiol for one month when my DVT happened. Now I am heartbroken and looking for any information that I can find to make my transition as effective as possible without the use of estrogens.
Any input would be appreciated.
Thank you in advance.

What you would have to rely on is the conversion from testosterone to estradiol. Normally spiro is used at a lower dose for blood pressure so testosterone isn't fully blocked. If your dose is sufficient to block all T production, then the only other source of estrogen is what's produced elsewhere in the body. I would suggest the next time you receive a blood test you as that your estradiol levels be checked to determine what your body is producing.

I don't know much about your blood clot issue but you might discuss a very low dose with your doctor. I am in the menopause range and still seeing body changes so it doesn't take much. Granted the transition will be far slower but it would be better than nothing.

I'd get a second opinion, and more if necessary. My endo treats trans patients with a history of blood clots and is very experienced in this area. More than 3000 patients and 20 years in trans medicine.

I'd also get a second opinion. There are studies showing that transdermal estradiol does not affect clotting, even reduces the risks in old men who have prostate cancer despite the dose being high and even in people who are predisposed to clots. In my humble opinion, this doesn't make much sense, just basing myself on the studies and puts you AT significant RISK as you will have low testosterone and low estradiol and essentially be in menopause for the rest of your life. As a result, your mood will suffer, you increase your risks of diabetes, cardiovascular problems, osteoporosis, you might feel fatigued, unmotivated, will age quicker, etc. Your memory might also deteriorate over time. If it were me, I would definitely seek a second and third opinion. I can share these studies with you, if you want in private and you can show the doctors.

I forgot to mention the following as well...

1) on just low testosterone and estrogen, there won't be much feminization.
2) ask your doctors what happens when a pre-menopausal ciswoman has a clot. Is she instructed to take drugs or remove her ovaries to stop her body's production of estrogen? If not, why not if transdermal estradiol mimics the type of estrogen delivered (i.e. estradiol) and the way in which it is delivered (i.e. directly into the blood) to ciswomen? If you are told you can't be on transdermal estradiol then shouldn't ciswomen who have a clot be treated likewise?

I apologize for my insistence and must mention I'm not an expert in the matter but it just frustrates me personally when a decision that is made does not appear to be supported by logical arguments and/or studies and when that decision adversely affects another person. Unless of course, I'm missing something... please keep us posted.

Take care.

Yes, I'd like another opinion but the catch is that the last doctor that specializes in HRT in the valley where I live has a 7-8 month waiting list. I'm Considering a 2 hour drive to LA or San Diego...

On spiro alone, you will become feminine, but not passable like a woman. Think of a "nymph-fairy-male", you will have a hard time getting a womanly figure, but you would become slender-weak-muscled-smoother skin.

I was on Spiro alone for 2 years on-off, and I didn't want to masculinize anymore at age 18.

The worst part of spiro is that you will eventually become too weak, and your bones will become frail, and then you will get arthritis/osteoporosis without estrogen. Your hair may get thinner.

Unless you can pass already, it will feminize you but not make you passable. You also sacrifice your bone health/energy levels for it too.