Susan's Place Transgender Resources

My endocrinologist said Bicalutamide causes an increase in adrogen production. Can any of you fine girls link me some sources, provide your own anecdotes, and share with me more information that either supports this, or renders it false? I would love to know more on this subject. Is it true? Is it false? Let me know.

He said the testes will fight against it and begin to produce more androgens as a result of taking it. That's why he doesn't want to prescribe it to me.

Bicalutamide, taken alone, will indeed raise androgen production because it blocks androgen receptors BUT since it blocks  those receptors, the end result is still significant anti-androgenic action. If it were not sufficiently anti-androgenic, it would surely not have been used in men with advanced prostate cancer for decades whose survival depends on T and DHT being as inhibited as possible. It's also been shown to be effective for hirsutism in ciswomen. Studies have clearly established it is a strong and powerful ANTI-ANDROGEN. Read the wikipedia page, there are many references supporting the information in there. Check the references.

That's the whole point though, it's not the increase in androgen production while taking the drug that he's concerned about, but the consequences of what comes next after seizing its intake. He doesn't want me to be forced to take it indefinitely. Which I would be comfortable with doing, it's just the whole.. "What if I change my mind?" Regardless, I'm under the assumption that the androgen production will indeed stabilize back to a more desired level some time after discontinuing the drugs use. Any increase in masculation would be temporary. It wouldn't be THAT big of a deal. If I really did change my mind about the drug and wanted to stop, I'd be willing to deal with a phase of undesired effects.

I can try talking with him about this again, and let him know how I feel about the pros/cons. If he still refuses, and I'm that serious about trying it out, I can perhaps seek a 2nd opinion. I don't think that will be necessary though. I'm not that determined to take it. Curious yes, but not full on sights. It would be nice; though, to satisfy that curiosity. The results could either be A.) Appreciated. B.) Neither appreciated; nor, unappreciated. C.) Unappreciated.

I'd be willing to take the risk.

Like Kay said when taken ALONE there is an increase in free testosterone as by it blocking the receptors there is no takeup of T. However, when other hormones like estradiol are being taken, the body's signal for T lowers.

I don't see his reasoning myself. It is not much different than taking spironolactone. Spiro can sometimes lower T output because of its side effects but is less effective at T blocking than bicalutamide and has a lot more side effects in general.

As others have said, the fact that bicalutamide might raise your T level seems to be a moot point, as it's blocking the receptors.

I've been on it for four months now, and I should almost be getting a royalty check based on how often I tell people about the positive experience I've had, compared to some of the horror stories I've heard about spiro.

I detest the side effects of spironolactone. My skin becomes extremely dry when I take it prolonged, and starts cracking in various places, and chipping off like flaky powder. It gives me really bad headaches as well. I do fine without anti-androgens, but it's not entirely a bad idea, if a bad idea at all trying new medications and fine-tuning/optimizing my approach to acquire a more satisfying result. I'll bring it up to him again the next time I see him, and take things from there. He's denied me on scripts in the past that he eventually came through and prescribed me, so like most things in life; consistency is usually key to getting what we want.

Once you have removed the testes by either GCS or orchiectomey, there is no need to take an anti-androgen of any kind.

The main source of Testosterone is gone. The adrenal glands do produce some Testosterone, but at a much lower amount, easily putting us in the female range.

I'm in the female range regardless. It's more of a curiosity thing for me to want to take this medication. I don't need it, but I do want it. To at least try it and see if I benefit from it. If not, then I'll simply scratch it off the list, and move on without it. At least I gave it a shot to see for myself. If it were to set back my transition by some slight amount by causing a short raise in testosterone production. So what?! Lol. That wouldn't bother me one bit. How much is it going to raise it? 10 ng/DL from 14 to 24? Whoopdy do. Life goes on.

I honestly believe there are other reasons not mentioned he doesn't want to prescribe it to me. Perhaps he's already uncomfortable giving me things "off label" that haven't been approved for transgender care, and doesn't want to add more of that to the list. Seems more personal to himself than it has anything to do with me. At least, that's my observation of the matter.