Susan's Place Transgender Resources

ok, i've noticed a lot of you say you docs have put you on some form of E, and some form of anti-androgen, usually spiro for short. the list i got from my friend at walmart of the $4 meds lists it as a heart health and blood pressure medication.

in my understanding, most of you on here that are taking it, i'm interpreting it to mean that it is an anti-androgen and blocks testosterone, but i am not sure because if i look up the effects of some of these medications by search and transsexual is included, i don't get the info i'm looking for. it goes the same for if i look up spiro by itself. my ex wanted to know why the docs would prescribe this med for hrt. and i would like some proper info on it for myself.

am i correct that it is used as an anti-androgen? if so, please explain how.

am i also correct in assuming that it's MOST common function is for docs to prescribe it for heart health and blood pressure?

any help is greatly appreciated, so i can realy the info to my doctor, he has swithced me to the Estradiol, so it will cost me less, but i'm not sure about any AA's yet. my ex's theory, is that he didn't see a lot of masculinity in me to begin with and may have assessed that i do not need it yet as it may lower my T too much.

does her theory sound valid?

waiting for those that can help....thanks Warrior Princess Mekayla

Spiro has a side effect of blocking testosterone.  It is used for blood pressure and as a diuretic.  We use it because of the side effects,  ;D

Janet

the amount of t "needed" is mostly a blood serum thing, (and genetics, depending on the sensitivity to androgens)
here's a nice little .gov page on spiro
http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682627.html (http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682627.html)

Spiro is a very old BP med that is rarely ever prescribed nowadays because it isn't as effective to lower BP as newer meds and it has a very strong side effect to shut down Testosterone production. That is why we take it. It is getting more expensive too. While I have a prescription, I get mine overseas at a fraction of the cost in the USA. I don't need it for T lowering now but I keep taking it for my BP cause it works for me.

i see but i'm confused on two of the side effects. it's prescribed for women with abnormal facial hair, but it also can cause hair growth on the body?? would this include the face as well? sounds like it shoots yourself in the foot? also it can deepen your voice? i really don't want that after i've worked so hard to get it where it is now, it's not perfect, but no one sirs me on the phone at all. can someone unconfuse me, please?

Quote from: The Only Warrior Princess Mekayla on May 28, 2009, 12:28:51 PM
i see but i'm confused on two of the side effects. it's prescribed for women with abnormal facial hair, but it also can cause hair growth on the body?? would this include the face as well? sounds like it shoots yourself in the foot? also it can deepen your voice? i really don't want that after i've worked so hard to get it where it is now, it's not perfect, but no one sirs me on the phone at all. can someone unconfuse me, please?

Since Spiro lowers Testosterone, it also lowers DHT a derivative of testosterone which causes hair to fall out i.e. baldness. The net effect is some hair growth.  It has no effect on the voice at all.  It does inhibit female hirsutism  ( beards and other male pattern hair) because Testosterone promotes male pattern hair growth in women.

http://en.wikipedia.org/wiki/Spironolactone (http://en.wikipedia.org/wiki/Spironolactone)

Spiro is really very common in MTF HRT. Just about every transwoman I know has been taking it. Some for years and years. 

Maggie

so then i should highly recommend that my gyno prescribe this for me? does it cause a lot of hair to fall out? is there meds to counteract this or does it does it fix itself?

Quote from: The Only Warrior Princess Mekayla on May 28, 2009, 12:51:11 PM
so then i should highly recommend that my gyno prescribe this for me? does it cause a lot of hair to fall out? is there meds to counteract this or does it does it fix itself?

You won't lose any hair by taking Spiro. GG's with hirsutism do. As for asking your Doctor, I am surprised that he/she hasn't prescribed it already.  Certainly it is worth discussing it.

Maggie

Quote from: Maggie Kay on May 28, 2009, 01:05:21 PM
You won't lose any hair by taking Spiro. GG's with hirsutism do. As for asking your Doctor, I am surprised that he/she hasn't prescribed it already.  Certainly it is worth discussing it.

Maggie

Actually to be fair to the doctors, while they may be familiar with prescribing HRT to cis females, many are not familiar with prescribing the same for MtF.

-={LR}=-

well he acted like he had at least done some research, cuz he went over a number of ways of how medicines and surgeries could be performed. i don't have a lot of facial hair to begin with, but i don't want anymore either, and i just don't think estrogen alone is goiing to stop it or make my breasts develop like i want(hopefully). guess i will need to mention it to him when i go see him again, my next appointment is in oct. should i see him before then or wait till then? i usually don't have a problem getting an appointment, just getting someone to watch my kids...lol.

This is really the kind of thing that should be handled by an endocrinologist or at least a physician who specializes in transgender HRT.   And you are correct, estrogen won't stop facial hair from growing. It gets finer and does slow a bit but there are just as many hairs as before.

the sad thing is they don't exist in my area, they are all over 2 hrs or more away in either direction of travel. i'm grateful that this dr. is at least giving it a shot. i'll probably have to get him updated on some of this so anybody else that comes after me won't have to explain so much.

It's a potassium storing diuretic. It will make you pee more and cause your body to retain sodium. For me, maybe it's just because I am forced to drink a lot more water, but it fixed my lifelong constipation problem wonderfully. Any effects that you get from lowered testosterone will be granted by spiro.

Also I just discovered tonight that cappuccino mix has a HUGE amount of potassium in it (800+ per 100g), not a good thing considering I just drank 6 extra strong cups at Dennys. Eeergkh.

Just for the record ... the above poster probably meant that it "... cause your body to retain Potassium...".  You'll be dumping sodium, which is one of the reasons you'll also be craving sodium.  In some ways Spiro is a perfect little drug for MTF's, causes more hair on top and less below ;)   Also knocks out Testosterone.  Down side are the side effects, but just make sure your doc is monitoring your electrolytes etc and you should be fine.  Most only need Spiro for  a while.

So...does spiro do anything to reduce body hair in males or only in females? Which is to say, I'd love to have at least some reduction in the acreage I have to shave every other day, if it's possible.

Even if I'm not ready for E yet, knocking down some of the T wold be a coolness.

Laura,

A DHT blocker like Avodart is much better at the body hair issue ;)

Check this out, I think it gives a good summary.

http://en.wikipedia.org/wiki/Hormone_replacement_therapy_(male-to-female)#Anti-androgens (http://en.wikipedia.org/wiki/Hormone_replacement_therapy_(male-to-female)#Anti-androgens)

Quote from: CharleneT on August 02, 2009, 10:43:51 PM
Laura,

A DHT blocker like Avodart is much better at the body hair issue ;)

What ho?!
(that's old english stuff, not name calling...trying to be cute might be misunderstood lol)

the same thing that treats enlarged prostate and uninary flow issues (the latter of which I have) is also a DHT blocker?

Oh my my my...will have to look into that...

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Post Merge: August 03, 2009, 02:59:11 PM

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listed potential side effects...

Quote
Less serious Avodart side effects may include:

    *

      decreased libido (sex drive);
    *

      decreased amount of semen released during sex;
    *

      impotence (trouble getting or keeping an erection); or
    *

      breast tenderness or enlargement.

I'm in!!!

>:-)

ahem... bad news (other than some of the side effects) is that Avodart is pricey stuff since it is pretty new.  There is an older drug called finasteride ( Proscar or Propecia) that does similar things.  Not quite as well.

Bummer. I was hoping it was on the $4 list

I was taking Flomax when I was on medicaid but it's not on the $4 list either.

I've heard of Propecia. You are saying that's a potential DHT blocker too?

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Post Merge: August 03, 2009, 03:31:16 PM

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the wiki page on Propecia suggests that when DHT is blocked, E has a greater effect but also that T levels rise..would that ultimately be self defeating?

And is this also true of Spiro and the others stuff mentioned here?

If you want a DHT blocker, saw palmetto does that pretty well. I took hundreds and hundreds of those before I moved on to stronger stuff.

BTW, on the subject of the other drugs, while you can get these meds on line w/o a prescription, they are all pretty heavy meds and can really cause major problems if you aren't being monitored by a physician.  Serious stuff. Self medication is really a last resort.  What good is having boobs when you are drooling from a stroke?

The most dangerous drug that I was willing to try as an anti-androgen when I was not at the place where my family would allow me to seek care for being trans was cimetidine.  It is Tagamet and available over the counter.  It does block testosterone and does cause breast development.   Spiro isn't cheap but the cimetine actually cost me more and it isn't as effective.  I took 1800 mgs a day of cimetidne but when I look back at it, it was a stupid thing to do.  I should have done it according to HBS and WPATH. I was desperate and had no family backing.  When my GID became crippling, I finally got help and from a doctor.

Maggie

Well, I'm not thinking directly of self-medication - I'm thinking of something a doctor would prescribe for a condition I actually have which happens to be available generically and, happily, has a transition friendly side effect.

I've seen differing opinions about SP

the side effects I'm interested in are first and foremost effects on body hair, secondly combating thinning on top and thirdly breast effects.

But I'm not considering going outside the system - money would prevent that if nothing else.

When I first took Saw Palmetto for an enlarged prostate, in a matter of weeks I noticed that my body hair sprouted out all over the place.  My head hair was receding fast too before that.  The problem with blocking DHT is that it then causes a higher level of testosterone because DHT is a breakdown product of T.  The hair came out was male pattern hair that was no longer being inhibited by DHT. 

Spiro is pretty well tolerated and while most non trans educated doctors don't ever prescribe it, it is common as salt in most transwomen I know.  I still take it because I have high blood pressure and my wife has edema. Spiro works for both of us in that way.  I don't need an anti androgen. 

The body hair that I do have today is very fine, like a baby's and not the long coarse stuff that I used to have.  It is so fine that I rarely have to epilate my legs or arms.  Maybe once every six weeks. It used to be every weekend. Oh, I probably said it before but my head hair seems to have stopped receding and the thinning areas seem to have light hair returning.  Not all get this though. I think it depends on how long the follicles had exposure to DHT.

Quote from: Maggie Kay on August 03, 2009, 04:01:34 PM
When I first took Saw Palmetto for an enlarged prostate, in a matter of weeks I noticed that my body hair sprouted out all over the place. My head hair was receding fast too before that.  The problem with blocking DHT is that it then causes a higher level of testosterone because DHT is a breakdown product of T.  The hair came out was male pattern hair that was no longer being inhibited by DHT. 

Oh my lord NO! the LAST thing I need is MORE body hair!!!

Quote
Spiro is pretty well tolerated and while most non trans educated doctors don't ever prescribe it, it is common as salt in most transwomen I know.  I still take it because I have high blood pressure and my wife has edema. Spiro works for both of us in that way.  I don't need an anti androgen. 

One wonders if one could ask a doctor who was considering treating blood pressure if they would use spiro to treat it.
I'm still a bit confused about the effects of spiro alone (as opposed to in conjunction with some sort of E)

My thoughts keep running to the idea of trying to get on spiro as soon as possible even if it's a year or two before I get on E in order to try to deal with the hair issues (and also to find out what hair I can lose that way before I ever pay for laser to remove something unnecessarily)

Quote
The body hair that I do have today is very fine, like a baby's and not the long coarse stuff that I used to have.  It is so fine that I rarely have to epilate my legs or arms.  Maybe once every six weeks. It used to be every weekend.

This is the sort of thing I'm interested in....fewer hairs, hairs in fewer places, and less coarse hair where it does exist.

(of course, I'm also greatly impatient to get an epilator when I have the spare cash)

Quote from: Laura Hope on August 03, 2009, 04:19:01 PM
Oh my lord NO! the LAST thing I need is MORE body hair!!!One wonders if one could ask a doctor who was considering treating blood pressure if they would use spiro to treat it.
I'm still a bit confused about the effects of spiro alone (as opposed to in conjunction with some sort of E)

Careful, the effects of S.P. and a DHT blocker like Avodart are not the same.  Important note:  the DHT blockers do not stop testosterone production, rather they stop testosterone from attaching to the receptor sites.  Hence your free testosterone value may go up at first.  As for doc's scripting Spiro it may vary as to what they think, it is an old drug for blood pressure and newer ones work better.  I'd be honest about the reason you want it.  They are likely to be ok with TS/TG status. 

Spiro alone will basically shut down testosterone production after a while ( hence why a combo of Spiro and Avodart is so popular , you're getting rid of T at both ends of the process).  Spiro can trigger some other feminization  things, just not as well as Estrogen.  Remember that one of the common side effects off Spiro is reduced or eliminated libido.

Quote from: Laura Hope on August 03, 2009, 04:19:01 PM
My thoughts keep running to the idea of trying to get on spiro as soon as possible even if it's a year or two before I get on E in order to try to deal with the hair issues (and also to find out what hair I can lose that way before I ever pay for laser to remove something unnecessarily)
This is the sort of thing I'm interested in....fewer hairs, hairs in fewer places, and less coarse hair where it does exist.

(of course, I'm also greatly impatient to get an epilator when I have the spare cash)

hmm... not sure Spiro is the best for that hair issue.  I have a friend who uses a DHT blocker solely for hair issues and it leaves the libido intact.  Something to consider.  IF it is possible for you to borrow someone's epilator I would recommend it.  They work well for some and not at all for others.  Somewhere inbetween for most.

QuoteAs for doc's scripting Spiro it may vary as to what they think, it is an old drug for blood pressure and newer ones work better.  I'd be honest about the reason you want it.  They are likely to be ok with TS/TG status.

Well, my BP is borderline so "doesn't work as well" would be alright - and my doc knows about me and didn't react negatively so she'd be sympathetic to the reasons probably.

QuoteSpiro can trigger some other feminization  things, just not as well as Estrogen.  Remember that one of the common side effects off Spiro is reduced or eliminated libido.

Yeah, I've thought about that - particularly about the ability for erection. One part of me kind of likes the idea that this would be a "side effect" that I had no control over (i.e. "not my fault") as far as my wife is concerned...and another part of me is pretty uncomfortable with the idea of being sneaky about that.

Quote
I have a friend who uses a DHT blocker solely for hair issues and it leaves the libido intact.  Something to consider.

That wold certainly be an ideal outcome. Depending of course on the cost of the drug and so forth.

Albeit, if it were possible to get feminzing side effects from anything and still be able to achieve erection for her sake that would be the best of all.

It's hard to get the best of both worlds with feminizing hormones ( pun intended )


Char