I'm on my way to an appointment with an endocrinologist to talk about androgen blockers, and I wanted to ask everyone what I should know before going into the appointment and, more importantly, what I should ask the doctor.
I don't know whether your already on HRT.
Some doctors will want you to start on estrogen first. My doctor told me that some people naturally block T when given E. Other doctors start you on AA's first.
My understanding is that it's very unhealthy to be on T-blockers without E for long periods of time.
I'm not on HRT already, and I'm not sure whether I'm going to be. My therapist has recommended blockers as a temporary measure, to give me time to think.
Where did you get that information? Because that may be critical to me.
Look on the Transition section of the board under Hormone Replacement Therapy. In a nutshell you either need a minimum level of T or a minimum level of E to feel well. The longer term issues of having neither include loss of bone density leading to fractures. Not a happy place to go.
Then, again, how long is temporary? These are issues the endo can address.
Erin
This is a 'consult your doctor' kinda thing. The minimum T or E level thing only gets complicated after a couple of years, from what I understand about the matter.
Okay, thank you. Is there anything else you would recommend I ask the doctor?
Is the doc you're going to a doc that does trans patients routinely?
Huh? How old are you?
Im sure though the blockers will make you feel better...
they dont create new things...but they stop all those testosterone has created...
I went to see the doctor (yes, she treats trans patients regularly) and we decided, in conjunction with my parents (I'm a minor) that due to how late I am in puberty (Tanner stage 4.5-4.75) I'm not going to be going on blockers at the moment
Well from my experience spiro killed my erections and ejaculate pretty quickly; within the first month. They also make u pee NO STOP!
Yeah, the doctor suggested spiro, and we were pretty concerned when the doctor said it was a diuretic. It kind of disturbs me how much they use medicines that are supposed to be used for other things, almost as though they're being used for the side effects they produce in high doses, instead of the way they say it, which is that spiro's diuretic properties are a side effect.
Also I'm pretty sure the idea of androgen blockers is to kill erections and other T-induced functions.
I haven't taken my spiro in about 2 months but ive kept up with my injections.... today I had some "alone time" and im still not producing ejaculate, so im starting to think I may not need spiro; or atleast not much :-\
To expand on what suzi said, estrogen or testosterone is required for bone maintmence. If you are still growing doctors may be a bit worried to put you on antiandrogens without replacing it with estrogen as it could interfere with your bones, if you are fully grown then the doctor will have to weigh how important stepping you up from antiandrogens to estrogens and antiandrogens against how much bone density he or she thinks you need and at what rate bone density loss is expected.
So tl;dr bone density will drop without enough T or E but your doctor will be well aware of it and make choices with this in mind.
T blockers are a world of fun. And like many other things, it's a case of finding the one that works with you.
Spiro is common, and it's anti-androgenic properties are secondary.
There are more potent anti-androgens, but they're not available everywhere, so rely on your endo.
Personally, spiro did very little to me. My T was still normal for a male after months on it. I switched to Androcur which has been amazing.
Spironolactone (Spee-row, for short), is generally an effective and well tolerated T-blocker. Yes, it is principally a diuretic, but the reason drugs are commonly used for effects for which they are not indicated by the manufacturer is because it costs too many millions of dollars to get FDA approval for the other effects, and usually little profits available afterwards due to patent issues - not because they are either unsafe or un-effective. There are certainly also some cases with some drugs where this is not true, where there can be inherent dangers. Androcure (Cyproterone acetate - Cypro) is a powerful anti-androgen, but carries a risk (however small) of causing liver damage, although it is available in Europe (but not in the USA because there is no FDA approval for any use).
When one starts one of these T-blockers, the sudden drop in T can result in a shift of the Estrogen-Testosterone balance toward the Estrogen to T ration being higher. This can go on, apparently for some time, particularly because the male body gets at least some of its Estrogen by converting T to E. I'm not sure why, but apparently this conversion is eventually down-regulated, or there simply is not enough T to convert to sufficient E - eventually, development of female attributes (fat redistribution, breast growth, etc.) is curtailed.
Some, but not all, people experience mild breast development and fat redistribution, after beginning T-blockers. The reasons for the curtailing mentioned above is my speculation on why this development eventually stops. It would be nice to see a chart of serum bound T and E total amounts, ratios, and free hormones over time, beginning with just before a person begins T-blockers, in order to have a clearer picture of what is actually happening. If anyone has had those measurements performed on themselves, or if they know where such a chart can be found, please do let us all know.
Quote from: Suziack on March 27, 2014, 10:22:46 AM
This can go on, apparently for some time, particularly because the male body gets at least some of its Estrogen by converting T to E. I'm not sure why, but apparently this conversion is eventually down-regulated, or there simply is not enough T to convert to sufficient E - eventually, development of female attributes (fat redistribution, breast growth, etc.) is curtailed.
I'm not sure where the above is from, but this is not the way my endo explained Androcur working. I was told that it does two things. 1) Blocks the signals ( hormones ) from the pituitary gland which tells the testes to make T. And 2), binds to some free T in a similar way to spiro.
This is why the testes atrophy on such drugs, because they're no longer being used to produce T.