Susan's Place Transgender Resources

Community Conversation => Transitioning => Hormone replacement therapy => Topic started by: LexiDreamer on May 16, 2017, 02:31:33 PM

Title: Experience with Bicalutamide or Casodex?
Post by: LexiDreamer on May 16, 2017, 02:31:33 PM
There doesn't seem to be a lot of information on Transwomen taking Bicalutamide for anti-androgenic effects.

The small amount I've read has some women reporting a complete and permanent loss of body hair, this side effect sounds very enticing. 

Can anyone who has taken it please respond and relate how you feel about it?

Thank you.  :)
Title: Re: Experience with Bicalutamide or Casodex?
Post by: KayXo on May 16, 2017, 04:33:34 PM
I took it for awhile pre-op. I didn't really notice any additional effects on top of what I was already experiencing before. From what I read, it seems to be a relatively safe but expensive androgen antagonist. It is apparently very effective for reducing body hair growth. It only blocks androgens, does not reduce their concentration.
Title: Re: Experience with Bicalutamide or Casodex?
Post by: LexiDreamer on May 17, 2017, 09:23:25 AM
Quote from: KayXo on May 16, 2017, 04:33:34 PM
I took it for awhile pre-op. I didn't really notice any additional effects on top of what I was already experiencing before. From what I read, it seems to be a relatively safe but expensive androgen antagonist. It is apparently very effective for reducing body hair growth. It only blocks androgens, does not reduce their concentration.

Can you remember what the mental affects were?
If it doesn't reduce T production and theoretically will increase T production by just blocking androgen receptors, the excess T will still have an effect on the brain. This is my main concern about Bicalutamide.

Personally I'd love to get off of Spiro, as I am taking a fairly high dosage right now. I'm also currently taking SL Estradiol and Prometrium, for cross-hormone therapy.

I'm also taking Welbutrin for mild depression and Vyvanse for focus issues.

Any known concerns with mixing Bicalutamide with other meds?
Title: Re: Experience with Bicalutamide or Casodex?
Post by: Dani on May 17, 2017, 08:19:28 PM
Lexi,

I looked up drug interactions for you and I did not see any of the drugs you mentioned as causing a significant interaction with Bicalutamide.

As for mental side effects, the only thing listed was a little nervousness. The reference did not specify how the nervousness was expressed. 
Title: Re: Experience with Bicalutamide or Casodex?
Post by: KayXo on May 18, 2017, 11:44:28 AM
Quote from: LexiDreamer on May 17, 2017, 09:23:25 AM
Can you remember what the mental affects were?

None as far as I could tell.

QuoteIf it doesn't reduce T production and theoretically will increase T production by just blocking androgen receptors, the excess T will still have an effect on the brain. This is my main concern about Bicalutamide.

If taken alone, T production will go up. If taken with E, T production will go down as E reduces LH and testicular production of T. Bicalutamide blocks androgen receptors in the brain too, this is is why LH is increased in bicalutamide monotherapy, the pituitary gland is at the base of the brain.

QuoteI'm also taking Welbutrin for mild depression and Vyvanse for focus issues.

Studies show estrogen and progesterone to exert anti-depressive actions, more so estrogen while the latter aids with concentration. Haven't you found that your need for these medications lessened since HRT? Unless your doses are very low, too low to have any significant effect.

QuoteAny known concerns with mixing Bicalutamide with other meds?

https://www.drugs.com/drug-interactions/bicalutamide.html

This site can also be helpful.
https://en.wikipedia.org/wiki/Bicalutamide
Title: Re: Experience with Bicalutamide or Casodex?
Post by: Lucie on May 21, 2017, 02:45:06 PM
I have been taking bicalutamide since July 2016. As for now I have been mostly disappointed as it has not really speed up or increased the feminisation of my body (compared with estradiol+progesterone only). The only positive effect that I might attribute to bicalutamide is that I now have almost no more body hair.

I must add that so far I have experienced absolutely no adverse or side effects of any kind.
Title: Re: Experience with Bicalutamide or Casodex?
Post by: LexiDreamer on May 22, 2017, 09:22:02 AM
Quote from: Lucie on May 21, 2017, 02:45:06 PM
I have been taking bicalutamide since July 2016. As for now I have been mostly disappointed as it has not really speed up or increased the feminisation of my body (compared with estradiol+progesterone only). The only positive effect that I might attribute to bicalutamide is that I now have almost no more body hair.

I must add that so far I have experienced absolutely no adverse or side effects of any kind.

Lucie, thank you very much for sharing your experience.
I don't think it is supposed to increase any feminization, as that's what the E and P are for.
The reduction of body hair is the primary effect I'm looking for. I've been taking Spiro since August 2016 along with Estradiol and my body hair hasn't slowed down much. I did get full body laser done and it zapped most of the dark hairs on my body, but I'm very blond and so is the majority of my hair. I have to epilate most of my body once a week and it is a pains-taking and lengthy process.

A few questions if I may:

Have you taken any other anti-androgens such as Spironolactone, if so did you notice any differences?
Do you have it prescribed to you, and if so was it hard to convince your Dr?
About how long after taking it did you notice your body hair reduction?
Did it affect your facial and pubic hair at all?

For anyone else willing to weigh in (especially KayXo as she seems quite knowledgeable), would there be any kind of risk/benefit from taking both Spiro and Bicalutamide at the same time?


Title: Re: Experience with Bicalutamide or Casodex?
Post by: Lucie on May 22, 2017, 10:04:00 AM
Quote from: LexiDreamer on May 22, 2017, 09:22:02 AM
Have you taken any other anti-androgens such as Spironolactone, if so did you notice any differences?

Bicalutamide is a quite strong anti-androgen indeed. So far I have not taken any other anti-androgen.

QuoteDo you have it prescribed to you, and if so was it hard to convince your Dr?

My endo did not know bicalutamide at all and at first she did not want to prescribe it. I showed her the wikipedia page about that molecule and she eventually accepted to write the prescription.

QuoteAbout how long after taking it did you notice your body hair reduction?

I don't remember exactly, a couple of weeks maybe.

QuoteDid it affect your facial and pubic hair at all?

It had absolutely no effect on facial and pubic hair.

QuoteFor anyone else willing to weigh in (especially KayXo as she seems quite knowledgeable), would there be any kind of risk/benefit from taking both Spiro and Bicalutamide at the same time?

IMO taking bicalutamide in addition to spironolactone should not harm. But I am not a doctor. As for the possible benefits your mileage may vary. It might allow you to stop taking spironolactone.
Title: Re: Experience with Bicalutamide or Casodex?
Post by: KayXo on May 23, 2017, 02:34:30 PM
I personally don't see the benefit of taking both anti-androgens. However, Spiro can reduce water retention and help some with high blood pressure. But, there are potential side-effects associated with it (constant peeing, dry skin, dizziness, hyperkalemia). Please discuss options with your doctor.
Title: Re: Experience with Bicalutamide or Casodex?
Post by: LexiDreamer on May 30, 2017, 02:08:00 PM
I tried talking my GP into switching me to Bicalutamide

I sent her this message:

I've been having some difficulty with some of the side effects of the Spironolactone I've been taking. Mainly the dehydrating effect and subsequent cramping and malaise I often experience from it.
I've heard of some very positive results (for Transwomen) from another anti-androgen medication called Bicalutamide (brand name Casodex).
It has a much lower side effect profile than Spironolactone, with much more of the efficacy. It doesn't lower the production of testosterone, but instead blocks the testosterone receptors so the testosterone has no effect on the body. It also appears to be very effective at lower doses for these results. As I understand it, only the liver enzymes need motioning for safe administration, since testosterone levels would only be effected by the estradiol I'm taking.
I'd like to propose switching out the Spironolactone for a trial run of the Bicalutamide.


Her response:

As discussed at your first appointment, we follow the Calllen Lord guidelines as far as hormone
replacement and blockers. If you would like I can refer you out to Endocrinology for transgender
care whom have a broader range in what they are willing to order. At this time I did send a lower
dose of the Spiro to the pharmacy.

I guess she missed the point. :(

I was trying to avoid self medicating...
Title: Re: Experience with Bicalutamide or Casodex?
Post by: April_TO on May 30, 2017, 02:23:51 PM
I noticed they have Cyproterone Acetate. I was on it for 2 years on minimum dose even lower than what was suggested on the guide and I saw huge improvements in feminization compared to Spiro. Since she wouldnt prescribe Bicul. then I will explore CPA if that will interests you.

Goodluck!
Title: Re: Experience with Bicalutamide or Casodex?
Post by: LexiDreamer on May 30, 2017, 02:52:24 PM
Quote from: April_TO on May 30, 2017, 02:23:51 PM
I noticed they have Cyproterone Acetate. I was on it for 2 years on minimum dose even lower than what was suggested on the guide and I saw huge improvements in feminization compared to Spiro. Since she wouldnt prescribe Bicul. then I will explore CPA if that will interests you.

Goodluck!

Thank you for the idea April!
Coincidentally, I just replied back to her asking what they prescribe to trans women that don't tolerate spiro.

At this point, the Bicalutamide is on order. Since, I've found very little evidence of any negative side effects from it, I want to give it a try. I'm in a continuous battle with the hair on my body, and I'd really like to get the upper hand. Since many have reported permanent body hair reduction from it,  I think it's worth a try.
Title: Re: Experience with Bicalutamide or Casodex?
Post by: LexiDreamer on May 30, 2017, 02:54:34 PM
Quote from: April_TO on May 30, 2017, 02:23:51 PM
I noticed they have Cyproterone Acetate. I was on it for 2 years on minimum dose even lower than what was suggested on the guide and I saw huge improvements in feminization compared to Spiro. Since she wouldnt prescribe Bicul. then I will explore CPA if that will interests you.

Goodluck!

Could you list the differences you noticed from taking the Cyproterone Acetate that you weren't getting with the Spiro?

Thanks!
Title: Per my experience ...
Post by: Annecy on May 30, 2017, 03:09:50 PM
Quote from: April_TO on May 30, 2017, 02:23:51 PM
"I noticed they have Cyproterone Acetate.
I was on it for 2 years on minimum dose even lower than what was suggested on the guide and
I saw huge improvements in feminization compared to Spiro.
Since she wouldnt prescribe Bicul. then I will explore CPA if that will interests you.
Goodluck!
"
I was started on HRT in Amsterdam ...
In Europe CyproteroneAcetate/Androcur is (generally) used ...
instead of Spiro ...
I was on (varying doses ... for various reasons) Androcur for 13years ...
imo Androcur is FAR superior to Spiro ...
Androcur is generally not available in the USA ...
although (imo) it should be ... and is obtainable ...

Now that I have (finally) had GCS/SRS
I no longer have to deal with no fully safe/effective Anti-Androgens ...
Title: Re: Experience with Bicalutamide or Casodex?
Post by: Saskia_F on June 27, 2017, 06:17:06 AM
Last year I started HRT and took Bicalutamide the first time before I interrupted everything for a couple months.

All I can say is that it didn't seem to have the effects of Androcur that I've been taking for 3 months now. Comparing my blood test results from last and this year shows a significant difference: 4.6 Testosterone on Bicalutamide at a daily dose <not allowed> and after 5 months (last year), now 0.7 Testosterone at a daily dose <not allowed> of Androcur after 3 months!

Moderator Edit: Please, no dosages.  That's not allowed under the Terms of Service.
Title: Re: Experience with Bicalutamide or Casodex?
Post by: LexiDreamer on June 27, 2017, 11:14:33 AM
Quote from: Saskia_F on June 27, 2017, 06:17:06 AM
Last year I started HRT and took Bicalutamide the first time before I interrupted everything for a couple months.

All I can say is that it didn't seem to have the effects of Androcur that I've been taking for 3 months now. Comparing my blood test results from last and this year shows a significant difference: 4.6 Testosterone on Bicalutamide at a daily dose and after 5 months (last year), now 0.7 Testosterone at a daily dose of Androcur after 3 months!

From what I understand, you really can't compare the two anti-androgens with Testosterone tests.
Androcur actually reduced production of T, where Bicalutamide, only block the T receptors. Bicalutamide would not lower your T results.

After taking the Bicalutamide for 5 months, did you notice any difference in body hair growth?

Body hair reduction is the primary effect I'm looking for with the Bicalutamide.
Title: Re: Experience with Bicalutamide or Casodex?
Post by: KayXo on June 27, 2017, 04:46:08 PM
Quote from: LexiDreamer on June 27, 2017, 11:14:33 AM
From what I understand, you really can't compare the two anti-androgens with Testosterone tests.
Androcur actually reduced production of T, where Bicalutamide, only block the T receptors. Bicalutamide would not lower your T results.

Exactly. Androcur also blocks T, in addition to lowering it.
Title: Re: Experience with Bicalutamide or Casodex?
Post by: Chloe on August 29, 2017, 05:10:54 PM
Quote from: LexiDreamer on May 16, 2017, 02:31:33 PM
The small amount I've read has some women reporting a complete and permanent loss of body hair, this side effect sounds very enticing. 

Lexi, loss of body hair is true. This includes legs, chest and underarms (but not forearms, go figure!) Found an new expanded reference here (https://en.wikipedia.org/wiki/Bicalutamide):
QuoteBicalutamide may also be used to treat excessive hair growth in women,(14)

Worked for me!! After taking a reduced dose of Casodex for at least 7 years have found it's effects more or less permanate, as if my androgen receptors gave up, finally bit the dust!! Now 61 I stopped about 5 years ago, still have a full head of hair, and suffered no ill masculine effects.

States further down (https://en.wikipedia.org/wiki/Bicalutamide#Transgender_hormone_therapy) in the article that:
QuoteIt is also noteworthy that, when used as a monotherapy, bicalutamide significantly increases estradiol levels in biological males and hence can have indirect estrogenic effects in transgender women; this is a property that can be considered to be desirable in transgender women, as it can produce or contribute to feminization.

Currently on maintain dose of estrofem only, the only downside I've seen with Casodex is greater cost.

CHEERS  :angel: