Susan's Place Transgender Resources

Community Conversation => Transitioning => Hormone replacement therapy => Topic started by: JustAnotherGirl on July 09, 2017, 05:29:04 PM

Title: Taking Estradiol without Spironolactone? Pros / Cons
Post by: JustAnotherGirl on July 09, 2017, 05:29:04 PM
Hi again,

I'm  curious what life might be like just taking Estradiol only?

Just wondering what I'd get out of it alone vs. taking it with Spiro?


I'm wondering? Does Estradiol by itself help promote Hair growth on your head without Spiro? 
Also Wondering how not taking Spiro -  how your Penis , Testicles & Sperm function differently?
Does Taking Estradiol only by itself decrease the probability Breast growth ?

What in Everybody Opinions on here does Spironolactone give you extra for your HRT Regimen ?


Just so ya' know ......I've been on an HRT regimen for about 6 months and have read plenty about what I'm taking I'm
just curious what some of you think threw YOUR Real World Experiences or Some of YOUR Friends Real World Experiences ETC?

Also hoping some Gals on here might be taking Estradiol ONLY and can share their experiences?

Thanks in Advance  :)
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: Dena on July 09, 2017, 07:03:56 PM
Without a blocker, I continued to have dysphoria full force, down below still functioned fine but fortunately or unfortunately I started late enough that most of the masculine development was finished so I didn't have any additional masculine changes. Feminization was slow but that could be because my body was slow to develop or because the testosterone inhibited the estrogen function. I know Spiro has some nasty side effects but if you can live with them, you are better off with Spiro than without.
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: JustAnotherGirl on July 09, 2017, 07:38:05 PM
in your opinion what do you think my experience would
most likely be if say :

Im not a very hairy MTF and
have a subtle receeeding hairline ( i care a lot about my hair as far as being a feminine thing )
and
don't really care for or if any boobies ( how much does Spiro influence breast development anyways and how much does Estradiol ? )
and
Do care if my Penis (for now) works???

I'm sorry if this seems weird or whatever?
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: Dena on July 09, 2017, 08:10:11 PM
Body hair will depend on your  genetics. My dad was relatively hairless however my mom had leg hair. I tend to lean toward my father's lack of hair except that I ended up with hairy legs. As far as head hair, both side of the family had pretty good hair but if your worried about losing it, there are medications you can take that will  prevent it. Talk to your  doctor about it if you are interested.

Spiro has little influence on breast development so on estradiol you should see some. How much will depend on genetics but after 6 months you should be getting an idea how responsive your body is. It will take a couple of years to 5 years to determine how much development you will have. If you are showing growth now, you can expect more even without Spiro.

As for a function bottom, if that is your primary goal, the doctor could reduce your  Spiro dosage allowing your body to  function while still retaining relatively low testosterone levels. This would have to be monitored with blood tests to hit the correct dosage but it could reduce dysphoria, reducing the risk of hair loss while still allowing you to function.

As always, the best person to discuss this with is your doctor as your doctors will know your body far better than we do.
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: DawnOday on July 09, 2017, 08:52:20 PM
My hair is thicker and stronger with Estradiol. In my prior 25 years on low dose Spiro I had some breast enlargement but nothing like I have now, and my hair continued to thin. However, my last test showed my T was still a little high. So my doc offered two alternatives. Finasteride or Orchiectomy. Orchi would be the ultimate as the t would hover around 0. Finasteride will give a boost to breasts, limited though it may be. But is probably a side effect of lower T. However Finasteride also known as Propecia is used to reverse male pattern baldness. Last but not least Spiro is a diuretic mostly used for congestive heart failure to keep fluid from building in the pericardium. Thus you pee like a demon. Of course this is my experience so far your result will vary.
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: SadieBlake on July 09, 2017, 09:21:33 PM
Estradiol valerate intramuscular was all I needed to fully suppress testosterone. My levels run apx 225 pg/ml E, 17 ng/ml T. I will get new post op levels in a couple of weeks, I assume the E will be unaffected.
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: LindseyP on July 09, 2017, 09:50:10 PM
What works for each person for HRT is different.  It's why our endos monitor our blood results and tweak what they are doing.  Spiro is just a tool to block T.  If the Estradiol gives you elevated E but you still have high T, you can get some imbalances that could have you not feeling well, or leave you fatigued.  Zero levels on each aren't good either.  I stopped trying to second guess it, and just told my endo what I was going for.  I am having much better results now, and I also feel better. 

Edit:  As explained by someone else, Spiro does not block T in everyone.  It does have a major impact in blocking the effects of Androgens.  This does not change my larger point about having clear communication with your medical professionals to achieve the best results for you.  What has happened with someone else may be completely different when applied to your physiology. 
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: kelly_aus on July 09, 2017, 10:18:44 PM
At high enough levels, E will suppress T levels sufficiently in most people. That said, I do think antiandrogens are useful for initially bringing the T level down, but long term use can be problematic.
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: SadieBlake on July 10, 2017, 12:31:34 AM
Quote from: kelly_aus on July 09, 2017, 10:18:44 PM
At high enough levels, E will suppress T levels sufficiently in most people. That said, I do think antiandrogens are useful for initially bringing the T level down, but long term use can be problematic.

My E level noted above isn't high and my dosage is 1/4 what would be considered a normal dose. Hormones affect everyone differently (I know a trans woman who takes about 12x more estradiol valerate im than I do to get the same E levels)
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: kelly_aus on July 10, 2017, 12:55:25 AM
Quote from: SadieBlake on July 10, 2017, 12:31:34 AM
My E level noted above isn't high and my dosage is 1/4 what would be considered a normal dose. Hormones affect everyone differently (I know a trans woman who takes about 12x more estradiol valerate im than I do to get the same E levels)

Clearly, 225 pg/ml is high enough for you.. And, as I said "At high enough levels, E will suppress T levels sufficiently in most people.". For me, levels of 500-600 pg/ml is what's required for T suppression.

EDIT: My comment was not directed at you specifically, was just a general comment on the necessity of antiandrogens.
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: KayXo on July 10, 2017, 09:36:29 AM
Quote from: Dena on July 09, 2017, 08:10:11 PMSpiro has little influence on breast development

In men taking doses comparable to what is typically prescribed to transwomen, the incidence of gynecomastia (swelling of breast tissue) can be quite common. In one study, 5 out of 8 men had it, in another 6 out of 9.

Spironolactone significantly inhibits androgens and slightly increases estrogen levels. On its own, you can already begin experiencing breast development.

Quote from: DawnOday on July 09, 2017, 08:52:20 PM
My hair is thicker and stronger with Estradiol. In my prior 25 years on low dose Spiro I had some breast enlargement but nothing like I have now, and my hair continued to thin. However, my last test showed my T was still a little high. So my doc offered two alternatives. Finasteride or Orchiectomy.

Spiro may not reduce T levels at all and still produce anti-androgenic symptoms because it ALSO BLOCKS ANDROGENS. People keep forgetting this and this has been confirmed in several studies in cismen. So, T levels isn't the whole story, you need to look at how your body is responding, the blood tests can only tell you so much.

Finasteride DOES NOT reduce T, only DHT.


Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: Rambler on July 10, 2017, 10:13:46 AM
May I ask why you are considering going off Spiro & only using estradiol?
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: Balerie on July 11, 2017, 09:17:25 AM
I'm Intersex 47XXY Klienfelters and am on a low dose of only Estradiol pills. My T has always been low and blood tests confirmed that I do not need blockers. After a one month follow up my doctor told me my levels were that of a post menopausal woman. Changes started in the first two weeks and painful breasts started at around the 3 week mark. Prior to starting HRT I had gynecomastia and they were a 44C. Today marks three months and the pain continues and I'm up to about a D cup so far. My case is very different but as others have said, talk to your doctor and let the blood tests speak for themselves.


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Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: RobynD on July 11, 2017, 06:12:19 PM
It would seem to me that if you can tolerate spiro the benefits far outweigh the negatives. There are lots of factors and everyone is different though, very true.
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: SerenaOhSerena on July 18, 2017, 02:32:15 PM
If you have to skip one, if anything skip the estradiol and take the T blocker until you're able to get on E.
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: KayXo on July 18, 2017, 02:55:57 PM
Taking a T blocker alone will result in overall low sex hormones, making you feel tired/lethargic, depressed, in the long-term result in osteoporosis and many other health problems. It's not a particularly healthy nor desirable state to be in. You'll also feel and look old.
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: kelly_aus on July 19, 2017, 03:00:41 AM
Quote from: SerenaOhSerena on July 18, 2017, 02:32:15 PM
If you have to skip one, if anything skip the estradiol and take the T blocker until you're able to get on E.

Why take a T blocker when sufficient levels of E will suppress the testosterone?
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: Jayne01 on July 19, 2017, 03:19:47 AM
I am currently on E only. It has had no effect on my dysphoria at all. I have only been on hormones for about 6 weeks. I see my endo again next week, so I will know more after I see him.
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: luna nyan on July 19, 2017, 04:40:04 AM
On E only (pellet).  No spiro.  T effectively close to zero
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: laurenb on July 19, 2017, 07:38:07 AM
Quote from: luna nyan on July 19, 2017, 04:40:04 AM
On E only (pellet).  No spiro.  T effectively close to zero

Luna - had you been on Spiro at all? Or just E from the beginning? I'm curious and following this thread because I see a day when I'd like to be off Spiro myself.
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: Paige on July 19, 2017, 10:32:22 AM
Hi,

I'm on low dose E and dutasteride.  I stopped spiro when I started E.  I've been on E for about a year, dutasteride for 2 years.   It does seem to put a small dent in my dysphoria because when I tried to stop it almost drove me crazy.  I've had some breast growth but I can still wear a t-shirt.   I would like my T levels to be lower.  Here's my last test, they're on the low end for a man but too high for a cis-woman.

Testerone is 11.8  nmol/L.  Testosterone Free 175pmol/L.

Hope this is helpful,
Paige :)




Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: luna nyan on July 20, 2017, 03:16:56 AM
Quote from: laurenb on July 19, 2017, 07:38:07 AM
Luna - had you been on Spiro at all? Or just E from the beginning? I'm curious and following this thread because I see a day when I'd like to be off Spiro myself.

Started on E (pills) then added Spiro.   When I switched to pellet implant the E levels rose enough and were consistent enough that T has been completely suppressed without Spiro.

I'll be updating my thread soon.
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: laurenb on July 20, 2017, 06:11:13 AM
Thanks Luna. Good information. I believe I read somewhere, and would love to find some clinical verification, that once the T factory is shut down for a while then it doesn't come back while E is present. That's my intent or it's going to have to be an Orchi. I look forward to you updating your thread, BTW. -L
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: kelly_aus on July 20, 2017, 06:38:25 AM
Quote from: laurenb on July 20, 2017, 06:11:13 AM
Thanks Luna. Good information. I believe I read somewhere, and would love to find some clinical verification, that once the T factory is shut down for a while then it doesn't come back while E is present. That's my intent or it's going to have to be an Orchi. I look forward to you updating your thread, BTW. -L

http://www.touchoncology.com/articles/androgen-deprivation-therapy-and-re-emergence-parenteral-estrogen-prostate-cancer (http://www.touchoncology.com/articles/androgen-deprivation-therapy-and-re-emergence-parenteral-estrogen-prostate-cancer)

Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: KayXo on July 20, 2017, 11:08:26 AM
E will bring down T on its own due to negative feedback at the hypothalamus and pituitary gland. As long as there is a decent concentration of sex hormones in the body, regardless of what they may be (P, E or T), the brain stops signalling the testes (or ovaries) to produce sex hormones because it senses there's enough.

Bio-identical estrogen taken non-orally has indeed been shown to be much safer, even in men of a certain age with advanced prostate cancer as the above link attests to. And shown to be effective on its own at reducing T to castrate levels.
Title: Re: Taking Estradiol without Spironolactone? Pros / Cons
Post by: DanaDane on August 02, 2017, 05:17:53 PM
Long term use of Spiro is very dangerous.   The build of of visceral fat is almost impossible be rid of.  There are other long term uses issues as well and doing a Google search will reveal multiple studies. 

Remember, it was never intended to be what we are using it for.   I don't think it was ever meant for long term use. 


Quote from: JustAnotherGirl on July 09, 2017, 05:29:04 PM
Hi again,

I'm  curious what life might be like just taking Estradiol only?

Just wondering what I'd get out of it alone vs. taking it with Spiro?


I'm wondering? Does Estradiol by itself help promote Hair growth on your head without Spiro? 
Also Wondering how not taking Spiro -  how your Penis , Testicles & Sperm function differently?
Does Taking Estradiol only by itself decrease the probability Breast growth ?

What in Everybody Opinions on here does Spironolactone give you extra for your HRT Regimen ?


Just so ya' know ......I've been on an HRT regimen for about 6 months and have read plenty about what I'm taking I'm
just curious what some of you think threw YOUR Real World Experiences or Some of YOUR Friends Real World Experiences ETC?

Also hoping some Gals on here might be taking Estradiol ONLY and can share their experiences?

Thanks in Advance  :)