Susan's Place Transgender Resources

Community Conversation => Transgender talk => Topic started by: Nevoxia on October 19, 2017, 01:45:08 AM

Title: HRT, anti-androgens, breast development
Post by: Nevoxia on October 19, 2017, 01:45:08 AM
I have read the terms of service and I have seen the warning against asking the wrong questions regarding HRT. Forgive me for being dense, but I'm not entirely sure what we are allowed to ask about it or say about it.

I have been reading some scientific articles, and it appears there is more than one type of anti-androgen available. As I am soon to begin HRT with my endocrinologist, I was wanting to make an informed decision.

One of the scientific articles I read was a comparison of different rates of success in breast development correlating differently with different anti-androgens used. So the question I would ask, if allowed, would be for personal testimonies of the girls here and how they would rate their own satisfaction/breast development and which anti-androgens they have used. If this question is not allowed, I apologize.

I can also post a link to that scientific article about different types of HRT, if that is allowed.



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It seems to be allowed so I will post the link to the article here:

https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2012-2030

Basically, it sounds as if spironolactone correlates with increased need for surgical breast enlargement. Compared to other anti-androgens that don't appear to correlate as strongly. I plan to ask my doctor to put me on bicalutamide, but I don't know if she actually will. Just because something is mentioned in a study doesn't mean doctors feel comfortable prescribing it... And I'm also not sure about its affordability. But based on the evidence that seems like it may be one of the best. If not that, I'm still tempted to request something other than spironolactone. Although I live in the US so I cannot have cyproterone acetate.  I know that spironolactone is the most common one, but I've read a few things about it that made me think it may not be the best.

I currently get finasteride from my dermatologist for hair loss, I requested dutasteride because I read it was more effective, but they would not prescribe it to me. Actually they just ignored me flat out. Would have been nice to receive some sort of reasoning as to why they wouldn't do it. Hopefully my endocrinologist will be more helpful.
Title: Re: HRT, anti-androgens, breast development
Post by: Cindy on October 19, 2017, 02:04:25 AM
Quote from: Nevoxia on October 19, 2017, 01:45:08 AM
I have read the terms of service and I have seen the warning against asking the wrong questions regarding HRT. Forgive me for being dense, but I'm not entirely sure what we are allowed to ask about it or say about it.

I have been reading some scientific articles, and it appears there is more than one type of anti-androgen available. As I am soon to begin HRT with my endocrinologist, I was wanting to make an informed decision.

One of the scientific articles I read was a comparison of different rates of success in breast development correlating differently with different anti-androgens used. So the question I would ask, if allowed, would be for personal testimonies of the girls here and how they would rate their own satisfaction/breast development and which anti-androgens they have used. If this question is not allowed, I apologize.

I can also post a link to that scientific article about different types of HRT, if that is allowed.

Hi Hon,

What we do not allow is discussion of dosages. So we don't want links to articles that contain them either. But you are welcome to discuss types and combinations etc. You may find that there is quite a variety.
In general a MtF will take (at least for some time) and anti-androgen which is usually either Spironolactone or Cryptone Acetate (Androcur/Deprova) I think Androcur is not available in the USA, as anti androgens. Finistrade is also often prescribed. In children GnHr analogues are used but not often in adults. As far as the cross sex hormone for a MtF that is oestrogen and nowadays bioidentical oestrogen is the standard hormone. Again there are a number of trade names and subtle differences but essentially do the same job.

People often come off the antiAA after sometime or after surgery. You can never really come off the cross sex hormone (unless you are elderly) as you need them for other physiological reasons beyond secondary sex organ development.

Title: Re: HRT, anti-androgens, breast development
Post by: Nevoxia on October 19, 2017, 12:51:31 PM
Thank you for that clarification. I will edit my original post to include the information that I was initially afraid to post.
Title: Re: HRT, anti-androgens, breast development
Post by: Megan. on October 19, 2017, 01:01:56 PM
Just to add to Cindy's great response,  UK based trans* adults (myself included) are typically given gnrh analogues, they have fewer health risks, and are very effective,  but are also expensive compared to other options.
Whichever AA you use, if it reduces your Testosterone to female levels,  it will clear the way for any Estrogen to do its thing. Just make yourself aware of any side effects and adjust your lifestyle as required to stay healthy. X

Sent from my MI 5s using Tapatalk

Title: Re: HRT, anti-androgens, breast development
Post by: Nevoxia on October 19, 2017, 01:10:04 PM
Quote from: meganjames2 on October 19, 2017, 01:01:56 PM
Just to add to Cindy's great response,  UK based trans* adults (myself included) are typically given gnrh analogues, they have fewer health risks, and are very effective,  but are also expensive compared to other options.
Whichever AA you use, if it reduces your Testosterone to female levels,  it will clear the way for any Estrogen to do its thing. Just make yourself aware of any side effects and adjust your lifestyle as required to stay healthy. X

Sent from my MI 5s using Tapatalk

Yeah that's the main thing I'm concerned about, is side effects. Especially if I'm going to be on this drug for long-term. I tried to educate myself as best I can, even into the technical stuff as you may see in that article I posted. I would much rather be in the UK system! I have occasionally wondered how long a person has to live there in order to receive their transgender health care. I actually spent part of the summer in Scotland last year, as part of a study abroad program at University of St Andrews. I got sick while I was there and they took care of me, which I totally didn't expect. Something I could not expect here in the US. It has made me consider applying for my Master's Degree in the UK, however the cost of the tuition might make that point moot. But yeah, sorry, that's way off topic isn't it!
Title: Re: HRT, anti-androgens, breast development
Post by: Megan. on October 19, 2017, 01:15:51 PM
It did take almost 30 months between seeing my GP and starting HRT, the NHS certainly isn't perfect!

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Title: Re: HRT, anti-androgens, breast development
Post by: I Am Jess on October 19, 2017, 03:52:28 PM
I was never on Spiro.  Instead I just continued on Dutasteride which I had been on for BPH.  I started with IM Estrogen injections and have been giving myself shots for 2 1/2 years.  In the first 6 months I developed into an A cup.  In talking with my therapist, endo and plastic surgeon none of them thought there was any reason to wait on breast augmentation.   So at 6 months I had BA with 500 cc implants under the muscle.  Best decision I made in my transition.  Getting misgendered dropped to almost nothing. 

I have been very happy not being on Spiro and my changes have been fantastic.  My boobs have continued to develop normally even with the BA and look incredible. 

Good luck and maybe you can get your endo to prescribe the Dutasteride.
Title: Re: HRT, anti-androgens, breast development
Post by: Nevoxia on October 19, 2017, 10:18:36 PM
Quote from: I Am Jess on October 19, 2017, 03:52:28 PM
I was never on Spiro.  Instead I just continued on Dutasteride which I had been on for BPH.  I started with IM Estrogen injections and have been giving myself shots for 2 1/2 years.  In the first 6 months I developed into an A cup.  In talking with my therapist, endo and plastic surgeon none of them thought there was any reason to wait on breast augmentation.   So at 6 months I had BA with 500 cc implants under the muscle.  Best decision I made in my transition.  Getting misgendered dropped to almost nothing. 

I have been very happy not being on Spiro and my changes have been fantastic.  My boobs have continued to develop normally even with the BA and look incredible. 

Good luck and maybe you can get your endo to prescribe the Dutasteride.

That is reassuring to know. I'll keep that in mind when consulting with my doctors. But it would be at least a couple of years before I can afford any augmentation types of things. So I think the affordability coincides with the other timelines.