I just started to see a new doctor (due to a change in insurance in the States) and she will not prescribe me my regular does of Spiro and other hormones cause she sees it as unsafe. Right now she has me a fraction of what I used to take for the Spiro. Also she wants me to find alternatives for anti androgens that won't mess with potassium.
Is there a website I can point her to, to help teach her about some trans care? I'm going on my 6th month without my HRT after being on it for almost five years. Both my body and facial hair have returned in a vengeance. Also I'm loosing my hair again.
I am on Androcur (Cypro) instead of Spiro and it works amazingly for me. I just have one every other day as it's very potent. Another AA I heard is good is Casodex (Bicalutamide).
Sorry, Androcur is not available in the US.
Yes, there are many alternatives to Spironolactone as an Androgen Blocker. Most of these drugs are used for prostate cancer and they all have side effects. In my opinion, Spironolactone is the safest Androgen Blocker today with most people not having any problem with their potassium levels.
One thing really bothers me, if your new doctor wants you to find alternatives to your HRT, that doctor is not doing their job. You are not expected to be an expert in HRT. The prescriber is the expert. If your new doctor doesn't have that knowledge base, then ask for a doctor who does, such as an endocrinologist, or better yet, a new primary care doctor who knows what they are doing.
Casodex, it is inexpensive and does not cause issues with potassium "K" , it is easier on the system than Lupron for most. The other option is increase estrogen levels to suppress testosterone.
In my non-expert opinion, I actually find bicalutamide (and LhRH agonists) to be the most efficient just based on what I read in various scientific publications, with generally less side-effects than spironolactone but many do quite well on Spiro too. Bicalutamide may, rarely, cause liver issues but that is usually at higher doses in older men and as with any other medications, serious side-effects can occur but these appear to be VERY rare. LhRh agonists are used quite frequently in the UK in transsexual women and seem to be preferred over cyproterone acetate because the latter may have an adverse effect on mood (also is strongly associated to the onset of meningiomas, although rare). Bicalutamide used to be quite expensive, I believe it's more affordable these days if you don't have insurance and if you take lower doses which may be sufficient for our needs since we also take estrogen. LhRh agonists remain quite expensive but if you have insurance, it's doable. :)
Bio-identical estrogen may also be sufficient on its own to suppress T levels as some transwomen are finding out but they are usually taken non-orally (pellets, patches, injections) as it's deemed safer that way. In men with prostate cancer, it's been shown to be relatively safe, effectively reduce T to castrate levels and cause no increase in thromboembolic complications, despite advanced age, cancer and high doses of estrogen.
Just reporting...please do your research and speak to doctors. Best of luck. ;)
I agree with Dani. You need to be under the care of a qualified health care professional. Based on your description they should have referred you to a specialist knowledgeable in HRT or a different primary care doctor.
Your doctor should be using the WPATH Standards of Care, and those list several potential AA's.
https://www.susans.org/wiki/Standards_of_Care_for_the_Health_of_Transsexual,_Transgender,_and_Gender_Nonconforming_People