Susan's Place Transgender Resources

Community Conversation => Transitioning => Hormone replacement therapy => Topic started by: BlueJaye on March 21, 2018, 02:28:26 PM

Title: Would androgen blockers alone help?
Post by: BlueJaye on March 21, 2018, 02:28:26 PM
Hi, I'm slowly admitting to myself that I'm really mtf trans and I'm terrified of coming out and transitioning! It's all so scary! I'm really intimidated by big physical changes over a short of time. Has anyone tried just androgen blockers to stop testosterone as a first step? If so, did you obtain any relief from gender dysphoria by just getting testosterone out of your life?
Title: Re: Would androgen blockers alone help?
Post by: Cindy on March 21, 2018, 02:52:55 PM
Using blockers is quite common as a primary step. You can block T production or binding using a variety of drugs, the most common are Spironolactone and Androcur, although several others are also in use. However once the T is blocked it eventually has to be replaced by another androgen, oestrogen, this is because of the side effects of losing an androgen on physiological functions such as bone density.

Hence it is also common to go onto low dose oestrogen that blocks T function but provides the androgenic effects.

There are benefits and side effects with all of the approaches and that is one reason that a good gender therapist and an endocrinologist who knows what they are doing is so important.
Title: Re: Would androgen blockers alone help?
Post by: Northern Star Girl on March 21, 2018, 02:57:41 PM
Quote from: WhatAmI? on March 21, 2018, 02:28:26 PM
Hi, I'm slowly admitting to myself that I'm really mtf trans and I'm terrified of coming out and transitioning! It's all so scary! I'm really intimidated by big physical changes over a short of time. Has anyone tried just androgen blockers to stop testosterone as a first step? If so, did you obtain any relief from gender dysphoria by just getting testosterone out of your life?

@ WhatAmI:

Well, I really trust that you are seeing your doctor for your T-blocker meds and other HRT drugs.  Your doctor will best determine the required regimen and types of HRT drugs to start you on and to maintain your transition goals.... but you will be subject to frequent doctor ordered blood tests to determine dosages and the exact HRT drugs that your unique body will safely require.   
PLEASE be safe... see your doctor for your HRT which includes androgen blockers.
Danielle
Title: Re: Would androgen blockers alone help?
Post by: AnneK on March 21, 2018, 03:03:53 PM
I'm currently on Dutasteride, for BPH.  It is sometimes paired with estrogen for MtF.  On it's own, it sometimes causes breast growth, which I am hoping for.  I suspect it is having some effect in that regard.

https://en.wikipedia.org/wiki/Dutasteride (https://en.wikipedia.org/wiki/Dutasteride)
Title: Re: Would androgen blockers alone help?
Post by: KayXo on March 21, 2018, 03:29:07 PM
Quote from: Cindy on March 21, 2018, 02:52:55 PMit eventually has to be replaced by another androgen, oestrogen

Hi Cindy,

Just to correct, oestrogen is not the same as androgen. Oestrogens include oestradiol, oestrone and oestriol. Oestradiol is the most potent, oestriol, the least. Androgens include DHEA, androstenedione, testosterone and DHT (dihydrotestosterone). Oestrogens are commonly referred to as female sex hormones, although also present in men in small amounts. Androgens are commonly referred to as male sex hormones, although also present in women in small amounts.

I believe they do a good job at complementing each other.

QuoteHence it is also common to go onto low dose oestrogen that blocks T function but provides the androgenic effects.

Oestrogen is anti-androgenic and reduces/inhibits androgens. It exerts oestrogenic effects.

Title: Re: Would androgen blockers alone help?
Post by: Ellement_of_Freedom on March 21, 2018, 04:57:37 PM
I felt pretty weak and had hot sweats in the middle of the night when I was low on both T and E. Once my E came up everything settled nicely. So I think having only an AA is really not healthy for the long term in my experience. That's just my opinion.
Title: Re: Would androgen blockers alone help?
Post by: BlueJaye on March 21, 2018, 05:57:11 PM
Quote from: Alaskan Danielle on March 21, 2018, 02:57:41 PM

@ WhatAmI:

Well, I really trust that you are seeing your doctor for your T-blocker meds and other HRT drugs.  Your doctor will best determine the required regimen and types of HRT drugs to start you on and to maintain your transition goals.... but you will be subject to frequent doctor ordered blood tests to determine dosages and the exact HRT drugs that your unique body will safely require.   
PLEASE be safe... see your doctor for your HRT which includes androgen blockers.
Danielle

Yes, of course. I am under the supervision of a doctor. Her recommendation was originally androgen blocker plus estrogen, but I really don't know if I am ready to start feminizing. Although I want that so bad, the effects on my life scare me. Can estrogen doses be kept low enough to not have significant feminization for a while?
Title: Re: Would androgen blockers alone help?
Post by: Northern Star Girl on March 21, 2018, 06:15:56 PM
Quote from: WhatAmI? on March 21, 2018, 05:57:11 PM
Yes, of course. I am under the supervision of a doctor. Her recommendation was originally androgen blocker plus estrogen, but I really don't know if I am ready to start feminizing. Although I want that so bad, the effects on my life scare me. Can estrogen doses be kept low enough to not have significant feminization for a while?

@ WhatAmI:  Oh very good.  The way that your original post on this thread came across it sounded a little like you were self-medicating with androgen blockers from wherever!!!   Sorry, but that is why I worded my reply the way it is.

My thoughts in response to your question in bold print above is that if you do not want feminization for a while or just "not significant feminization for a while" then it might be better to just wait until you are ready to commit.   Transitioning and HRT are not halfway endeavors.   It is either all or nothing ... and it is one of the most important life changing decisions you can make.... so think on it, research it, talk to others about it and then either go forward or don't go forward, it is entirely your call.   I think that you certainly want to talk to your doctor about your desires and goals that you expressed here.
Danielle

Title: Re: Would androgen blockers alone help?
Post by: pamelatransuk on March 22, 2018, 07:09:21 AM
Danielle

I think a number of members may disagree with your second para.

Some of us may either wish to try HRT as a confirmation factor that it is right - that we are indeed where we think we are on the gender spectrum - the need to explore/confirm. Secondly some wish to remain on low dose for as long period of time as they cannot transition for personal reasons usually either family or career or other physical ones.

Finally a large number of "oldies" like me do intend definitely to transition but not till the HRT takes effect physically and have to wait but know they are on the right road at the start of HRT.

Pamela
Title: Re: Would androgen blockers alone help?
Post by: Northern Star Girl on March 22, 2018, 12:09:51 PM
Quote from: pamelatransuk on March 22, 2018, 07:09:21 AM
Danielle

I think a number of members may disagree with your second para.

Some of us may either wish to try HRT as a confirmation factor that it is right - that we are indeed where we think we are on the gender spectrum - the need to explore/confirm. Secondly some wish to remain on low dose for as long period of time as they cannot transition for personal reasons usually either family or career or other physical ones.

Finally a large number of "oldies" like me do intend definitely to transition but not till the HRT takes effect physically and have to wait but know they are on the right road at the start of HRT.

Pamela


Pamela:   Not a problem.... That's completely fine if you and others may have a different thought about this...  I only stated my opinion based on my own personal experiences on my initial transition decision and transition journey.

The bottom line in my opinion is that the doctor needs to be brought into the conversation!!!
Danielle
Title: Re: Would androgen blockers alone help?
Post by: Charlie Nicki on March 22, 2018, 01:34:10 PM
You could start with the blocker at first, I had a friend who only took that for a whole year until finally deciding to go on hormones. In any case, even if you go on hormones right away, changes are often extremely slow and almost imperceptible. It's the combination of the hormonal induced changes with facial hair removal, surgeries, etc and time that actually make people notice.
Title: Re: Would androgen blockers alone help?
Post by: MicheleAdams on March 22, 2018, 09:52:06 PM
I spent a little time in this situation and generally would not recommend. Having neither estrogen nor effective testosterone has several concerns that will still require essentially the same monitoring, bone density concerns,  slowing metabolism which often leads to weight gain and possibly adrenal unpredictability. I'd also anticipate a hit on sex drive. Gynecomastia, male breast growth, is possible and tends to look permanently different than female breast growth, especially if gaining weight at the same time. Upon later starting estrogen, you'd also need to redo startup levels of monitoring.

While uncertainty is present, however, I'd suggest asking your doc about finesteride or dutasteride. They won't lower testoserone when used alone, but will lower DHT. This could delay nasty things like balding on the head or new hair follicles starting elsewhere (sorry, existing 'elsewhere' follicles will remain). Gynecomastia  remains a concern with these since they give a small estrogen bump, but, in theory, less since you'd not slow your metabolism down as described above.

Making a concerted effort to find where you are and setting a path will minimized the time on any partial medication regimen, so a very good gender therapist may be especially important in your case. I hope this is helpful.
Title: Re: Would androgen blockers alone help?
Post by: pamelatransuk on March 23, 2018, 06:34:27 AM
Quote from: Alaskan Danielle on March 22, 2018, 12:09:51 PM

The bottom line in my opinion is that the doctor needs to be brought into the conversation!!!
Danielle

Noted Danielle and I agree entirely doctor and/or gender therapist should be brought into discussion.

Pamela
Title: Re: Would androgen blockers alone help?
Post by: BlueJaye on March 23, 2018, 10:32:37 AM
I do want to be clear that I am under medical supervision. In fact I have an appointment with my therapist in a few hours. I am just not a fast mover with anything major and prefer "baby steps" over big leaps. I feel intimidated by just jumping into full transition with both feet.

Just scared overall. It's weird to be at a point where I just don't feel like I can keep living the way I am, but be afraid to make the needed changes. It seems so illogical.
Title: Re: Would androgen blockers alone help?
Post by: Northern Star Girl on March 23, 2018, 10:38:27 AM
Quote from: WhatAmI? on March 23, 2018, 10:32:37 AM
I do want to be clear that I am under medical supervision. In fact I have an appointment with my therapist in a few hours. I am just not a fast mover with anything major and prefer "baby steps" over big leaps. I feel intimidated by just jumping into full transition with both feet.

Just scared overall. It's weird to be at a point where I just don't feel like I can keep living the way I am, but be afraid to make the needed changes. It seems so illogical.

Yes, it is good that you are under medical supervision.... and when you meet with your therapist be certain to make perfectly clear your goals and your fears in transitioning.

Being scared about transitioning is completely normal for many.... just look over many of the threads and replies on this site.... you are not alone in this regard.

Best wishes to you....  looking for future updates from you.  Good luck with your conversation with your therapist today.

Hugs, Danielle
Title: Re: Would androgen blockers alone help?
Post by: BlueJaye on March 23, 2018, 02:21:39 PM
The meeting went okay. We've been dealing with a lack of cooperation from the local LGBT clinic. I went there last month at the referral of my therapist and they basically said if you're not willing to go all the way with transition immediately, we can't help you.

So, my therapist is such a wonderful person, she's going to consult with some of her other colleagues and see if there might be any other options that would help me take a slower approach to transitioning.