I started my HRT on Estrogen 7 weeks ago as per the recommendation of my endo - I have read posts where people began only with an AA such as spiro.

Am wondering which approach is best and why ? Is both a better option ?

Thanks to everyone - really enjoying the support and wisdom on the board - should be called Transwiki ;-)

Bianca

I doubt that two endocrinologists would agree on what day of the week it was, never mind the best HRT protocol. I was started on E alone, the theory being that it boosts sex hormone binding globulin (SHBG) which mops up T and gives an idea of what level of AA to start you on.

My T level dropped to <1 on E alone so AA wasn't required, I eventually went on spiro to modify hair growth cycle, which has worked dramatically for me.

I would have faith in your endo, I certainly trust mine and she treats me and all of her patients with care so that they get the treatment benefit in a safe way.

Many many if not all TG people will push their endos to increase levels etc for perceived benefit. A good endo wants to keep you healthy at the same time!

Bianca, let me second Cindy's observations.  Endocrinologists have differing approaches to the same goals.  And do not be surprised if things do not go according to plan, and the HRT regimens change, based on how you respond to the medications.

Personally, I was happy to have started off on estrogen only - for the same reason that my doctor recommended it, that, like Cindy, I never ended up needing anything else. I hate taking medication, so being able to avoid taking a second drug was an advantage. Not to mention that I have a terrible memory, so getting estrogen by patch that I have to remember to do only twice a week versus two different medications, one a twice-daily dose, that have to be taken more or less independently and at different times...

My endo let me make the choice myself and I went Spiro first.  I wanted to get the T outta the way so the E could do its work.  Maybe that wasn't necessary but I'm okay with it.

Thank You Cindy James and everyone else for the helpful information.

@Misato - What effect did starting on AA have on your energy levels and mood - were you tired or depressed ?

I am trying to work out whether my fatigue and depression is related to too much E or not enough ?

Thanks everyone - this is a great forum.

Bianca

The Spiro just calmed me right down and helped me be less impulsive.  Was quite wonderful.  I wasn't tired or depressed at all.  After I started E then yes, I have experienced more tiredness.  That and everything tastes saltier.  Even water that has no salt in it.

It makes no difference...spirolactoone and estrogen have different targets of action

I started with E, Spiro and Finesteride all at once.

But it really comes down to what your doctor prescribes, neh?

N.J.