IMO, the spiro is fine. Progesterone is iffy. There isn't much evidence it promotes breast growth but I heard it can assist in feminiztion and the maintenance of a libido. The Premarin...I would switch to Estrace or Estrofem. I read a post awhile back from someone in Canada that took Premarin and she said that it had side effects and that they vanished when she switched to Estrace and that she feminized at a much more rapid pace after switching.