Hey Peeps,

Just got back from my 4 month Endo appointment. He reduced my Spiro by 75% and increased my Estradiol by like 50% and prescribed some type of topical estrogen creme(Elestrin)

I trust my Endo 100%, just wanted to know if this happened to anyone else. Or if anyone else has been given Elestrin?

(Side note: I had a mini anxiety attack in the Endo lobby, the lady at the front desk called me Sir and Mr and idk normally it doesn't get to me but in this case it did and I almost broke down.)

Taking only a low dose of spironolactone could leave you vulnerable to spikes in T production that can have harmful mental and physical consequences. If T is too high, it will drown out the effects of the E and prevent feminization. All of that has been happening with me. It is tempting to use as little spiro as possible due to its unpleasant side effects, but at the end of the day, they are a small price to pay for the improved feminization (especially breast development) that is made possible by the spiro. The debate between higher E and lower T ignores the fact that both are necessary for good feminization and should be pursued simultaneously.

My doctor tried to give me elestrin, but I turned it down because topical products tend to be rather ineffective at producing sufficient levels for feminization, and have been even less effective in me than in my endocrinologist's other patients. It was only after I spoke up about that, that I was offered estradiol pills. Topical products do improve mood by producing a stable baseline level, but are very costly for the low amount of feminization achieved.

Sometimes it is necessary to question the endocrinologist. I trusted mine 100% until I did my homework and realized that he is making up facts in order to deny me an effective feminizing regimen. He came off so endearing that it was hard to discover.

No antiandrogen at all in my case, feminization for me has been great as far as I know. My stable mood and general feelings of health are the best part.

I don't take oral, though. I am doing implanted pellet HRT- for which I think the bioavailability of estradiol is much higher than pills. So, it would make some sense to me that increased estrogen absorption drives down T. But, that is just a guess and I am no doctor. Take my affirmation on this topic worth a grain of salt All I know is that I've had great results from E+P alone, never taken an AA in my life.

Quote from: Steph34 on January 07, 2015, 12:24:24 PM
Sometimes it is necessary to question the endocrinologist. I trusted mine 100% until I did my homework and realized that he is making up facts in order to deny me an effective feminizing regimen. He came off so endearing that it was hard to discover.

I will ask him about it next time I see him. I don't think he would be making up facts as he is a very strong supporter of the community and has been involved with LGBTQ for over 3 decades.

Quote from: akegia on January 07, 2015, 01:07:05 PM
I will ask him about it next time I see him. I don't think he would be making up facts as he is a very strong supporter of the community and has been involved with LGBTQ for over 3 decades.

I personally would not want to change my regimen without knowing why. Yes; ask difficult questions; my doctor's scheme began to unravel when he had a hard time providing satisfactory answers. Unfortunately, my endocrinologist also has a reputation as being among the 'best' endocrinologists for transgender care, and has more than a decade of experience. Even one therapist who co-wrote general guidelines for transgender care had nothing but praise for him. Reputation in the medical community, like anywhere else, can be bought by good salespeople. I am certainly not implying that your endocrinologist is incompetent; there are many approaches and not everyone responds positively to the same one. I do, however, think that better care is received when the patient plays an active role in the process.

Have you had any issues with low blood pressure, dizziness or waking up too frequently to pee? All of those and perhaps other things could lead your end to make the changes you report.

I'll check my BP when I get home, but I have had those symptoms all day. Its a first for me though.

Quote from: Dee Walker on January 07, 2015, 01:24:48 PM
Have you had any issues with low blood pressure, dizziness or waking up too frequently to pee? All of those and perhaps other things could lead your end to make the changes you report.

Quote from: Steph34 on January 07, 2015, 01:20:32 PM
I do, however, think that better care is received when the patient plays an active role in the process.

Hi,

Normally I do speak up and try to be involved just today I wasn't feeling it and just wanted to get out and back home as quickly as possible.

Quote from: Dee Walker on January 07, 2015, 01:24:48 PM
Have you had any issues with low blood pressure, dizziness or waking up too frequently to pee? All of those and perhaps other things could lead your end to make the changes you report.

Hi,

I have had issues with Low Blood Pressure all my life. I get dizzy if I stand up too fast all the time. The pee thing is annoying but manageable.

If you have chronic low blood pressure and dizziness that would explain the reduced spiro. I have high blood pressure. My PCP had me on losartan HCTZ and the end put me on Spiro. I developed your symptoms (which I had had when I was younger). When that happened my PCP took me off of the losartan.