I knew this might be an issue, but I'm having trouble with spironolactone at even a very small dose. I can't provide dose information of course, but it's well under what a typical one is. I was started at a low dose since we knew I might have some issues due to an existing medical condition. I don't think I can tolerate it though. It's definitely aggravated the symptoms of my existing condition.

I'm really disappointed and don't want to give up on an anti-androgen. Are there other anti-androgens available in the US that work comparably well to spironolactone? I'm waiting to see my doctor again, but meanwhile he gave me finasteride but told me it's not as effective.

What about an orchiectomy? Is this a plausible work-around to taking anti-androgens? I do plan on having grs at some point, though and I think I've heard that having an orchiectomy can impact grs later due to affects on the scrotal skin. Is that right?

There ARE alternatives.

1) Bicalutamide (Casodex). Expensive (unless insured) but affordable at lower doses. Blocks androgen only, except in brain.

2) LhRh analogue, Lupron, Zoladex, Synarel. Stops production of testicular androgens. Expensive option unless insured.

3) Injectable E (estradiol valerate) can suppress T on its own while not increasing health risks. You don't need an anti-androgen.

4) Cyproterone acetate. Yes! You heard right. This is not FDA approved but it appears doctors have the right to still prescribe it to their patient on an individual basis and have it imported.

5) Orchie with potential complications later on with GRS, not sure.

Thank you so much for your reply. I was worrying so much over this. It's good to know before my next appointment (which isn't for months unless I switch over to another doctor I prefer which looks like it'd take a long time to get in anyway) that there are in fact alternatives!

Before the blockers were available, we transition with oral estrogen. It didn't always shut down the T factory so the mental benefits of the blockers were missing. Being unable to use a blocker won't halt the transition but it might make it a bit more difficult.

Quote from: Dena on February 15, 2016, 05:01:37 PM
Before the blockers were available, we transition with oral estrogen. It didn't always shut down the T factory so the mental benefits of the blockers were missing. Being unable to use a blocker won't halt the transition but it might make it a bit more difficult.

More difficult in what ways?

Will it take longer?

The mental fog or discomfort will remain if T production is not reduced to a fairly low level. People on blockers report the fog clears out after about a week or two where as mine didn't leave until after surgery. Not having the blockers will not slow down the transition and in some ways it might even speed it up because you still have the drive pushing you forward.

Some of the girls appeared to get T shut down on a standard dose of estrogen. Blood levels weren't checked but because I remained fully functional, I suspect my T levels never approached the levels they reach today.

It is a different world I see today where many of the girls place GCS as the last surgery on the list sometimes waiting several years to obtain it. We used to aim for GCS as soon as the one year cross living time was over and only had other surgery if we had the time and money to do it. Often what little facial surgery that was available and BA was done along with GCS.

Quote from: Dena on February 15, 2016, 05:01:37 PM
Being unable to use a blocker won't halt the transition but it might make it a bit more difficult.

Not if enough E is taken by way of injections (or implants). This will reduce T to castrate levels while keeping things safe. E is also anti-androgenic and anti-gonadotropic.

The estrogen that was taken by Dena and others at the time was not bio-identical, hence the greater risks (clotting, blood pressure, liver) and the fear of increasing dose too much. Times have changed, for the better.

Quote from: KayXo on February 16, 2016, 08:51:59 AM
The estrogen that was taken by Dena and others at the time was not bio-identical, hence the greater risks (clotting, blood pressure, liver) and the fear of increasing dose too much. Times have changed, for the better.

It was not bio-identical because it was bio duplicate. Premarin can still be used in treatment at the same dosage I took. We used it because it was the safest medication available at the time. Today it is costly and there might be some question about other components that are not in estradiol. The dosage was only oral which carries a higher risk of side effects and the doctors were some what over cautious about using it. After surgery, my dosage was reduced to what would be considered a near post menopause level. Today the dosage would be left at twice what I was given for many years. I never heard of anyone having issues with Premarin at the dosage we took but then we were healthy and didn't self medicate.

I see no reason to take it today or prescribe it to anyone as its health risks are greater than bio-identical estradiol, and it contains EQUINE (horse) estrogens that affect our body differently and harmfully. Regardless of dose. Bio-identical E is the way to go, always. Same with progestogens...Provera should NEVER be prescribed given what we know about it and the availability of safer alternatives that are just effective, like bio-identical progesterone.

Common sense. My 2 cents.

Zoladex (GNRH agonist) is great, comes in the form of a small implant that goes in your abdomen , it lasts 3 months each time which is great, they also make once a month implants. IT has no side effects and brings T to castrate levels. I can't fault it it's great albeit on the expensive side, I'm on my last implant as my surgery is coming in a week and a half.

Also everything Kay says will help you, she's a little on the stubborn, sassy side but she knows her stuff. Lol