My HRT doctor told me that they usually only start patients on Estradiol and only add in Spiro later if the E isn't doing enough to reduce testosterone levels on it's own. I've read some of you say that's how you chose to start, but I've never heard that this was a recommendation by the doctor. Has anyone else had the same experience? I just feel like I've waited for long enough and even though I know things aren't going to change over night, I would like to be doing as much as possible to move things along more quickly.

If E does indeed reduce T on its own, there would be no reason to add an anti-androgen such as Spiro. But, unless you are taking E in the form of pellets or intramuscular injections (which I doubt) or your T levels are already quite low, I don't think it will be enough. In any case, it's a change in the right direction and that way, at least, you'll know, if you have side-effects (which is unlikely but still...), what is causing it.

Spiro is somewhat nasty in that your diet may need to change. More salt and less potassium is the rule when you are on Spiro. In addition you will have to force yourself to drink enough fluid to replace what the Spiro will draw out of your system. You might be one of the lucky ones who E will suppress your T levels or you may only need a small dose of Spiro to do the job. The only way to determine this is to start you on E and then find out how much Spiro will be required. This may take more than one visit to balance out.

I think a lot of doctors feel if you can get the job done with less meds, the patient will be better off.

Did they take your blood levels before prescribing?   If so, could also be a response to someone being low T from the start.

If not, then it's just a standard route that Doctor takes


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Melissa,

I went in for a blood draw the next day and I go back in two weeks to find out my lab results and determine whether it's safe for me to start hrt.

Yes, my endo also has this as a policy. It worked out well for me - I never had to use anti-androgens at all. At the 3-month checkup my T was at the middle of the female range (and I already had significant breast development and facial changes). It makes sense to me; most people will not be lucky enough to get by with E alone, but why take more drugs than we have to? Plus, if there's a bad reaction to HRT (which also happened to me, unfortunately) it's obvious which med was to blame if you start one at a time.