I tried talking my GP into switching me to Bicalutamide
I sent her this message:
I've been having some difficulty with some of the side effects of the Spironolactone I've been taking. Mainly the dehydrating effect and subsequent cramping and malaise I often experience from it.
I've heard of some very positive results (for Transwomen) from another anti-androgen medication called Bicalutamide (brand name Casodex).
It has a much lower side effect profile than Spironolactone, with much more of the efficacy. It doesn't lower the production of testosterone, but instead blocks the testosterone receptors so the testosterone has no effect on the body. It also appears to be very effective at lower doses for these results. As I understand it, only the liver enzymes need motioning for safe administration, since testosterone levels would only be effected by the estradiol I'm taking.
I'd like to propose switching out the Spironolactone for a trial run of the Bicalutamide.
Her response:
As discussed at your first appointment, we follow the Calllen Lord guidelines as far as hormone
replacement and blockers. If you would like I can refer you out to Endocrinology for transgender
care whom have a broader range in what they are willing to order. At this time I did send a lower
dose of the Spiro to the pharmacy.
I guess she missed the point.

I was trying to avoid self medicating...