Anti-Androgens Questions -

[Koka]

Hello !

I do have a question regarding anti-androgens. I am on Finasteride (My body rejects Spiro) and so far is working OK. I was wondering for how long can one be on anti-androgens? My understanding is that once estrogen takes over the body and after a few years on anti-androgens (i.e.spironolactone, finasteride), the testis will just stop producing Testosterone and at that point one can either reduce the dosage or stop.
There is also surgery to remove testis but I am wondering if one can transition with out SRS or removal of testis.

As always your input is appreciated. :battingeyelashes:

[Aprilrain]

My T is kaput and I have only been on HRT for 9 months. My Edno said that just progesterone and estrogen was enough to keep it down at this point. One can certainly transition to what ever point one wants, there is no requirement for surgeries. Some states will not consider you a woman without SRS but that is no reason to have life changing irreversible surgery.

[Frances]

I am not a doctor, but I don't think testicules ever stop producing T. They will stop producing sperm however. The dosage has be maintained pretty much forever unless you have an orchi or SRS. You can transition without surgery or hormones as a matter of fact, but you will feminize without them and your body will masculinize again if you stop hormones. Good luck on your transition.

[Koka]

April,

Thanks for the reply. So, you are saying you are not taking any t blockers? Only the estrogen and progesterone?

Again, thank you for the input.

[Koka]

Francis,

I know one can transition without hormones but I suspect it would be harder without the hormones. My question is then, what are the side effects of long term t blockers in the body?

Thanks for your help!

[Aprilrain]

I am self prescribing Cyproterone which is available everywhere BUT the US. It's powerfully effective in suppressing T. When I went to see my Endo for the first time I had been on hormones for about 6 months. I told him everything I had been taking and he said the Cypro was fine but that he could not prescribe it. At my last appointment just the other day he felt that with my T being so low that P and E alone would keep it suppressed at this point. I have not quit taking the Cypro but have FFS scheduled in January and will have to be off everything 2 weeks prior to surgery. Maybe afterward I will just take the P and E and see if that is sufficient. I know girls here who take only P and E and I have met some girls at my support group who's Endo's wanted then to quit spiro and only take P and E. Everyones endocrine system is different and there is only one way to tell if what you're taking is working, Blood test!

[CharleneT]

I need to double check with my endo, but if I remember our conversation long ago about Tblockers, after a while they are not needed. He said that you could easily go thru hormonal transition with nothing buy estrogen. The only difference is that it takes longer. He believed that there are some affects from them that are helpful, an example being that Spiro tends to augment breast development to a small degree. Once your testicles are dormant, they will not produce significant amounts of testosterone (if any). There are other sources of small amounts of testosterone production - which explains why women normally have a small circulating level of T.

[Aprilrain]

There are other sources of small amounts of testosterone production - which explains why women normally have a small circulating level of T.

The pituitary gland produces up to 20% of a persons total t level

[Koka]

Very interesting.

I cannot take Spiro, my body does not take it. My blood pressure is low by nature and on top of that I am yogini and it keeps it even lower, when I took spiro, I was like super weak, dizzy, and with headaches. I am on in Finasteride and I feel better. Most of the girls use spiro. According to my endo, Finasteride does the work and it also helps with growing of hair. I wonder the effects it will have on my prostate during the years, perhaps it will end up the size of a raisin. LOL

I would love to talk to someone who has been on anti-androgen for years and share her experience.

[Melody Moore]

I am on Finasteride (My body rejects Spiro) and so far is working OK.

I think you will find that Finasteride is more effective in stopping Testosterone
being converted into Dihydrotestosterone than blocking Testosterone production.

Here are 3 of the most popular anti-androgens and how they work.


Finasteride is a synthetic antiandrogen that inhibits type II 5-alpha reductase, the enzyme that converts testosterone to dihydrotestosterone (DHT).
Source: http://en.wikipedia.org/wiki/Finasteride
Spironolactone inhibits the effect of aldosterone by competing for intracellular aldosterone receptors in the cortical collecting duct. This decreases the reabsorption of sodium and water, while decreasing the secretion of potassium. Spironolactone has a fairly slow onset of action, taking several days to develop, and, so, the effect diminishes slowly. This is because steroid pathways alter gene transcription, and it will take several days for the gene products to change (in this case the ENaC and ROMK channels will be decreased).

Spironolactone has anti-androgen activity by directly binding to and blocking androgens from interacting with the androgen receptor, by blocking androgen production, and by increasing estrogen levels. Production of androgens is decreased by inhibiting 17α-hydroxylase and 17,20-desmolase, which are enzymes in the testosterone biosynthesis pathway. Estrogen levels are increased by enhancing the peripheral conversion of testosterone to estradiol and by displacing estradiol from sex hormone-binding globulin (SHBG). Source: http://en.wikipedia.org/wiki/Spironolactone
Cyproterone acetate (Androcur, Cyprostat,Cyproteron, Procur, Cyprone, Cyprohexal, Ciproterona, Cyproteronum, Neoproxil, Siterone) is an antiandrogen (i.e., it suppresses the actions of testosterone (and its metabolite dihydrotestosterone) on tissues). It acts by blocking androgen receptors which prevents androgens from binding to them and suppresses luteinizing hormone (which in turn reduces testosterone levels). Its main indications are prostate cancer, benign prostatic hyperplasia, priapism, hypersexuality and other conditions in which androgen action maintains the disease process. Due to its anti-androgen effect, it can also be used to treat hirsutism, and is a common component in hormone therapy for male-to-female transsexual people.

Until the development of leuprolide, cyproterone was one of the few drugs used to treat precocious puberty. It was also used in animal experimentation to investigate the actions of androgens in fetal sexual differentiation.

In addition, cyproterone acetate has weak progestational activity (i.e., it acts like progesterone) and can be used to treat hot flashes. As part of some combined oral contraceptive pills (Dianette in UK and Diane-35 in other countries) it decreases acne and hirsutism (male-pattern hair growth). Source: http://en.wikipedia.org/wiki/AndrocurLong term use of these drugs does not stop testosterone production, so you would need to look at surgical means in
order to do that. Although removing the testicles wont stop all testosterone production as it is also produced through
the adrenal glad and other organs such as adipose tissue (body fat). See: http://en.wikipedia.org/wiki/Adipose_tissue