The imporatance of spiro

[MonicaJean]

Only day 3 but an observation of mine so far (I'm sure this will change over time but for now...) regarding spiro. When it kicks in, it's amazing. Even though the little Mr's both feel like they are being squeezed like juicebox at a fat kid's lunch, it's a good feeling.

Feeling the body NOT have to deal with T is noticeable compared when the spiro starts to wear off or is depleted before another dose can be taken. Emotions are clearer, more precisely understood is the big one for me. It's wonderful to be able to pin-point exactly what emotion I'm feeling at a specific time, something I could not do pre-HRT as the depressive state created a big ball of yucky emotions to sift through. It's almost like I'm re-learning what emotions are altogether given the clarity of them.

Don't get me wrong, E is important, but spiro is the guy doing a lot of the leg work in the background to make E's job much more successful. "Best supporting actress role goes to....Spiro!" :)

[Leanne2]

Good for you Michelle! I'm glad that the spiro is working for you. I am also on spiro and I feel much better. Have a great day and "Go Vols!" Leanne

[Kathryn Martin]

I don't want to rain on your parade, but there are a couple of things that should be mentioned. ".....feel like they are being squeezed like juicebox at a fat kid's lunch", really? that is your metaphor?

Day 3 of spiro would see no significant drop of T in the body. Sorry, but that is just not enough time. You may well be wishing in the right direction, but seriously it's a little early. Generally serious T level drops are observed beginning in week 3 - 6 months and only in conjunction with estrogen intake.

Just don't use such metaphors, it's kind of uncouth......

Best of luck

[MonicaJean]

Fair enough on the metaphors, just reliving my own experiences with juice boxes long ago.

So if T hasn't dropped enough, what in spiro is causing things to happen? Sorry for the newbie questions.

[Angela Campbell]

For me the only thing that was apparent at 3 days was going to the bathroom more often.

[Dianne S]

I'm about 3.5 weeks in on spiro and haven't noticed much of a change except that I sleep much better at night. Don't really go to the washroom any more often than before because I think that'd be impossible... I have a small bladder and used to go as often as the average woman even before the spiro. :)

[Kathryn Martin]

So if T hasn't dropped enough, what in spiro is causing things to happen? Sorry for the newbie questions.

Spironolactone is a blood pressure medication. It is a Potassium sparing diuretic which reduces blood pressure by it's diuretic properties and which as one of it's side effects acts to act as weak antagonist to androgen receptors. Because of these properties it has side effects of breast tenderness, gynecomastia, testicular athrophy, infertility and erectile dysfunction. It tends generally to feminize males who take it.

It also is a potent inhibitor of testosterone production.

In order to reduce free testosterone in the body it has to be taken over a quite a period of time. While the relatively weak androantagonist properties kick in fairly quickly, the inhibition of testosterone production takes quite a while and is never at female levels without the action of estradiol at the same time.

[celeste26]

Spiro works by blocking the 'T' receptor sites, not by blocking production. If 'T' cannot be absorbed by the cells it will be discarded through the kidneys. With the receptor sites blocked there really must be some sort of other sex hormone present as a substitute, or other undesired effects occur.

[LeaP]

It absolutely blocks (more accurately, reduces) production. From the National Institute of Health:



Spironolactone exhibits antiandrogenic effects in males and females. The mechanism of antiandrogenic activity of spironolactone is complex and appears to involve several effects of the drug. Spironolactone decreases testosterone biosynthesis by inhibiting steroid 17alpha-monooxygenase (17alpha-hydroxylase) activity, possibly secondary to destruction of microsomal cytochrome P-450 in tissues with high steroid 17alpha-monooxygenase activity (e.g., testes, adrenals). The drug also appears to competitively inhibit binding of dihydrotestosterone to its cytoplasmic receptor protein, thus decreasing androgenic actions at target tissues. Spironolactone-induced increases in serum estradiol concentration also may contribute to its antiandrogenic activity, although such increases may not occur consistently; such increases appear to result from increased conversion of testosterone to estradiol. Spironolactone may have variable effects on serum 17-hydroxyprogesterone concentrations, possibly decreasing its production by inhibiting steroid 17alpha-monooxygenase activity or decreasing its conversion (with resultant accumulation) to androstenedione by inhibiting cytochrome P450-dependent 17alpha-hydroxyprogesterone aldolase (17,20-desmolase) activity. Serum progesterone concentrations may increase with the drug secondary to decreased hydroxylation (via steroid 17alpha-monooxygenase) to 17-hydroxyprogesterone. In children, compensatory increases in lutropin (luteinizing hormone, LH) and follicle-stimulating hormone (FSH) secretion can occur, probably secondary to the drug's antiandrogenic effects (i.e., a feedback response to decreasing serum testosterone concentrations and/or peripheral androgenic activity).

[Jocelyn Quivers]

I'm at about the 13 month point for being on it (E upgrade/enhancement hopefully will be my christmas/new years gift). It does seem my bladder has shrunk a lot, and I need to go to the rest room far more often than in the past. My muscle tone has decreased, and seems like I'm retaining water more so than in the past. The good things are that I am at the point of moobs/able to almost fill in some of my B cup bras as of now and I no longer feel it be appropriate to walk around shirtless anymore. Although I'm not at the point where I need to wear a bra full time. I am far more relaxed and calm, though still highly "wired" at times. The bad part which I do not like at all is the weight gain that has come along with all of this, and the frustration of working out almost twice as long as before I started, and getting only half the results. As well as my metabolism has drastically decreased which in a good way has caused me to stick with my diet plan more faithfully and avoid the ice cream, junk food binges. I still look, present, and have no problem passing as a guy, not that I was expecting to go get any feminine features as a result of being on it. Oh I also really am starting to loathe being in male mode for important things such as work, family functions etc.

[celeste26]

So those people with congestive heart failure (the main reason for using that drug) also get to lose their Testosterone production too?

Web MD tells us
Spironolactone is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. It is also used to treat swelling (edema) caused by certain conditions (e.g., congestive heart failure) by removing excess fluid and improving symptoms such as breathing problems. (all of those people also lose their testosterone production)

The other side effects listed are
Stop using spironolactone and call your doctor at once if you have a serious side effect such as:

numbness or tingly feeling;
muscle pain or weakness;
slow, fast, or uneven heart rate;
feeling drowsy, restless, or light-headed;
urinating less than usual or not at all;
shallow breathing;
tremors, confusion;
nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects may include:

mild nausea or vomiting;
dizziness, headache;
gas, stomach pain; or
skin rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.



This medication is also used to treat low potassium levels and conditions in which the body is making too much of a natural chemical (aldosterone).

Spironolactone is known as a "water pill" (potassium-sparing diuretic).

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This medication has also been used to treat excessive hair growth (hirsutism) in women with polycystic ovary disease.

There are other anti androgens

[LeaP]

Spiro is pretty benign. People tolerate it quite well for extended periods of time – years and years.unless you are one of the few who has the potassium problem (I do) there is usually no issue even with HRT–level dosages. There are other anti-androgens, but they have their own issues. Cryptoterone and Flutamide are both harder on the liver. GnRH analogs are HOLY CRAP! expensive.

The little understanding that I have of the use of Spiro with congestive heart failure is that starting dosages can be in the range of MTF HRT dosages, but maintenance dosages are usually quite a bit lower and kick in after the first few months.

[Kaitlyn Michele]

Hi Michelle..

Based on your recent posts I think you are suffering from GWTF syndrome....

Going Way To Fast... (in your mind)

This will all take time... you are doing something that is right for you, and that is hugely exciting but the end result is years away... the good news is that you will have lots of wonderful moments as you progress to be the person you know you are ...don't try to crowd them all into the first months...trust me if you do this right, it will all happen

my own transition started with hormones and it was about 2 years later that I got srs...and 3 months after that my name was changed... all through it I did electrolysis and laser on my face and still haven't quite got 100% of the hairs!!!
After SRS I learned that I still had a lot of work to do to really experience life as myself...I had spent all my mental and emotional energy on getting to SRS and I needed to regroup and start really living as myself and that took time...

I know you are considering your thinking to be clearer than ever, and that may be, but you want to be realistic and prepared for a lot of work..

Hey you may be one of the people that gets this done super fast, but i'd rather be pleasantly surprised by progress...

It's unclear from your OP btw if you are taking estrogen you may be feeling those effects ...

I know in my own case there was a big placebo effect... the instant I rubbed the Estrogen cream on my body I felt better.... I chalk that up to the idea of progress... It felt so wonderful to be doing something for myself I couldn't help but feel fantastic!!!
I'd chalk up your feelings to a similar thing...

[MonicaJean]

Based on your recent posts I think you are suffering from GWTF syndrome....

Going Way To Fast... (in your mind)

This will all take time...


You are right-on, this is going fast in my brain. At the same time, working with my therapist, putting together a plan of action on the first batch of steps. Following a plan will allow longer timelines to be realized and thus my brain can slow down.



This will all take time... you are doing something that is right for you, and that is hugely exciting but the end result is years away... the good news is that you will have lots of wonderful moments as you progress to be the person you know you are ...don't try to crowd them all into the first months...trust me if you do this right, it will all happen


Excellent practical advice Kaitlyn. Currently I’m learning to see each detail and emotion as it occurs. Then ask myself, what do I feel? and why do I feel that way? With depression cleared, sensing my own feelings and directives has never been available to me as the moutain of depression always was in the way, confusion my mind. And journaling as many of these as possible to gain even more clarity, then a couple years from now when I read these things, I’ll remember where it all started and all the struggles and fears and axieties that plagued me (and may still at that time, but hopefully not).

Yes, had E low dose injection along with spiro. No placebo effect for me, after reading many posts here on how not much, if anything changed initially, I was ready to ‘take notes’ to see any slight differences between day 1 and day 14. Well, that conservative view went out the window within a couple hours. It was real and still is. The clarity and predictability of emotions is, well, quite amazing. There’s no “high” on this HRT, just a calm, even-keelness to life now. Being able to sense and curtail anxieties as they happen is big progress in my world.

What amazes me is how spiro and E injection have such highly different results across trans women. This isn’t an over-the-counter pain reliever that offers predictable results. YMMV is so very true with MtF HRT.

[Cheryl123]

Hi Michelle .. I'm glad you're having a positive experience so quickly with HRT. That happened to me also two days after starting estrogen patches. It wasn't a placebo effect because because 14 months later I can still feel when my E levels get low and when I boost them that feeling of contentment returns. I'm also happy your depressions have lifted. For me that's always been the main benefit of HRT. I've concluded testosterone is a poison to trans-women. Estrogen will eventually reduce it's production, but you are right about Spiro being a supporting actress. (Androcur is a better one, but unfortunately it's not prescribed in the US, IMHO). I couldn't tolerate spiro. It made me feel like a zombie and gave me a huge potassium spike. I was glad to get off that stuff. But you are absolutely correct .. with HRT it's all YMMV. I'm sure your doctor has told you, but be sure to watch you potassium levels. Really high levels can lead to cardiac arrest. Anyway, I think you are well on your way, so enjoy the ride!

[Michaella]

I've been on it for about 5 weeks now and the only effects I've noticed are that I do not get spontaneous erections anymore, and I don't seem all that troubled by it, so reduced libido I guess. But I can't say I have noticed any emotional effects.

I have an appointment in 2 weeks to review things, which I suppose will include another testosterone level test. I will want to ask about whether things are progressing at the expected rate.

Michaella

[DebbieL]

Two years on Spiro and Estro.
When my heart doctor found out I was taking it, he was thrilled. He even offered to write the prescription if I wanted. Thanks to spiro I've been able to get off my heart and blood pressure medication. When he said "Most guys hate the side effects", I grinned and said "I'm not a guy, never was, and I love the side effects", The spiro was actually safer than what I was taking before.

The Estrodiol combined with the spiro has had some interesting side effects. Of course my breasts have grown, now a 40 C.
Peewee erect is down from 3 inches to 1. Soft from 1 inch to less than 1/4 (mostly disappears completely). Erections are useless for penetration and actually a bit annoying.
I was too small to use a urinal in less than 3 months (rare times when I tried to present as male). The "boys" are about half their original size and fall into place with almost any pair of underwear. Even in a bathing suit I'm flat as a pancake.

I still have orgasms, including multiple orgasms, but no ejaculation. No fluid at all. (love that).
Orgasms take longer to achieve, but the trip to the "belly whomper" is paved with wonderful multiple orgasms that are wonderful.
Even after a "belly whomper" I'm ready to go again in after about 5 minutes of recovery. Usually I'm just to tired to continue (bowl of jello).
Breast stimulation can cause orgasms. Direct manual stimulation of penis does not arouse.

I wouldn't trade it for the world :love: