Does reaction to spironolactone predict reaction to estrogen?

[Dianne S]

Hi,

I've been on spironolactone for about 5 months now, with dose recently doubled. I've definitely noticed tenderness around my nipples and some small amount of breast development which is quite encouraging. Is it safe to extrapolate that if I get some breast development just from spiro, I'll probably get good development from estrogen? What are others' experiences? (I'm hoping...)

[I Am Paula]

Unfortunately, you get the same answer as everyone else re: breast growth/hormones.
Maybe.

[Rianna Humble]

None of the members on this forum are medical practitioners who have studied your medical history, so none of us is quallified to say anything much beyond YMMV

[sandra-leigh]

Diane, what would you consider to be "good development" ?

I had some breast development on spiro alone (and I know I am not the only one). With spiro and estradiol, I might have peaked at large B cup, but I am at most small B cup now. On the other hand, 38B is the same volume as 34D, so it would be incorrect to think that I didn't get any volume; I am, without question, higher volume than my ex, and firmer; mine do not, for example, effectively disappear when I recline.

However, many bra styles skip 38A and 38B and start at 38C (typically 38C, 38D, 38DD) and bra specialty stores when they have 38B they are typically in the high end brands from $80 to $220. The last couple of surveys of USA have indicated that women with 38 band size are most commonly 38D or 38DD; reduce by at most 1 cup size for Canada and UK.

Thus if you consider "good development" to be "ending up with a pretty typical breast size for your band size", then No, good reaction to spiro does not forsage that. Especially not for older gals, and my recollection is that you are no longer in your 20s.

[LeaP]

All it tells you is that your body - specifically, your estrogen receptors - are responding to the now (relative) excess of estrogen. As happens to many teenage boys as well as elderly men, besides the odd bodybuilder who screws up his 'roids. No predictive value, I'm afraid.

[Dianne S]

Dianne, what would you consider to be "good development" ?

I've be very happy with a B. I'm blessed with a small frame (5'2" and 130lb), so usually wear a 36B bra with my forms. B's would be quite nicely proportioned for my body size.

Rianna: Yeah, I get that YMMV is about the only possible answer. I was just interested in people's experiences, especially those who were on spiro first and then went on to estrogen. Anyone who replies to this thread is understood to have included a giant YMMV disclaimer. :)

[DebbieL]

Dianne, if you are growing breasts just by taking Sprio, then there is a good chance that you may be producing your own estrogen. This is rare, but that's part of why your endo puts you on T-blockers first. He may even determine that you need little or no prescription E because you are producing your own.

There are so many factors that can impact how you respond to E as well as how you respond to S. The important thing to remember is that your doctor will give you the best dose to promote a safe and controlled transition, which will include breasts, fat redistribution, and changes associated with becoming a woman.

If you are producing your own estrogen, your endo and doctor may want you to come in for additional tests and may want you to check your bowel movements for blood. As I said, this is a very rare form of gender ambiguity and may take a while to decide what is safe for you.

[Dianne S]

Debbie,

Interesting. I actually don't have an endo yet. Where I live, a psychiatrist can prescribe spiro. I did have a baseline blood test prior to starting spiro and will probably need one soon to check my levels. I hope to start hormones in March, assuming I can get an appointment with the endo... the only ones who deal with transgender people in my city do so on a part-time basis and are very busy. :(

My breast development so far is very small. I don't think anyone would notice it, really... I'm just more familiar with my own body than strangers are. :) However, I do have a friend who got significant breasts just with spiro. She was later put on estrogen too, so I don't think breast development on spiro necessarily precludes estrogen.

About checking bowel movements for blood... I'm almost at the age (50) where I will need to do that anyway as a check for colorectal cancer. So I will talk to my doctor about that.

[LeaP]

There is nothing rare about the male body producing estrogen! Every last male on earth does.

[sandra-leigh]

LeaP is correct. A fraction of the free testosterone is converted to estrogen in males. A fraction of the free estrogen is converted to testosterone in women. The two are very closely related and the body converts between them. With testosterone reception blockers but no testosterone production blockers, the portion of produced testosterone that is bound goes down, leaving a higher proportion unused in the blood, making more available for conversion to estrogen so estrogen levels go up.

[Kimberly Kael]

There is nothing rare about the male body producing estrogen! Every last male on earth does.

In limited quantities, absolutely. Minimal breast development is an extremely common effect of spironolactone, generally seen as undesirable among men who take it as an antihypertensive. Blocking your androgen receptors starts your body down the path of processing estrogen, but it tells you little or nothing about how much breast development you'll see.

As I understand it, a solid B cup is not that common for your weight class. Set your expectations to "modest" and you might be pleasantly surprised. Then again, you may suffer fatal complications. HRT is prescribed more for emotional well being than physical development because its physical effects can be subtle and it carries non-trivial risks.

[LeaP]

There is no biological route for the conversion of estradiol to testosterone. It's a one-way street. The male body natively produces estrogens in several tissues and organs, primarily the testes (!) and adrenal gland. Spiro does inhibit T production somewhat, but it's secondary to receptor blocking.

[edit]

A few additional comments: First, Spiro is a progesterone agonist. I.e., it increases the efficiency of your progesterone receptors. And, like estrogen, the male body also produces its own progesterone. Second, it accelerates conversion of testosterone to estradiol. On the negative side, large doses of Spiro can actually work to your detriment. Under the right conditions, it can be – and is – used to enhance androgenic effects of testosterone! (Also known as more is not necessarily better!)

[donnalee]

I have been on low dose spiro for at least a dozen years for a heart condition. I have had definite growth and the development of erectile tissue in the nipple and aureola. The odd thing was that this seemed to be triggered by a different heart medication, this time for heart failure. Since then I have lost considerable weight and they are still about the same size. Far from huge, but definitely there (~44C). I have promised myself a bra fitting for the new year.