Is Finasteride a good t-blocker if spiro is problematic for you?

[Guest Born2RockOn]

I had a question about finasteride. Is it a good t-blocker? My doctor put me on finasteride because spiro was problematic due to aching muscles and having anxious weird feeling. I drink plenty of water. I'm taking low starting dose estradiol too. I don't have male hair baldness. My doctor says that finastride is a good t-blocker; however, all the websites i have read said that this medicine is good for reducing male balding only. I don't have aching muscles nor that anxious feeling on finastride. I'm confused on what info to believe. My doctor which has treated many trans women said that most take spiro for a t blocker; however, if the patient body doesn't agree with spiro due to pre-existing health conditions or the medicine causes negative side effects he puts people on finasteride. My breasts are slightly sore on the sides after i week of estradiol and finastride combo. In addition, my nipples are not tender but sensitive to touch(stick out). do you think this is a good combo if you cannot take spiro? My doctor plans on doubling my dosage of estrogen in two months after blood work is done. Should breast pain be starting after 1 week of hormones? I wish i could go on spiro because it is much cheaper than finastride.

I appreciate any feedback.

thanks

[Charlize]

I would think your doctor is right on. I know several folks who take finisteride alone. It also sounds like you are getting just the right results from the combination. I would relax and go with your doctor's recommendations and give it some time. Spiro does have some nasty side effects for some. I drank gallons of fluids and still had occasional cramps.

Hugs,

Charlize

[Guest Kenna Dixon]

I was switched from spiro to finasteride more than a year ago and haven't noticed any difference.

[Guest Myria]

Finasteride is a 5α-reductase inhibitor, 5α-reductase being the enzyme responsible for converting Testosterone to DHT (Dihydrotestosterone). As such it has no direct effect on Testosterone levels, but, even at relatively low doses, does result in a substantial reduction in DHT levels.

As to whether that's suffecient for MtF HRT, depends on the individual and regimen.

[VickySGV]

The problem with finding HRT information on Finasteride ((and Aldactone (Spironolactone)) is not really a problem at all. Simply the information does not exist at all in other than information posted on sites dealing with TG people such as this one. With both drugs, it is really a side-effect of the drugs that is helping us, and thus, it is termed an "Off Label" use of them, that falls under the phrase "and other uses as determined by your doctor". They were not developed specifically for T blocking for Trans* folk, and the "testing" being done is field experience versus laboratory testing as is the case with, say, a new influenza vaccine for the general population. This an issue of the Trans* population being under-served by the drug manufacturers and FDA, and it is why the doctors that treat us with the drugs need to be extra careful with us. Big Pharma testing is lacking, and that is why it is especially important to have health care providers keeping an eye on us and DIY is so dangerous.

We do not need the effects the drugs were developed for in most cases although even post SRS, I am on Spiro for its direct effect as a diuretic to control my blood pressure since the other more common drug crashes my Potassium levels to life threatening low levels.

[Guest Kaylee]

The timing of this post is perfect, since I have been on Finasteride for only a short 6 days. I too have had an issue with the Spiro making me uneasy… and causing some pretty emotionally intense dreams. Those dreams have settled down on what was my regular dose of Spiro which is on the low end of normal. Perhaps I have acclimated to it finally in that regard, but muscle soreness, and soreness in the hips is a really big problem at the moment.

My Endo mentioned Finasteride in a conversation about the negative effects of spiro (she hadn’t heard of any anxiety issues with spiro, but it was only a quick search on line for me), but mentioned that the Finasteride was not as effective at blocking the T, so would not really result in helping feminize the body.

Since I have issues with Hair loss though, I figured I would ask her for it anyway, which she prescribed… on the low end of low again, but for a 90 day supply. The cost out of pocket was $13.50 at Walmart. Seriously… I read that it was expensive too… and was really happy with $13.50, but still more than Spiro.

After 6 days… I noticed something just last night. This little addition seems to have nearly stopped body hair growth in it’s tracks! I have been shaving my body hair for 20 years… and while it does still grow, it’s really fine, and barely noticeable. I’ve been worrying about that taking just Spiro… but here it is, 6 days in… and there is a noticeable difference.

I guess as with anything… everybody reacts differently. I do wonder how long you have been on Spiro though. My Doctor lowered my dose, but I have worked back to the original script with no more crazy dreams or anxiety. I’ll settle for the soreness for now, because T just needs to die at 15 months today!

Die T… dieeeeeeeeeee!

Hugs,

Kaylee

[Guest Born2RockOn]

I took spiro alone without estrogen for about a month and was having problems with the medicine. My doctor change the medicine to finastride alone without estrogen for a couple weeks and my symptoms greatly improved. Now, my doctor has me on starting dose of estradiol and finastride as the t blocker. What do you want to block testerone or dht to make the effects of estrogen better? Do you have to be on spiro for maximum feminization benefits of hrt?

[Sakura]

There are quite a few drugs out there that block testosterone. Many though block as a side effect of the drugs intended purpose spironolatone is actually designed to treat hyper tension and high blood presure the side effect being decreased testosterone production. it actually makes your testosterone recptors deaf to it. most anything you get state side has roughly the same effectivness as spiro , finasterside as I understand it though is not actually a t blocker it keeps testoterone from converting to DHT the stuff that causes male patern baldness.

I found out a few years ago that I have become a medical oddity of sorts. I had been on spiro since I was 20 years old . my tests where like clock work 25-30 testoterone count . I started noting around 27ish that I was getting my morning visiter I was becoming more irritable and my body oder was becoming more akin to my hubbies. so to the dr I went . apon blood testing my blood testosterone level was in the 100s 140 roughly mid to high for a woman . my dr upped my dose of spiro for a month. my testosterone level was now in the 200s upon a fallow up blood test, with in a male range, the dr upped it again. and told me to come back in two months. that next visit caused me extreme stress as my t level was well up into the 300s at nearly the maximum safe dose of spironolactone. I asked her what where the alternatives. she said asides from removal of the testies in the united states spironolactone is the most readily used and effective for treating mtf transexuals. well I couldn't afford the orchi this is what she said to me" spironolactone was never intended to be a long term testosterone blocker, really none of them are. most mtfs stop treatment with in 2-4 years either due to stopping transition, personal reasons or getting surgery orchi or srs " she simply suspected that my body had become immune to it . she told me she didn't know what to do with her expeirince she had not incountered this problem nor was there enough testing on the drug in this use to compare against.... she offered me things like finasterside and a few others with wierd names... i chose option B.

What angers me is there are other drugs in the world that are specifically desgned to block testoterone completely though it is not fda approved. it is readily given to transsexuals in the rest of the world. That is the route I went... I still get blood tests so I am monitored. and my last several blood test have come back in the single digets. The drug I am on is siterone. it is thee most effective tblocker out side of surgical options.

[Guest Myria]

Do you have to be on spiro for maximum feminization benefits of hrt?

What constitutes an optimal HRT regimen is always going to be quite individual and, for better or ill, is and likely will remain something of a poorly studied subject. That aside, it's important to keep in mind that often anti-androgens are themselves a bit of overkill. While a bit of an oversimplification, fundamentally Estrogens and Androgens are on an inverse homeostatic loop to begin with. Exogenous Estrogens in most instances will result in a decrease in LH/FSH and, thus, in endogenous Androgen production.

While many doctors are going to titrate based on efficacy, frankly as good a way to go as any given our level of knowledge, if you're concerned you can always ask your doctor to run hormone level tests and compare them to baselines.

What angers me is there are other drugs in the world that are specifically desgned to block testoterone completely though it is not fda approved. it is readily given to transsexuals in the rest of the world.

While I'm not the biggest fan of the FDA, in the case of Cyproterone Acetate (Androcur, Cyprostat, Siterone, et al) they do kind of have a point. The biggest issue, and there are several, is hepatic toxicity. While relatively rare, it is dose dependent and almost invariably lethal. Personally I think it should be allowed as long as there is informed consent, but given the severity of some of the potential side effects and the relatively specific nature of the drug, with other, far less risky (if not quite as effective) options available, it's not hard to see why it hasn't gained FDA approval.

[StephanieVikingGirl]

Yep, we are all different in our HRT requirements. As stated, if your estrogen levels are high enough, it lowers your testosterone significantly. I am on E injections at a low dose, yet my body apparently produces extra estrogen, and very little T shows up on my blood tests with or without spiro (my E was 217, and T was at 8 on the last test). I am less than typical though in that I was born with an intersex condition, I have distal hypospadias, and my doctor is going to have my karyotype tested for XXY soon. We humans are very complex, all individuals, and the effects of our medications are just as individual. I find that for me a low dose of spiro has some effects beyond T reduction, it seems to promote more breast growth, although that is very dependent on body fat levels as well, and for me spiro also gives some calming, anti-anxiety, mental effects. I will reiterate that it is always best to be under a doctor's supervision when on HRT, it is best to for both safety, and effectiveness.

hugs,

Stephanie

[Sakura]

you are quite right miyra But then I am also of the mind set that spironolactone has equally the same chance of damaging your liver heck tylenol is sold over the counter and acetaminophen is linked to 10s of thousands of cases of liver damage a year due to accedental overdosing. I personally think that due to the nature of the drug and its direct application to transsexuals The fda is either dragging thier feet or refusing to test it all together. Or maybe I got my tinfoil hat on a lil to tight

[Guest Kenna Dixon]

I've just begun investigating the extent - if any - to which the VA and Medicare will cover orchiectomy.

Finasteride is the only medication I have to take, and I'd rather be off of it. More often than not these days, I forget. And then I'm reminded by the dysphoria starting to come back.

[Cosmo]

As previously stated, finasteride is not a T blocker and for some it can actually elevate T levels which superficially may sound like a big contradiction, it's not that bad.

Prolonged elevated levels of E even on the low end of the scale will eventually decrease and put T in the normal female range. Please note I said PROLONGED and EVENTUALLY. Estrogen is part of the normal biofeedback loop for regulation of T levels. Elevated levels of E will suppress T production until the liver metabolizes the E.

Finasteride blocks the conversion of testosterone to DHT. During feminization process of HRT E can effectively compete with T but not with DHT. DHT encourages and sustains terminal body hair and in its absence, every time body hair completes a growth cycle the newly emerged hair becomes finer and for some lucky few it becomes typical female vellus hair or disappears completely. However as DHT sustains body hair it shrinks scalp follicles and with every growth cycle scalp hair can become thinner and thinner until it becomes vellus hair and then disappears.

So why it is not a T blocker, finasteride does control DHT levels and the E suppresses T and starts feminization. Basically the destination is the same with Spiro and finasteride, they just both take different paths.

I'm on Spiro for BP control and finasteride for MPH. The combination is wickedly effective when estrogen is added to the chemical mix.

[Guest Cyndysub]

I take Sprio and procar both as well as

estradiol and micronized progesterone.

Cyndy.

[Guest Markietoo]

Hi,

this may be redundant but thought I'd add my own experience to the mix. I started on Estradiol two years ago and also Spiro. The Spiro had a negative effect on liver functions so the HRT doc switched me to Finesteride. Since then, liver function returned to normal for me and E levels are at female normal ranges. T levels are down to 25 and the doc and I are happy with the balance. No negative side effects and will continue going forward with this combo until surgery changes that this year. Follow your MD's protocols and keep up with the labs as directed. Do not go off on your own fiddling with dosages and other meds since serious harm can result from that route. Things can stabilize with a good doc and tracking the lab numbers. Good luck!

Markie Anna

[Guest Robin Winter]

I had problems of a different nature with spiro..it just didn't work. Being in Canada, Cyproterone is an approved drug and the results have been incredible. My t level dropped to just below the low side of female levels and has been rock steady. Been on it for over 3 years with regular blood testing and there have been no negative side effects to date. It's unfortunate that it isn't approved in the U.S, as has been mentioned many approved drugs carry similar risks.

As a side note, I also had little results with oral estradiol, and have been switched to the patch (Estradot) as of almost a year ago. Again, fantastic results, but if anyone finds themselves switching to the patch, avoid the generic ones at all costs, they're huge, they fall off and they caused a lot of skin irritation. The brand version is tiny, stays on even with showering, and no skin irritation at all. You're not saving money with generic, you're throwing it away.

[Guest]

I started Spiro and sublingual Estradiol, at the same time, then cycling Progesterone. Then my doctor added Finasteride. I was soon after switched to Progesterone every day and Estrodial Valerate injections which I feel are much safer.

After GCS, I have dropped Spiro, retained all others and my Gynecologist has added Estrace cream for vaginal use. I'm not sure for how long.

I have always tolerated Finasteride well. Now off Spiro, my doctor has added a different blood pressure med.

I've had such a blend, I'm not sure what cures what anymore. Jody