Spironolactone vs Orchidectomy?

[ToniTone]

Hey y'all. Without discussing doses with respect to the rules, I've been reading conflicting medical reports on the effectiveness of perscribed spironolactone as t blocker. I've been on estradiol/spironolactone for going on two months now. I desire to get an orchidectomy down the road, but I'm in no rush. I still need to get set with a gender therapists (at very least to approve it), and while I'm certain about transitioning, I still have my hesitations about surgeries.

 

I feel like my fat distribution and muscle loss is changing subtly. The estradiol/spironolactone combination is so prolific, so there must be something said to it's effectiveness, right?

[VickySGV]

The T blocking effects of Spiro are actually a "side effect" of its potassium sparing properties as a diuretic used to treat high blood pressure.  I am post-op GCS and still take  it for the blood pressure control use.  Its effectiveness varies from person to person, and must be carefully monitored by their prescribing physician to be sure there is not an unhealthy build up of potassium in the body.  You need potassium for good health, but too much can harm or kill you. There are those who swear by the drug, and those who swear at it.  If your doctor thinks it is safe and useful to you, who am I to argue.  An Orchiectomy may keep you from needing it for Anti T, although I am on it 6 years after my GCS because my doctor thinks I should be.  (Another diuretic drops my potassium much too low.

[Josie Beth]

There’s a new clinical study being conducted by doctors who treat transgender women with HRT and they are comparing the health benefits and risks of all the different methods of administering estrogen and t blockers. They are also discovering that a high enough regulated dose of estrogen has its own anti androgen effects and over time can be just as effective as taking a t blocker. It’s different for everyone but so far they have determined that the most effective way to administer this is through injection of a specific kind of estrogen as opposed to oral or sublingual. So it seems that the most cutting edge HRT method is actually nodding back to the days they didn’t prescribe any t blockers. This has a lot to do with the concerns that many transgender women have raised with their doctors about long term health, even the possible negative effects of estrogen prescribed by other means than injections. I’m seriously going to discuss this with my doctor and request that I be allowed to switch to this method. The drawback is it has to be scheduled as I have to be able to keep the schedule and the cost increase. It’s still an early study but I’m hopeful. 

[ToniTone]

Yeah, I've read about that. I read somewhere else that the t blocking effect of both combined is enough to null the effect of testosterone, somewhere else that spiro nullifies some of the effect of oral estradiol. 

 

I want an orchi, but I'm being patient about it and transition in general. Surgery/going under kinda preoccupy me (I know it's not a life threatening surgery or anaesthesia, but still), and I'm nowhere near being authorized for it anyway. But I am still taking my options into consideration.

[ToniTone]

And in the meantime, research! I always had a fascination with medical and surgical related matters.

[Carolyn Marie]

An orchie is a very personal decision, and any surgery needs careful thought, research and discussions with your doctor before deciding, and you obviously know that already, Toni.  I have read that doctors who manage trans HRT are not as sold on Spiro as a T-blocker as they used to be, probably because of its side effects.

 

I decided on an orchie several years ago so I could get off of Spiro, which was causing me some unwanted side effects, plus I wanted the comfort and physical appearance changes that an orchie could give me.  Once CA mandated coverage for such surgery I jumped at the chance, and was the first trans orchie to be performed within my medical group.

 

Whatever decision you make, Toni, if its the right one for you, then I wish you all the best.

 

Carolyn Marie

[ToniTone]

Thank you Carolyn Marie, Josie and Vickie! 

Like I said I'm going to be very patient with alot of things, notably the orchi. I'm still pretty early in transition and kinda torn. It is one of those big step, one-way decisions that I should really discuss with a therapist. I guess I'm not too hung up about that aspect of my anatomy, just the rest of it, lol! 

 

I am concerned about the impact of hrt though, the risk to benefit ratio. So far I'm in good health 

[ToniTone]

And I seem to be taking to it alright. I think my fat distribution has changed subtly too. Not enough to show yet, but it is inspiring some confidence.