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trans girls! doctors overprescribe us spironolactone and don't tell us about alternative regimens that are more effective and have less side effects (like brain fog and diminished breast development) and long term health risks (like blood clots and high cortisol)! thread
i highly recommend reading "the case against spironolactone" and also giving it to your doctor. i'm gonna break it apart in this thread so it's easier to understand.
https://moderntranshormones.com/2018/01/01/whats-wrong-with-spironolactone/
https://moderntranshormones.com/2018/01/01/whats-wrong-with-spironolactone/
spiro does not effectively reduce testosterone.
"a single estradiol injection accomplishes what the spiro-based protocol may need over 3 years to do"
"a single estradiol injection accomplishes what the spiro-based protocol may need over 3 years to do"
spiro interferes with estradiol.
spiro increases cortisol, which may lead to brain fog and cognitive dysfunction.
"if a patient is already depressed ... [spiro-induced hypercortisolism] traps the individual in a depressive state which does not respond to antidepressants"
![spiro interferes with estradiol.spiro increases cortisol, which may lead to brain fog and cognitive dysfunction."if a patient is already depressed ... [spiro-induced hypercortisolism] traps the individual in a depressive state which does not respond to antidepressants"](https://pbs.twimg.com/media/EbyGcP9UMAAi8v5.jpg "spiro interferes with estradiol.spiro increases cortisol, which may lead to brain fog and cognitive dysfunction.\"if a patient is already depressed ... [spiro-induced hypercortisolism] traps the individual in a depressive state which does not respond to antidepressants\"")
![spiro interferes with estradiol.spiro increases cortisol, which may lead to brain fog and cognitive dysfunction."if a patient is already depressed ... [spiro-induced hypercortisolism] traps the individual in a depressive state which does not respond to antidepressants"](https://pbs.twimg.com/media/EbyGcUJUMAEq-UI.jpg "spiro interferes with estradiol.spiro increases cortisol, which may lead to brain fog and cognitive dysfunction.\"if a patient is already depressed ... [spiro-induced hypercortisolism] traps the individual in a depressive state which does not respond to antidepressants\"")
spiro increases cortisol, which may lead to brain fog and cognitive dysfunction.
"if a patient is already depressed ... [spiro-induced hypercortisolism] traps the individual in a depressive state which does not respond to antidepressants"
the blocked out part was relating this to the incidence of self harm etc in the trans community
"spiro belly" - hypercortisolism from spiro may encourage the growth of visceral fat, specifically in the stomach, which is very difficult to remove naturally, and can't be removed by surgery. this also encourages fat from elsewhere in the body to migrate to this area.
spiro harms breast development.
the availability of injection estrogen outside the US is sparse/complex/expensive and that is really fucked up. i hope it improves ASAP to get more girls off harmful meds like spiro, medroxyprogesterone, diane-35, etc
ALSO: there are many counterfeit black market estrogens and progesterones. please confirm 100% that you are taking real meds.
i will answer dm's in this thread so it helps more people!
this is my regimen, plus 500 mg rutin per day (non prescription)
injection dosage equation:
strength = dose / volume
where the strength of your vial is in mg/mL, the dose you want is in mg, and the volume you put in the syringe is in mL
my vial is 40mg/mL, so if i want to inject 5.3 mg:
strength = dose / volume
40 = 5.3 / x
solve for x
strength = dose / volume
where the strength of your vial is in mg/mL, the dose you want is in mg, and the volume you put in the syringe is in mL
my vial is 40mg/mL, so if i want to inject 5.3 mg:
strength = dose / volume
40 = 5.3 / x
solve for x
just make sure you always match your units!! it should always be in mg and mL but if the units are different, convert the individual numbers to mg and mL FIRST. also feel free to dm me to make sure cuz i will hella respond before u inject fuckin a bajillion mg of estrogen lol
my brand of bioidentical micronized progesterone is Prometrium, and i got the prescription from planned parenthood
taking bioidentical progesterone with estradiol injections, as opposed to E injections alone, reduces your risk of breast cancer by like 60-70%
taking bioidentical progesterone with estradiol injections, as opposed to E injections alone, reduces your risk of breast cancer by like 60-70%
https://twitter.com/zedsexism/status/1278086036141285378?s=21 https://twitter.com/zedsexism/status/1278086036141285378
your best option to get off spiro is to switch to injection estradiol. it is kinda impossible to get high enough estradiol on pills to suppress testosterone without a blocker. and difficult / complex on sublinguals. injections, or maybe patches, are the most effective
disclaimer: i'm not a doctor or licensed professional. but i am sharing and paraphrasing info from doctors and researchers, including ones who are trans women themselves. taking this advise is at your own risk. taking your doctor's advise is also at your own risk/discretion.
https://twitter.com/zedsexism/status/1278098589412143104?s=21 https://twitter.com/zedsexism/status/1278098589412143104
do not just stop taking spiro because of this info. if you're on pills or sublinguals, you likely need a T blocker. plus, you need to TAPER off spiro, or you risk T rebound. when i started injections i tapered off spiro by halving the dose every 2 weeks
i really have nothing to help with needle aversions/phobias i'm sorry 
all i can say is that i used to be scared of shots/blood draws, and now i'm over it. and those use THICK needles. the injection needles (25 or 27ga) are SO thin. mine does NOT hurt. it's kinda comforting tbh
all i can say is that i used to be scared of shots/blood draws, and now i'm over it. and those use THICK needles. the injection needles (25 or 27ga) are SO thin. mine does NOT hurt. it's kinda comforting tbh
injection 1: had a BREAKDOWN crying on the floor because i was so scared
injections 2-4: realized it doesn't hurt, still took me like 10+ mins to work up the courage
injections 5-8: gotta take a deep breath
injections 9+: i can literally do it in 10 seconds. in a moving car
injections 2-4: realized it doesn't hurt, still took me like 10+ mins to work up the courage
injections 5-8: gotta take a deep breath
injections 9+: i can literally do it in 10 seconds. in a moving car
i can't provide any help on black market stuff. but i have never heard of anything counterfeit coming from inhouse pharmacy. i think another popular one is all day chemist but i know NOTHING about them lol. drop info below if you know anything
i get my estradiol and progesterone from planned parenthood, but i had to ask for it specifically, but after i listed my spiro side effects they agreed to it. i am the only trans person not taking pills at that entire clinic, but standards differ regionally and between clinics
i aim for 400-600 pg/mL estradiol, and 6-15 ng/dL testosterone. this is my sweet spot in terms of getting max results with minimum side effects (like leg swelling or cramps, often indicative of too much E)
i once had estrogen dominance when attempting to absorb my sublingual pills as suppositories. i had white hairs, extremely swollen legs feet and ankles (my mom said i looked very pregnant), and would wake up crying and cry the whole day. not fun!!!
in my OWN experience, 7 months of spiro and E sublinguals gave me *nothing* in terms of good results. my tits developed tiny breast buds but that's it. i started injections and literally started passing within like a month or two.
it's recommended that you delay progesterone until tanner stage 3 of breast development, when you have convex fullness on top of the boobs, to mimic natural development. it needs to build a big base before the progesterone make it shoot out, otherwise u can get tube boob
can't offer tons of insight on patches or gels but those are both transdermal forms of estradiol and thus don't pass thru the liver like pills, so they can be just as effective. i know patch wearers may have issues with high number of patches, sweating, transferring etc
the other (best) option is a pellet implant which is basically automatic injections that lasts like half a year and gives you a steady estradiol supply. it's rare though, i would have to go to CA for it, and hella expensive
my injections are less than $20 a month, even way less if you have insurance.
guide: https://moderntranshormones.com/2018/01/25/estradiol-injections-are-not-expensive/
guide: https://moderntranshormones.com/2018/01/25/estradiol-injections-are-not-expensive/
please drop advice on stuff other than estradiol valerate!! people ask me about cypionate and benzoate and all i know is cypionate has a slightly different time graph, i think the half life is longer
