Thanks lotus some things for me to digest, heres a link to the report they talk about http://press.endocrine.org/doi/full/10.1210/jc.2012-2030 which im about to read myself

Thanks bobie, I briefly looked over it, it has some sobering stats:

The aim of this study was to compare those patients who go on to request breast augmentation with those who do not and to identify markers that predict which individuals are likely to require later breast augmentation.

The breasts of transsexual natal males taking estrogen therapy follow the same stages of development as are seen in natal female puberty (2). As such, it takes 2 yr of therapy to achieve maximum growth (2). Because the bony frame of the male chest differs greatly from the female, the resulting appearance of the thorax still differs from that of similarly developed natal females, often resulting in an appearance that is deemed unsatisfactory by patients, leading approximately 60% to request an augmentation mammoplasty (3). Breast augmentation surgery in the male to female transsexual population is accordingly an issue of particular importance.


With regard to the use of antiandrogens, overall there was no statistically significant difference in the use of antiandrogens between those requiring breast augmentation and controls (see Table 3). Comparing the types of antiandrogens used, however, showed that previous spironolactone use was higher in those requesting breast augmentation as compared with other, more specific antiandrogen types (4.8 vs. 1.8%, P = 0.025) (see Table 3). There was no difference in GnRH analog use between augmentation and control groups.

I'll check out more later.

Thanks lotus, excuse the copy and paste if you read this elsewhere, A little update, i went to see my gp this morning who is going to refer me to the nearest gender identity clinic, he was very nice about it all and knows that i am self medicating (which he was either fine about or didnt say anything) and has also agreed to blood tests which i will be having done tomorrow which in addition to the basic stuff includes oestrogen, testosterone and prolactin

Spiro has a whole raft-load of unpleasant to nasty side effects, some of which suggest to me other deleterious systemic effects. As one poster (in the link from the OP) on Susan's put it:

"And herein lies the problem, there's virtually no conclusive research to be found for those of us who seek cross gender hormone therapy- so most doctors rely on old methods without questioning it. They stick to the book, and they do not ask questions. What do they do (as endocrinologists for mainly cis people) if the book is old and there is nothing new? They stick to the book and tell you to shut up."

Consulting your doctor is only going to help you depending on "which book" they are going by and unfortunately more often than not, it's the "cover your ass" medical advice book. Even endos (in my experience with my own patients) are notoriously uninformed about their own field, let alone about cross-gender HRT which many don't even study in school.

I strongly suggest you check out the experiences and information available on the DIYHormones group on Yahoo.com. Hundreds if not thousands of TG women on that site will tell you to have patience, skip the spiro and let estradiol work it's magic. Like PM, estradiol has antiandrogenic effects, but they take time to manifest. Spiro is NOT needed since better and safer forms of estrogen are now available to TG women.

I strongly suggest you check out the experiences and information available on the DIYHormones group on Yahoo.com. Hundreds if not thousands of TG women on that site will tell you to have patience, skip the spiro and let estradiol work it's magic. Like PM, estradiol has antiandrogenic effects, but they take time to manifest. Spiro is NOT needed since better and safer forms of estrogen are now available to TG women.

I agree with the rest of your post, but I've been a member of DIYhormones for quite some time, and its not "hundreds if not thousands of TG women" saying that an AA is unnecessary, it's one extremely self confident TG and a small group of her followers. Most of the members of that group use an AA, at least for the first few months of HRT.

That being said, I'll go with just a DHT blocker and E myself after six months probably. It seems like as is the case with hormones in general, age is the deciding factor as to what program is needed to provide results. I'm sure that people who are older don't need an AA.

Edit: Just to be clear, I don't like spiro either. Give me androcur anyday! LOL

chrishoney is this the group with a picture of estrofem and androcur on the page?

When the local gic takes me on later in the year i will be on an anti androgen for sure, so i guess its chosing the best one for me?

I'm Trans,been on hrt 10 months and can't complain. I have pics on the pictures page of my progress. My doses are 200 mg spiro and 2 mg estradiol every day.

I really need to get my arse into gear and get my bloods done again, its been 4 months since i was last tested, i picked up the bloods form from the gic earlier in the week so theres really no excuse, emma do you take your estradiol orally or sublingually? i have seen a number of the pictures you have posted and have always been amazed, how i wish i had done this a decade ago when i where your age rather than waiting

I take them sublingually. Eh as time progresses I'm content, though my worst demons are me wishing I knew and started before puberty so I could get female hip growth. That's the most painful thing for me... Still makes me cry to this day....

I know exactly where you are coming from on the hips front, i just try and remind myself that i have to work with what i have got, that doesnt make it any easier particularly during the summer months when girls arent wearing a lot, i had a few rough days on my recent holiday in the south of france, i ended up sat in my car crying on one of them, still some hope for you with regards to hips though isnt there? unless im wrong your under the age of 25 and since in most the hips dont fuse until about 25 there is the potential for some growth

In dunno do not think so but if there is Oh how ever thankful I'd be