25-05-2016, 10:14 PM
25-05-2016, 10:25 PM
(This post was last modified: 25-05-2016, 10:27 PM by tanysquirrel.)
interesting:
http://www.medpagetoday.com/MeetingCoverage/ENDO/46497
"Adding the anti-androgens spironolactone or finasteride didn't help, and actually appeared to slightly raise testosterone levels, Leinung reported"
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by Kristina Fiore
Staff Writer, MedPage Today
This article is a collaboration between MedPage Today® and:
Medpage Today
CHICAGO -- Simply giving estrogen to male-to-female transgender patients won't completely suppress testosterone levels, researchers reported here.
In a study from a single-center experience, patients achieved good estrogen levels but only about half reached sufficient testosterone suppression with estradiol with or without a progestin, Matthew Leinung, MD, of Albany Medical College in New York state, reported at the joint meeting of the Endocrine Society and the International Congress on Endocrinology here.
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Adding the anti-androgens spironolactone or finasteride didn't help, and actually appeared to slightly raise testosterone levels, Leinung reported.
"I don't know why I found what I found," he said during an oral presentation. "I don't have a good explanation because that's not what the conventional wisdom is."
There are many treatments for male-to-female transgender patients, but the optimal regimen isn't established because of a lack of evidence. Transgender medicine guidelines agree that, in general, patients should be brought into normal hormone levels for their desired gender, and that suppressing endogenous gonadal function is essential.
To get a better understanding of the hormonal response to oral estradiol in male-to-female transgender patients, Leinung assessed all patients seen at his transgender clinic from 2008 through 2013 (He picked 2008 as baseline because a major switch from ethyl-estradiol to oral estradiol occurred at that time).
His therapeutic strategy was to titrate all patients to 4 or 6 mg of oral estradiol, adding 2.5 to 10 mg of medroxyprogesterone if testosterone levels weren't sufficiently suppressed.
He said he would also add spironolactone or finasteride to lessen body hair, without regard to testosterone levels.
During that time, Leinung saw 162 male-to-female transgender patients, but ultimately used data from 82 of them. He excluded those who hadn't been on estradiol therapy long enough, who weren't on full doses, who had gender reassignment surgery, or who had been on Premarin.
He found that 46% of patients started on the 4-mg dose (6/13) had their testosterone levels sufficiently suppressed, below 100 ng/dL.
[b]probably due to lack of aromatase.[/b]
http://www.medpagetoday.com/MeetingCoverage/ENDO/46497
"Adding the anti-androgens spironolactone or finasteride didn't help, and actually appeared to slightly raise testosterone levels, Leinung reported"
save
saved
author name
by Kristina Fiore
Staff Writer, MedPage Today
This article is a collaboration between MedPage Today® and:
Medpage Today
CHICAGO -- Simply giving estrogen to male-to-female transgender patients won't completely suppress testosterone levels, researchers reported here.
In a study from a single-center experience, patients achieved good estrogen levels but only about half reached sufficient testosterone suppression with estradiol with or without a progestin, Matthew Leinung, MD, of Albany Medical College in New York state, reported at the joint meeting of the Endocrine Society and the International Congress on Endocrinology here.
advertisement
Adding the anti-androgens spironolactone or finasteride didn't help, and actually appeared to slightly raise testosterone levels, Leinung reported.
"I don't know why I found what I found," he said during an oral presentation. "I don't have a good explanation because that's not what the conventional wisdom is."
There are many treatments for male-to-female transgender patients, but the optimal regimen isn't established because of a lack of evidence. Transgender medicine guidelines agree that, in general, patients should be brought into normal hormone levels for their desired gender, and that suppressing endogenous gonadal function is essential.
To get a better understanding of the hormonal response to oral estradiol in male-to-female transgender patients, Leinung assessed all patients seen at his transgender clinic from 2008 through 2013 (He picked 2008 as baseline because a major switch from ethyl-estradiol to oral estradiol occurred at that time).
His therapeutic strategy was to titrate all patients to 4 or 6 mg of oral estradiol, adding 2.5 to 10 mg of medroxyprogesterone if testosterone levels weren't sufficiently suppressed.
He said he would also add spironolactone or finasteride to lessen body hair, without regard to testosterone levels.
During that time, Leinung saw 162 male-to-female transgender patients, but ultimately used data from 82 of them. He excluded those who hadn't been on estradiol therapy long enough, who weren't on full doses, who had gender reassignment surgery, or who had been on Premarin.
He found that 46% of patients started on the 4-mg dose (6/13) had their testosterone levels sufficiently suppressed, below 100 ng/dL.
[b]probably due to lack of aromatase.[/b]
28-05-2016, 06:04 AM
I'm not worried about full transition. I took 50mg of spironolactone twice a day for 3 months the three times a day for 3 more months. I had no negative side effects beyond and uncontrollable desire for salty foods. Which drove me nuts.
At my last visit to the clinic I decided to stop spironolactone. I am only on 1mg of estradiol three times a day. I am scheduled to take this dose for the next 6 months. When I started HRT my brain cleared almost immediately and all desires to buy or wear clothes evaporated. I am hopeful that estradiol alone will suffice to keep me clear headed.
At my last visit to the clinic I decided to stop spironolactone. I am only on 1mg of estradiol three times a day. I am scheduled to take this dose for the next 6 months. When I started HRT my brain cleared almost immediately and all desires to buy or wear clothes evaporated. I am hopeful that estradiol alone will suffice to keep me clear headed.
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