When I started medically transitioning, my doctor at the time wasn’t too confident about prescribing HRT himself, so he gave me a prescription for spironolactone and referred me to a doctor he worked under who has an interest in trans health.
That doctor gave me estradiol on my first visit, and it’s been a series of appointments about 2 months apart since to adjust dosages. A few months in, there was a massive shortage of spiro in my area, so I switched to cyproterone for androgen suppression at one quarter of a 50 mg tablet a day. The tablets are hard to break that small without them turning into powder, so when he mentioned we could up it to a half tablet, I figured, sure that will make it easier, so we upped the dose.
I’ve had issues with low (nonexistent) libido since starting HRT, and hoped starting progesterone at 6 months would help. It did not. The only other thing I found that could cause it would be having your T be too low, so we talked about adding that to the mix, but T wasn’t in my last batch of bloodwork, so he sent me to get more blood drawn and we’d talk at my next appointment.
At this point I finally got my first appointment at the trans health clinic in my city and they pulled up my bloodwork and pointed out that my T being so low it couldn’t be detected at all is because when they prescribe cyproterone they start at a quarter tablet a day, and go down from there, often ending up around a quarter tablet a week!
I am so mad at my doctor who, even at the trans health clinic, has a good reputation for knowing about trans health, but also at myself beacause I didn’t look into dosages for cypro. I had looked into everything else I’ve been taking for HRT, and beyond my doctor saying taking progesterone rectally rather than orally doesn’t significantly raise bloodstream levels, everything else has lined up. My wife and I aren’t super horny people, but if I had looked into this one medication like I did the rest, our sex life wouldn’t be on the critically endagered list!
TLDR; My doctor has been giving me a cypro dose 4-14x what most people seem to need and it’s killed my sex drive/life for months
That sucks girl. Cypro can have gnarly side effects at higher doses. It’s important for your liver to be able to completely clear it from your system before you take more. It’s negligent for the doc to prescribe without knowing this and informing you fully of it.
It is your doctor’s job to inform you, it’s not your fault, you were let down. I’m hoping you have it under control now.
Side note. Most pharmacies sell pill cutters that can accurately cut pills in half and quarters. Worth picking one up, they’re cheap.
I was advised to go cold turkey on cypro for a few weeks and then back to a quarter every other day. The pill cutter I bought does a worse job than I do by hand, but the nurses at the trans health clinic told me I can request the pills be pre cut for me, so we’ll see how they do with that
Oh that’s cool that you can get them pre cut. I’m really glad you have been given good advice now. Wishing you all the best
jesus youd think a doctor would look up dosages before prescribing medication… with the resources they have readily available it shouldnt have taken more than a few minutes. i cant tell if doctors are overworked to the point of negligence or if they really just dont care, but either is fucked.
all the side effects of androgen blockers are why i decided to go straight for monotherapy via injections. my doctor thankfully predcribed a good dosage from the beginning, but also claimed rectal progesterone isn’t recommended even though its really the only way that even works.
i’m on 2.5 mg/d and wondering if i need it. in theory a high enough E level should suppress T-production anyway. but i’m scared of growing a beard again or smth. (i know that’s not how it works. for the record.)
i am thinking more and more abt the “yeet” option.
edit: sorry firgot to say why i want to get rid of it:
- maybe a little libido here and there would be nice.
- logistically getting hands on duch low dosage is a nightmare. there is a (read: one i know of) pharmacy that produces such capsules. (12.5 or 25 mg/week sounds easier though.)
I had been on a fairly low dose of spiro for a little over 2 years and recently asked my doctor if I could discontinue it. She said it should be safe since my testosterone levels had been suppressed for so long and estrogen alone should keep it down now; my last labs coming out to 11ng/dL.
I never really had any issues with it, but I started a new medication that also had the chance to interact with my water/salt levels and wanted to avoid potential complications. It’s been 2 weeks so far, and I haven’t noticed any rebounding effects… though apparently it can take anywhere from 2-12 weeks for anything noticeable. I’ve also had absolutely zero libido since transitioning (progesterone didn’t help), so waiting to see if that returns and how my next routine labs come out!
