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To Hormone or not to Hormone?

  • To my knowledge, Spironolactone isn't used to treat androgenetic alopecia in this country. Right now, it's just Finasteride, under the two brand names Propecia (1mg) and Proscar (5mg). Actually, I don't think that Proscar is used to treat hair loss, unless there is also a diagnosis of prostate trouble, where you'd be killing two birds with one stone.

    As an amateur, I would think Spironolactone would be of some benefit regarding male pattern baldness, but I'm assuming that it isn't prescribed because it's more of a general antiandrogen, whereas Finasteride supposedly specializes in reducing DHT production only. Most males wouldn't want lower testosterone levels across the board, so maybe that's why Spironolactone isn't a good choice, unless you're a tranny. I'm just taking a semi-educated guess, though. I've heard some European trannies talk about using Cyproterone Acetate (Androcur, Cyprostat) as an effective antiandrogen, but everything I've read about that drug scares me to death (aside from the fact that it's not FDA approved in the USA)! Spironolactone and Finasteride seem to be the safest way to go while still getting good results. I wonder whether any doctors prescribe a combination of the two.

    I'll be glad when Finasteride finally goes generic. I have seen a brand called Affasin from Sintofarma/Uniao Quimica on the Pharmacy International ( website, but it's not any cheaper than Propecia at ( How much Spiro do you take every day? Most trannies say their doctors start them off at 100mg and then go to 200mg if necessary. I've noticed that the prices for Aldactone are outrageous, and in the USA, the generic version is still fairly expensive. Spirotone, a generic brand from New Zealand, is the cheapest I've seen. A couple of girls on this board say they are using it.

    So, how did your doctor react when you explained you had self-prescribed Spironolactone and Premarin? Did you get a lecture? I've heard some things about Premarin that would lead me to believe a combination of Estradiol (Estrofem, Estrace) and Medroxyprogesterone Acetate (Provera) would be a safer choice.

    You're right about the variables of my regimen. It would be much less complicated to start using prescription hormones, even if I just wanted to start with small doses. I'm glad I tried the herbs, and I'm still planning to ride them out for a few more months, but it's a lot to keep up with. Depending on where I am socially and financially (I'm considering buying a new house) later this year, I'm seriously considering talking to a doctor later. Psychologically, I'm ready, but I have to plan ahead for the social ramifications, taking things very slowly.

    In the meantime, I enjoy educating myself about all of the possibilities. I'll be very interested to hear what a doctor suggests for me.
      April 13, 2003 10:14 PM BST
  • I think herbs are much more effective, as an alternative, with genetic females who are simply trying to restore a natural hormonal balance, when HRT using prescription drugs causes too many problems. Trying to feminize a male body is just too much to ask of herbal supplements because they are having to work against the natural male physiology, whereas a female's body works with the herbs. However, in large enough doses, you can get some degree of feminization, but it's like rolling a ball uphill.

    I haven't noticed any negative results from using herbal supplements, yet. Well, they did cause my bank account to shrink a bit.

    Yes, I've intentionally avoided Saw Palmetto (the only effective phytoantiandrogen, to my knowledge) for two reasons. One, I'm taking a chemical antiandrogen, Finasteride (Propecia), and from what I gather, you don't mix herbs and prescription drugs that do the same things. Two, I've read several reports that suggested Saw Palmetto does block DHT production to some degree, but it also has the potential to increase male hormone levels, which, if true, would work against any feminization efforts. For a male non-tranny who isn't already using a prescription drug, Saw Palmetto is supposed to be very healthy, though. So, based on my research, the bottom line seems to be that Saw Palmetto might be an androgen inhibitor (at least for DHT), but it doesn't help to feminize the male body. If so, there's no reason for trannies to use it. Besides, any adult male can easily get a prescription for Finasteride, assuming the expense ($500.00 per year) isn't an obstacle.

    I have a prescription for Finasteride so that I can keep my hair. Fortunately, I was able to start using it before I went bald. I've always worn my hair long, and I don't intend to let go of it. I'm considering adding a second anti-androgen, Spironolactone (Aldactone, Spirotone), but I need to hear what a doctor has to say about my continued use of phytoestrogens and phytoprogesterones.

    There's another reason some prefer herbs, and that's the fact that sometimes, in some patients, long-term chemical hormone therapy can cause tumors, cancer, heart problems, etc. Considering that transsexuals (and transvestites who intend to feminize their bodies) will usually need to take these chemical hormones for the rest of their lives, that an important factor. That's also why a doctor needs to be involved, to monitor things over time.
      April 13, 2003 1:19 AM BST
  • Well, I agree for the most part. I started using herbs in September 2002. I have noticed some results, but they are by no means significant, compared to the results other trannies have achieved with chemical hormones. However, herbal supplements do work to a small degree, and I'm generally pleased with the results, because I never expected to magically wake up with a female body one morning from taking herbs. I have noticed some slight changes in my chest and butt (puffiness and slight soreness), and, at times, I have felt some sort of buzz from the herbs (whether it's psychological or physical, I don't know).

    Why did I choose to go the herbal route?

    As I stated earlier, I consider herbs to be training hormones (for me). I do not want to become female in the SRS sense, but I do want a more feminine-looking body. Just how feminine I want it is something I'm still dealing with, mainly because of social and employment reasons. Herbs won't do anything drastic in the way of feminizing my body, but it will give me a chance to test the freak-out factor when noticing slight changes in my body. Just knowing that I am consciously taking steps to feminize my own body is a concept that I have to get used to. Yes, I want to do it, but I also want to see what I'm getting into before going into high gear.

    I'm taking heavy doses (the maximum safe doses) of several herbs, and I don't plan to keep it up for any longer than one year. It's true that, while individual herbs alone are very inexpensive, by the time you add up the costs of several herbs together that you take twice every day, the expense is considerable. Sometime between now and September 2003, I'll decide whether to switch from herbs to prescription chemical hormones, or just quit altogether. Small doses of herbs can be taken for long periods, but I can't keep taking large amounts for long, and it takes large amounts to do anything at all in the way of feminization.

    I've been seeing specialists for a couple of other related issues, and I might eventually discuss hormone therapy with a doctor.

    Here's what I've been taking:

    My multi-vitamin is Especially for Women from the Vitamin Shoppe.


    Black Cohosh Root = 2060 mg (four 515 mg capsules)
    Red Clover = 860 mg (two 430 mg capsules)
    Dong Quai = 50 mg (as part of a multi-vitamin; two 25 mg tablets)


    Vitex Agnus-Castus = 800 mg (two 400 mg capsules)
    Wild Yam Root = 1000 mg (two 500 mg capsules)
    Suma = 1000 mg (two 500 mg capsules)

    Phytoantiandrogens (testosterone blockers):



    Vitamin E = 200 I.U. (as part of a multi-vitamin; two 100 I.U. tablets)
    Pregnenolone = 60mg (two 30 mg capsules)
    Black Currant = 100 mg (as part of a multi-vitamin; two 50 mg tablets)
    Royal Jelly = 100 mg (as part of a multi-vitamin; two 50 mg tablets)

    Non-herbal Drugs


    Finasteride (Propecia) = 1 mg (1 tablet; prescription only)
      April 12, 2003 1:38 AM BST
  • I took Black Cohaosh for 2 months. My blood presure started to get higher and I became nausiated. My Dr thought the bad effects were because I had a conjenital heart problem and diabetes II My libido went down too. But I was much calmer in myself. I stopped taking them at his advice. I have developed small breasts because of the hormones and they are still growing slowly. My libido is still down a bit. I feel fine now though We cant all take them because of other problems Pity 1 Joanna

      April 5, 2003 12:12 AM BST
  • Hi Andi

    We both seem to have our four months of hormones behind. My dosis is somewhat lower than yours, but it WORKS, too.
    I´m also happy about my travel and start to be sure, for some reason, that everything will be just fine.


      March 31, 2003 6:33 AM BST
  • Hmmmm.. Stevie

    Only maybe that you must remember to drink more water. It makes you thirsty because its main function is diuretic. And flushing your body inside doesn´t harm anything. If it is only water and not BEER.
    But if you mean REAL problems, NO.

      March 26, 2003 5:43 AM GMT
  • Have you noticed any problems with the Spironolactone?
      March 25, 2003 12:55 PM GMT
  • Yes Stevie

    My dosis is the double to three times higher than the amount used in birth control on born females. Lower dosises would not change my hormone level into the female range. Essential in the whole is also the spironolactone. Without spiro the necessary estrogen input should be still higher and thus more dangerous to the patient.

      March 25, 2003 6:01 AM GMT
  • Thanks Laura.

    From MediResource:

    "Levonorgestrel - ethinyl estradiol is a progestin (levonorgestrel) and estrogen (ethinyl estradiol) combination birth control pill used for the prevention of pregnancy. This medication may also be taken to regulate the menstrual cycle."

    As you see, Laura is taking that birth control pill with other drugs.
      March 24, 2003 12:45 PM GMT
  • Hi Stevie and others

    I have now had my daily spiro 100mg and ethinyl estradiol (plus levonogestrel) 100 mikrograms for over 4 months. I feel maybe more stable than in the beginning, no more easy cryings. And the main thing...I feel much more confident about my goal and I´m starting to be sure about myself passing as a woman in later phase.
    Hormonally I am a woman already. And my male dog can smell it, he has started rebelling, not obeying any more. "Who would listen to a girl". So in him I have a good training for a new female how to handle men later on...


      March 24, 2003 10:47 AM GMT
  • I can see it now... "The Julie Project"

    I wish I had some advice to offer. Maybe someone will have an idea. Deciding whether to make a specific change (or changes) is tough, but actually making the change is often just as difficult, more so, in some cases.

    My social situation keeps me from going at a fast pace, but that's probably a good thing. I'm ready to advance, but I've got to be careful.
      March 23, 2003 3:45 PM GMT
  • i cant seem to break the live from day to day stuff... food, clothes, rent, work, sleep, etc.
    i wanna go further.....
    can anyone "make me their project?"( take me from this man to the woman i wanna be...)

    sadly living as a man most of the time, i need a change....
    there are endless loops that seem to re-occur, so i cant move forward. need to smash the chains... any ideas??

    love you all....


    patience is a virtue, or is it simply a card game, and whos the dealer?
      March 22, 2003 5:12 PM GMT
  • Crowe, I really think you'll get better results buying individual herbs and taking them together than you will from taking an herbal cocktail such as Estroven. Not that Estroven doesn't have good things in it, but you probably won't get enough from its ingredients to produce the results you want. Then again, if it's working for you, who am I to tell you to switch. Herbs are strange, and if you find a combination that works for you, it might not work for someone else. Unlike chemical hormones, herb use is based on tradition and word of mouth, not clinical studies. However, my personal experience with herbs and some of the information I've gotten from others who've used them is that full doses of various herbs taken together usually get the maximum results offered by herbal therapy.

    Red Clover is a good phytoestrogen, so if you're taking Estroven already, that should be a good combination. I've gotten good results (well, good for herbs) with Red Clover and several other herbs together.

    Everyone knows that chemical prescription hormones shouldn't be taken without consulting a doctor, but I know many trannies experiment with them anyway. Not that I condone the use of chemical hormones in the absence of a doctor, but if you are going to use them, you really shouldn't mix herbal hormone supplements with chemical hormones of the same kind, based both on my research and what I've been told. For example, don't take Estradiol and Black Cohosh together, because they both affect estrogen levels in the body. Also, don't take Saw Palmetto (a phytoantiandrogen) with a chemical antiandrogen, such as Spironolactone or Cyproterone Acetate.

    As for using herbs and chemical hormones of different types, I haven't found anything that suggests that's unsafe, or that there are any negative interactions among any of the specific herbs and prescription drugs I'm using. For example, I've been using chemical antiandrogens to block my testosterone while using phytoestrogens and phytoprogesterones to increase my estrogen level.

    I wouldn't recommend using birth control pills alone to feminize. If you're going to move from herbs to chemical hormones, you should use the ones developed for HRT. I'm not an expert, but I've never heard of a doctor prescribing contraceptives for M-to-F feminization, unless they are part of a multi-drug prescription. I know some drugs used to prevent pregnancy are similar to drugs used in HRT for females and HT for M-to-F trannies (I think Provera, for example, is used for both), but to use a drug for HT that was specifically designed for birth control is probably unwise, unless a doctor specifically prescribes that drug for you. Even then, in the case of Provera (Medroxyprogesterone Acetate - a progestin), the doctor would probably prescribe some form of estrogen, and possibly an antiandrogen, to go with it. Maybe some of the other girls can verify this for me. I know just enough to know how dangerous it can be to misuse these drugs.

      March 22, 2003 12:29 AM GMT
  • Here are a few on-line stores. I haven't used them all, but I do recommend The Vitamin Shoppe. Click on the links below.

    Vitamin Shoppe

    GNC (I don't think they actually have an on-line store of their own.)

    Green Canyon

    Mother Nature

    Web Vitamins

    Cedarvale Natural Health

    Total Health Discount Vitamins

    Herb Cupboard



    Answers with Herbs

    Penn Herb Company, Ltd.

      February 22, 2003 12:09 AM GMT
  • Personally, I prefer to mix my herbs myself, rather than taking those pre-mixed formulas. However, if it works for others, that's great.

    Crowe, your results are moving along a little faster than mine. After six months, I still haven't noticed any change in my hips. The mild breast development took most of the six months, and so did the slight change in the shape of my behind (slight, but a change, nonetheless). As far as completely changing one's body, herbs aren't supposed to do that. It takes prescription hormones (and often some surgery) for that "all girl" look. However, two years sounds about right, as far as getting the most out of herbs. I've heard it takes even longer with some individuals, though.
      February 21, 2003 1:58 AM GMT
  • Annik, if you know for certain that you are ready to deal with the drastic changes that prescription hormones cause, I agree with you. However, they aren't right for everyone. Unfortunately, I'm not at a point in my life where I'm ready to have a body so feminine that I can't go back to being a guy. I still have to live as a man at work and until I resolve several lifestyle issues, I can't take the plunge. The herbal supplements I've been taking over the past six months have actually worked, but they haven't done so much to my body that I can't still pass as a guy.<br><br>For those in similar position to mine, herbs might be the only option for a while (or forever). Going in, I had my doubts about their effectiveness, but I've experienced noticeable results, emotionally and physically, although the physical changes took a while to manifest themselves. Herbs won't do anywhere near as much as real hormones, but that's what makes herbs an attractive option for some of us. I can say that I have definitely not wasted my money, and I've got a much better perspective regarding a possible decision to use prescription hormones in the future.
      February 18, 2003 3:05 AM GMT
  • Shelley :)

    The substitute for spironolactone is cyproterone. So you could try that. But it costs some threes time more than spiro. A drug as Diane-35 contains estrogen and cyproterone, and it is a common starter of ts people, but on the long run it is not strong enough.

    Thanks Annik for your trusting words. I am just a girl, who is interested in these things and have read everything I got into my hands about it. But I´m no doctor...


      February 17, 2003 8:56 AM GMT
  • Girls,

    Follow Lauranatalia, she's very clever and seems to know a lot of the subject. I'm agree with her. Anyway I think that the herbal program it's a lose of time and money. Prescription hormones such 17 Beta Estradiol, are the right ones for breast and hips in a short time.

      February 17, 2003 2:55 AM GMT
  • Shelley

    Your mention about spironolactone strikes me with surprise, because I have never heard about problems with spiro before. The drug is mainly used as diuretic, that is to take water out of your body. Its side effect is that it blocks the effects of testosterone. And causes gynecomastia.
    In ts drug combination there normally ALWAYS is either spiro or cyproterone, which is very expensive. By blocking the effects of testosterone we can use much lower dosises of estrogen. And that is overall healthy for you.

      February 14, 2003 7:04 AM GMT
  • Stevie :)

    You are right. Herbals DO work, too, though very slow. Maybe you remember that I started with herbals last August and I noticed some effects right away. As the smoothening of my skin. But real hormones are of course a turbo version when compared with herbals.
    It is funny how they change your face, for example. You think you look the same, but have problems with your id-cards or your old friends just walk by and don´t see you.
    Mentally, I think for me the main effect is calming and a certain high, brightness... but at the same time it is just too easy to burst in tears, if there is a reason...

      February 13, 2003 7:46 AM GMT
  • I've finally started noticing some physical results from the herbs, but (as expected) what I'm seeing is minor compared to the reports from trannies who are using prescription hormones. However, even with herbs, I've noticed some of the emotional changes that Laura mentioned. Early on, I assumed the emotional changes were just the result of my mind playing tricks on me because I wanted the herbs to work, but now that I'm actually seeing a little bit a fat redistribution, I'm more comfortable with giving the herbs credit. I'm on my sixth month now, so things appear to be on schedule, based on what others have said they've experienced.
      February 13, 2003 3:50 AM GMT
  • Hi

    For those who think to start hormones. Be ready that you will change mentally, too. You will cry in sad movies and sometimes laugh so much that you´ll have wet undies... It will be easier for you to talk about your feelings and much easier to cheer up and hug your friends...
    You will not change into some stranger to yourself, you will be your female self. Not more, not less.

      January 28, 2003 12:30 PM GMT
  • Yes, I've read that, too, from several sources. Good advice.
      January 28, 2003 4:02 AM GMT
  • Just found out something interesting - If you move onto chemical hormones you need to stop natural ones - They compete with each other and the natural ones reduce the effect of the chemical hormones - If I can find te technical explaination again I will - But Trust me I noted the effect when I stopped taking all natural hormones -
    Luv and Huggs Rikki xxx Proud to be Transgender
      January 24, 2003 1:07 AM GMT
  • Jayne, I have yet to find anything negative regarding Red Clover, and it appears to fill in some gaps and offer things most other herbs don't. Plus, as a source of isoflavones, it's much cheaper than most Soy products I've found. It just seems to be an often overlooked herb.

    If I weren't already taking Propecia, I'd consider Saw Palmetto, too.

    Laura, that's good to hear. I really hope to move forward to prescription hormones before too long, but I have to take it slowly, for now. I'm almost through my fifth month of herbals.
      January 23, 2003 1:26 AM GMT