Posted by ed_uk on November 3, 2005, at 16:20:36
In reply to cyproterone acetate, transgender HRT+mental health, posted by iforgotmypassword on November 2, 2005, at 21:07:50
Hi IFMP,
>also goes by trade name ANDROCUR sometimes
........and Cyprostat
>i was just wondering if anyone knows much about cyproterone acetate
Yes, what would you like to know?
>if any specific mental health related problems or fatigue, malaise, or neurological health problems that may be associated it with its use
Cyproterone is associated with depression (can be severe), fatigue (can be severe), breathlessness and thromboembolism. High doses can cause liver damage.
>anyways, it's hard to find relevant info as i gather it's not a very popular med anymore (not even dispensed in the US). its mostly used as a (presumably less popular) treatment for prostate cancer, for sex offenders, in the Diane 35 and Dianette 50 birth control pills, and of course for transgender-related HRT.
It's dispensed quite a lot in the UK. Androcur is used as a treatment for pedophilia because it suppresses the libido. Cyprostat is used to treat advanced prostate cancer. Dianette is widely used to treat hirsutism and severe acne in women.
>HRT and other drugs
Estrogens.......
Ethinylestradiol, a synthetic estrogen, is very potent. It is found in most oral contraceptives. Tablets containing ethinylestradiol *alone* are also available. Such tablets allow the dose to be optimised, without the risk of ODing on the progestin. Ethinylestradiol is very feminising, and is particularly suitable for young pre-op transexuals. In patients who have not had an orchidectomy, ethinylestradiol is used in combination with an anti-androgen such as cyproterone.
Estradiol (the main human estrogen) is particularly suitable for post-op transexuals. When used alone, it may be less feminising than ethinylestradiol. In combination with anti-androgens, its effects are enhanced. After an orchidectomy, estradiol can be effective in the absense of anti-androgens. Estradiol is available both as tablets and as a patch. The patch is particularly suitable for older post-op transexuals.
Conjugated equine estrogens - seriously, who wants to take horse estrogen when you can take estradiol? I don't recommend it.
Progestins.............
The synthetic estrogens found in most oral contraceptives can be masculinising eg. norethisterone, norgestrel and levonorgestrel. Cyproterone and drospirenone (found in Yasmin and Angeliq) are both progestins and anti-androgens. Dydrogesterone (Duphaston) and medroxyprogesterone (Provera) resemble natural progesterone in their actions.
Anti-androgens.............
Cyproterone is widely used in Europe. It is a progestin and a powerful anti-androgen. In combination with an estrogen, it is very effective.
Drugs are available which 'shut down' the testes temporarily. Nafarelin, leuprorelin and goserelin are examples. Nafarelin is available as a nasal spray - it is used to treat prostate cancer. Similar drugs are available as implants. These drugs are very expensive. In addition, they are not well studied in transsexuals.
Spironolactone is a diuretic and weak androgen antagonist. It is used to treat fluid retention and hypertension caused by HRT.
As you know, anti-androgens are no longer necessary following an orchidectomy.
What do I think?
Ethinylestradiol tablets are very effective. The usual dose is 50mcg twice daily. Nevertheless, the risk of blood clots is a concern. The estradiol patch may be safer. Since you're very young (I think), ethinylestradiol might be acceptable. As you get older, the risks of ethinylestradiol increase, and the estradiol patch would be a better option. ........Btw, Estradiol is also available as a nasal spray!
Since you're taking cyproterone, you do not need to take medroxyprogesterone or dydrogesterone.
I think you have some difficult decisions ahead. Although effective, the side effects of cyproterone are unacceptable. The fatigue and depression can be too much to bear. You NEED to see a specialist in transsexualism. Don't attempt to self medicate.
I hope I've been of some help.
Feel free to email me if you like
[xxx]
Kind regards
Ed
PS. No, I'm not a transsexual!!!
poster:ed_uk
thread:574708
URL: http://www.dr-bob.org/babble/20051031/msgs/575054.html