I have been taking 50 mg of cyproterone acetate (by Novo, a Generic Brand) twice daily and 1 mg of micronized estradiol (Estrace) for a few months now, and while I have noticed my acne to resolve somewhat, it is still a problem (especially on my back). My body hair has thinned slightly as well, which is certainly welcome but the effect so far has been so minute I can barely even appreciate it.
Previously, when i had taken 150mg of cyproterone ONCE a day, my free testosterone level fell into the female range and hair seemed to just dissappear from my body (very cool). That dosage was set right before i turned 17. But then a backup inpatient doctor at a local hospital took me off of it roughly six months later. He implied that it could be causing depression. However it had already been proven otherwise by my real doctor who a month before even had me checked out my the endocrinology department (not fun). Unfortunately, the backup doctor was the last I saw before my discharge.
I’ve been trying it again for a few months now at 50mg twice a day (as was prescribed this time)…
And as i said, while there is some marginal improvement, it is not very noticable at all. This is very discouraging.
I am concerned as to whether this is because my dosage is insuffficient, or if that the time I was taken of the drug allowed for permanent hair growth that simply wont go away despite any hormone treatment.
Soon i will be seeing my endocrinologist (on Halloween) and i am going to see how close my free testosterone levels and estradiol are to the female range. Maybe that will give some answers.
However, i am still getting the feeling that my current medication and dosage is simply inadequate.
I have recently taken interest in goserelin acetate (Zoladex) for a number of reasons…
- As a ‘GnRH agonist’ it cuts off testosterone at the source by essentially shutting of hormone production in the testes (through preventing the release of the GnRH and related hormones that trigger gonadal hormone production). This seems like it may be more complete, simpler, and softer than fighting off testosterone after it has been released with high doses cyproterone or spironolactone.
- It DOES NOT list severe depression as one of the side effects or contraindications. This would ensure no confusion from any other doctors.
- It has much less side effects and seems safer (no blood clotting danger). It is listed as having excellent safety on the hormone FAQ on jennifer-o.com, whereas cyproterone is rated ‘fair’ for safety.
- Switching to spironolactone for safety is not an option as effective dosages make me dizzy and drowsy.
- Oestrogens may have less to compete with.
- It is injected, which makes me cringe (Does anyone know if it is painful?), but may ensure more balanced dispersal over time and better efficacy.
I know this drug isn’t the most popular as it is expensive. My doctor may not even have any experience prescribing it, so i may have to check with my GP, or find someone else who will prescribe it. However if i get the prescription, I think I can manage to get my hands on it it as i believe it is covered by my monthly ontario drug benefit card. (I checked a recent formulary and Zoladex was listed as covered.) Thats a plus for sure.
A drawback is that it will cause a temporary elevation in my testosterone for roughly 3 weeks as it begins to take effect. In this case however, I may just have to stay on the cyproterone at an elevated dosage for a short time.
If we find that the Zoladex hasnt reduced my testosterone adequately, spironolactone may be an option as i can tolerate it at low dosages.
I am also hoping to switch my oestrogen to weekly injectable estradiol valerate and add injectable progestrone (natural, NOT provera). As long as I can tolerate giving myself the injection (painful?).
Do you think this will help achieve better results?
Obviously I am concerned with a lot more than just hair, so sorry if some of this is a bit off topic. Many people on this forum seem to have a wealth of knowlege, and I’d very much appreciate any help anyone can give me. Thanks.
[ October 09, 2002, 06:37 PM: Message edited by: hopeful ]