Don't use Spironalactone!
Don't use Spironalactone. I know most doctors say the standard way to start medical transition is with it, but it:
-Is an insanely strong diuretic, get ready to pee every hour on the hour
-Can cause cortisol spikes up to 3x normal levels!! This both sucks mentally, and causes a buildup of difficult to get rid of fat in your abdomen (the cause of the roumored spiro belly)
-It INHIBITS breast development. I have been on it for 3 years, and have had exactly 0 progress in that time, other trans women report similar experiences
-It doesn't actually suppress your testosterone to the typical female range! Even after 3 years on a very high dose, my T is still not suppressed. This is corraborated by blood hormone level tests of many trans women
-It us possible to suppress your testosterone to desired levels using only Estradiol! How does this work? Well, the way that AMAB people's bodies regulate testosterone us by converting a portion of the T it creates to estradiol. If your bloodstream is full of estradiol (produced by your body or injected), your testes cease producing new testosterone until blood estrogen levels go too low
The reason Spiro was adopted into standard transition practice is that in the early 90's, evidence started coming out about increased risks of cancer and heart problems associated with high doses of horse derived estrogen (Premarin) and synthetic estrogens. At the time, bioidentical estrogens (like the estradiol in Estradiol Valerate) were lumped in with those estrogens, and so doctors began prescribing Estrogen doses too low to suppress Testosterone. They introduced Spironalactone to do the job, but the evidence and trans women's overwhelming personal experience show that it is outdated and by far a riskier method with less effectiveness than Estrogen injections alone