Re: Spironolactone - Is It Right 4 U - Ladies?

May 2, 2012

The problem is surgery isn't always an option for the patient due to cost of having it and epelerone for the same reason. I always mention the spiro because I was on it, but the epe I never tried so I forget to put that in when I am replying to someone on here. If one can afford it or paid for it seems most on here don't have many side effects from it. At least spiro is a million for 5 bucks....okay maybe not that cheap but it's cheap.

From: <jclark24p@...>Subject: Spironolactone - Is It Right 4 U - Ladies?hyperaldosteronism Date: Wednesday, May 2, 2012, 8:56 PM

Since I decided to give Cortisol a rest I got bored and decided I'd see what "extras" Spironolactone might be doing for the ladies, didn't have to look far!Hypoactive sexual desire disorder in premenopausal women: case studies.http://www.ncbi.nlm.nih.gov/pubmed/22314119Do you really need less Androgen?

May 2, 2012

My point exactly, . This was not a push for surgery but another reason

someone might be able to justify eplerenone to insurance. I still say

eplerenone should be the first choice for MCB treatment of PA with

spironolactone as an option for the PTN. I hate insurance companies! (My

pension is secure!)

>

> From: <jclark24p@...>

> Subject: Spironolactone - Is It Right 4 U - Ladies?

> hyperaldosteronism

> Date: Wednesday, May 2, 2012, 8:56 PM

>

> Â

>

> Since I decided to give Cortisol a rest I got bored and decided I'd see what

" extras " Spironolactone might be doing for the ladies, didn't have to look far!

>

> Hypoactive sexual desire disorder in premenopausal women: case studies.

>

> http://www.ncbi.nlm.nih.gov/pubmed/22314119

>

> Do you really need less Androgen?

>

May 2, 2012

It does seem though that the epe doesn't work for everyone nor does the dosing. Spiro tends to at least work very quickly for most. At least we can use it to help diagnose as Dr G suggests and then make the trade out when side effects start.

From: <jclark24p@...>Subject: Re: Spironolactone - Is It Right 4 U - Ladies?hyperaldosteronism Date: Wednesday, May 2, 2012, 9:20 PM

My point exactly, . This was not a push for surgery but another reason someone might be able to justify eplerenone to insurance. I still say eplerenone should be the first choice for MCB treatment of PA with spironolactone as an option for the PTN. I hate insurance companies! (My pension is secure!)> > > From: <jclark24p@...>> Subject: Spironolactone - Is It Right 4 U - Ladies?> hyperaldosteronism > Date: Wednesday, May 2, 2012, 8:56 PM> > > > Ã‚ > > > > Since I decided to give Cortisol a rest I got bored and decided I'd see what "extras" Spironolactone might be doing for the ladies, didn't have to look far!> > Hypoactive sexual desire disorder in premenopausal women: case studies.> > http://www.ncbi.nlm.nih.gov/pubmed/22314119> > Do you really need less Androgen?>

May 2, 2012

I was gonna say that sometimes it also the doc or the office and not always the insurance. My endocrin prescribed testosterone for me a long time back because I was low. Walgreens and I tried and tried to get the office to just get the approval (it's always approved, just gotta go through the hoops). They called, I called, his nurse told me "we don't do that." I argued for a bit, but she said they don't do the prior auths. So the next visit - this is over a year ago now - he gets mad and asks me why I am not taking the testosterone. I said "Are you kidding me?" And told him the story. He shrugged, said nothing, and never rewrote it. I just decided, since that was about the time I was feeling better, I'd try to, excuse the pun, "get it up" on my own. I haven't remembered to check it, but I think it's better. Hell, I made a baby after that.

.......she does look a little like the meter reader though...uhm........just kidding. All 7 have my mark of blonde hair blue eyes and devishly handsome.. I couldn't deny any one of them.

From: <jclark24p@...>Subject: Re: Spironolactone - Is It Right 4 U - Ladies?hyperaldosteronism Date: Wednesday, May 2, 2012, 9:20 PM

My point exactly, . This was not a push for surgery but another reason someone might be able to justify eplerenone to insurance. I still say eplerenone should be the first choice for MCB treatment of PA with spironolactone as an option for the PTN. I hate insurance companies! (My pension is secure!)> > > From: <jclark24p@...>> Subject: Spironolactone - Is It Right 4 U - Ladies?> hyperaldosteronism > Date: Wednesday, May 2, 2012, 8:56 PM> > > > Ã‚ > > > > Since I decided to give Cortisol a rest I got bored and decided I'd see what "extras" Spironolactone might be doing for the ladies, didn't have to look far!> > Hypoactive sexual desire disorder in premenopausal women: case studies.> > http://www.ncbi.nlm.nih.gov/pubmed/22314119> > Do you really need less Androgen?>

May 2, 2012

You certainly won't need any suppl. T. after your wife sees this!

Hmmm, Were you on Spironolactone at this time? Maybe you didn't need testosterone after all, maybe you needed Eplerenone! How was your cortisol? Depression? Think it through!

> > > > > > From: jclark24p@> > Subject: Spironolactone - Is It Right 4 U - Ladies?> > hyperaldosteronism > > Date: Wednesday, May 2, 2012, 8:56 PM> > > > > > > > Ã‚Â > > > > > > > > Since I decided to give Cortisol a rest I got bored and decided I'd see what "extras" Spironolactone might be doing for the ladies, didn't have to look far!> > > > Hypoactive sexual desire disorder in premenopausal women: case studies.> > > > http://www.ncbi.nlm.nih.gov/pubmed/22314119> > > > Do you really need less Androgen?> >>

May 2, 2012

Okay, I understand that is no longer important in your life - how about bones

and less fat?

source:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070250/?report=printable

Higher Serum Free Testosterone Concentration in Older Women Is Associated with

Greater Bone Mineral Density, Lean Body Mass, and Total Fat Mass: The

Cardiovascular Health Study

>

> Since I decided to give Cortisol a rest I got bored and decided I'd see what

" extras " Spironolactone might be doing for the ladies, didn't have to look far!

>

> Hypoactive sexual desire disorder in premenopausal women: case studies.

>

> http://www.ncbi.nlm.nih.gov/pubmed/22314119

>

> Do you really need less Androgen?

>

May 2, 2012

, is it that it doesn't work or is it a dosing issue? I don't remember

seeing much about it but sometimes I am affected by CRS!

> >

> > From: <jclark24p@>

> > Subject: Spironolactone - Is It Right 4 U - Ladies?

> > hyperaldosteronism

> > Date: Wednesday, May 2, 2012, 8:56 PM

> >

> > Ã‚Â

> >

> > Since I decided to give Cortisol a rest I got bored and decided I'd see what

" extras " Spironolactone might be doing for the ladies, didn't have to look far!

> >

> > Hypoactive sexual desire disorder in premenopausal women: case studies.

> >

> > http://www.ncbi.nlm.nih.gov/pubmed/22314119

> >

> > Do you really need less Androgen?

> >

>

May 2, 2012

So spiro acts like excess testosterone? It's a steroid right? Does excess aldosterone effect any of these things? All I understand fully is the control of the K and Na levels. It's ironic but being on the spiro for almost 2 years (2009 & 2010-prior to my diagnosis) seemed to actually help my libido whereas I've been wondering if it's been the aldosterone that has caused issue for several years without me realizing it. You're the one who brought it up so no fair saying TMI lol. Also when I was on spiro before I gained about 10-15 lbs and I never had any success losing the weight although I tried valiantly. So that seems to go along with your second thought there. VirginiaSent from my iPhone On May 2, 2012, at 10:00 PM, " " <jclark24p@...> wrote:

Okay, I understand that is no longer important in your life - how about bones and less fat?

source:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070250/?report=printable

Higher Serum Free Testosterone Concentration in Older Women Is Associated with Greater Bone Mineral Density, Lean Body Mass, and Total Fat Mass: The Cardiovascular Health Study

>

> Since I decided to give Cortisol a rest I got bored and decided I'd see what "extras" Spironolactone might be doing for the ladies, didn't have to look far!

>

> Hypoactive sexual desire disorder in premenopausal women: case studies.

>

> http://www.ncbi.nlm.nih.gov/pubmed/22314119

>

> Do you really need less Androgen?

>

May 2, 2012

I was referring to those on this list. It seems there has been a few where the epe seemed to take a long time to work or didn't work. I have never prescribed it that I can recall

From: <jclark24p@...>Subject: Re: Spironolactone - Is It Right 4 U - Ladies?hyperaldosteronism Date: Wednesday, May 2, 2012, 10:06 PM

, is it that it doesn't work or is it a dosing issue? I don't remember seeing much about it but sometimes I am affected by CRS!> > > > > > From: <jclark24p@>> > Subject: Spironolactone - Is It Right 4 U - Ladies?> > hyperaldosteronism > > Date:

Wednesday, May 2, 2012, 8:56 PM> > > > > > > > Ãƒâ€šÃ‚ > > > > > > > > Since I decided to give Cortisol a rest I got bored and decided I'd see what "extras" Spironolactone might be doing for the ladies, didn't have to look far!> > > > Hypoactive sexual desire disorder in premenopausal women: case studies.> > > > http://www.ncbi.nlm.nih.gov/pubmed/22314119> > > > Do you really need less Androgen?> >>

May 2, 2012

I had low T for years, long before I was ever on spiro. High stress, but that's where I lived most of my life and where I function best- somehwere in adrenaline town anyway.

I am not really prone to feeling depressed, thank goodness. I jumped on the ambulance at age 18 in South Central Los Angeles and LA County in '85. I think I learned to be able to find perspective, or understand sometimes there is no perspective, and always adapted well. I adapted and learned coping mechs early in life and they have served me well. The story is funny because I became a medic because there was a free program at the time, I was finished and was out of high school but didn't graduate and didn't know what else to do so my dad kind of talked me into it. For my personality and type of person I am it was probably perfect for me. I became a PA in 2001 and worked the rural ER's and clinics so what came in came in. I was always alone in the ER with a doc a couple hours and/or a phone call away somewhere.

So I always say about us EMS people, we live on a diet of possibility - meaning we don't kow what's coming in, but the adrenaline level is always turned on. That's why I wondered if we can burn those adrenals out in fields like that or military, etc. We sure see alot of like minded careers with PA and cortisol issues don't we?

Honestly, the hardest part of my life has been the past year or two, and I have been coming to grips with the bitterness over being misdiagnosed over and over, or just ignored. Saw a therapist for a bit, and she was great, but I know it takes some time and I am aware of it, so we'll fix it eventually. We all can find our own fault - and where we could have been more aggressive, but in truth I was alway honest and always had the perfect set up and labs for it to be PA. They just blew me off. Might have even been worse had I been a woman as they would have not only blown me off, but also treated me like crap

From: <jclark24p@...>Subject: Re: Spironolactone - Is It Right 4 U - Ladies?hyperaldosteronism Date: Wednesday, May 2, 2012, 9:56 PM

You certainly won't need any suppl. T. after your wife sees this!

Hmmm, Were you on Spironolactone at this time? Maybe you didn't need testosterone after all, maybe you needed Eplerenone! How was your cortisol? Depression? Think it through!

> > > > > > From: jclark24p@> > Subject: Spironolactone - Is It Right 4 U - Ladies?> > hyperaldosteronism > > Date: Wednesday, May 2, 2012, 8:56 PM> > > > > > > > Ãƒâ€šÃ‚ > > > > > >

> > Since I decided to give Cortisol a rest I got bored and decided I'd see what "extras" Spironolactone might be doing for the ladies, didn't have to look far!> > > > Hypoactive sexual desire disorder in premenopausal women: case studies.> > > > http://www.ncbi.nlm.nih.gov/pubmed/22314119> > > > Do you really need less Androgen?> >>

May 3, 2012

I wasn't trying to even imply that Spironolactone was your cause, I was only

suggesting that it needed to be investigated to see if it was exersasbating the

situation. (In " fixing " one situation do you worsen another - just something to

be aware of, IMHO.)

> > >

> > > From: jclark24p@

> > > Subject: Spironolactone - Is It Right 4 U - Ladies?

> > > hyperaldosteronism

> > > Date: Wednesday, May 2, 2012, 8:56 PM

> > >

> > > Ãƒâ€šÃ‚Â

> > >

> > > Since I decided to give Cortisol a rest I got bored and decided I'd see

what " extras " Spironolactone might be doing for the ladies, didn't have to look

far!

> > >

> > > Hypoactive sexual desire disorder in premenopausal women: case studies.

> > >

> > > http://www.ncbi.nlm.nih.gov/pubmed/22314119

> > >

> > > Do you really need less Androgen?

> > >

> >

>

May 3, 2012

Virginia,

Spironolactone is in a class of medications called aldosterone receptor antagonists.

Among other things it antagonizes androgen as part of the process (that is why it is often used as the first level of treatment for Transgender (M2F) changes.) . To break that down, let's look up a couple words:

androgen: male sex hormone: a natural or artificial male sex hormone responsible for the development of male sexual characteristics. Testosterone and androsterone are androgens.

Antagonists: pharmacology neutralizing agent: a drug that neutralizes the effect of a substance on the body

So this means it actually reduces testosterone. As for your experience, good for you but your experience is contrary to this study. There could be many reasons your libido went up, here are a couple. Was your testosterone too high to start with? Did Spiro correct PA to the point you got rid of that eternal headache? Now, if you used Eplerenone and left testosterone where it belonged AND fixed PA - WOW (Just remember you are not a teenager anymore and don't kill that old man!)

Sorry, NOT - you asked for that one! > > >> > > Since I decided to give Cortisol a rest I got bored and decided I'd see what "extras" Spironolactone might be doing for the ladies, didn't have to look far!> > > > > > Hypoactive sexual desire disorder in premenopausal women: case studies.> > > > > > http://www.ncbi.nlm.nih.gov/pubmed/22314119> > > > > > Do you really need less Androgen?> > >> > > >>

May 3, 2012

LOL. Thanks for the explanation. I'm still trying to learn about all this stuff. So low sex drive isn't a common complaint for hyperaldo it sounds like? And I'm not saying it was perfect when I was on spiro, but it was slightly better. Like you said, could just be because my body was healthier. VirginiaSent from my iPhone On May 3, 2012, at 5:58 AM, " " <jclark24p@...> wrote:

Virginia,

Spironolactone is in a class of medications called aldosterone receptor antagonists.

Among other things it antagonizes androgen as part of the process (that is why it is often used as the first level of treatment for Transgender (M2F) changes.) . To break that down, let's look up a couple words:

androgen: male sex hormone: a natural or artificial male sex hormone responsible for the development of male sexual characteristics. Testosterone and androsterone are androgens.

Antagonists: pharmacology neutralizing agent: a drug that neutralizes the effect of a substance on the body

So this means it actually reduces testosterone. As for your experience, good for you but your experience is contrary to this study. There could be many reasons your libido went up, here are a couple. Was your testosterone too high to start with? Did Spiro correct PA to the point you got rid of that eternal headache? Now, if you used Eplerenone and left testosterone where it belonged AND fixed PA - WOW (Just remember you are not a teenager anymore and don't kill that old man!)

Sorry, NOT - you asked for that one! > > >> > > Since I decided to give Cortisol a rest I got bored and decided I'd see what "extras" Spironolactone might be doing for the ladies, didn't have to look far!> > > > > > Hypoactive sexual desire disorder in premenopausal women: case studies.> > > > > > http://www.ncbi.nlm.nih.gov/pubmed/22314119> > > > > > Do you really need less Androgen?> > >> > > >>

May 3, 2012

And epe is not without side effects. I tried it for 3 weeks and had a blazing headache the entire time, could not get rid of it. And I was started on a low dose, compared to the dose of spiro I was taking. I was thrilled to go back on the spiro. From: Bingham <jlkbbk2003@...>

hyperaldosteronism Sent: Wednesday, May 2, 2012 10:10 PM Subject: Re: Spironolactone - Is It Right 4 U - Ladies?

The problem is surgery isn't always an option for the patient due to cost of having it and epelerone for the same reason. I always mention the spiro because I was on it, but the epe I never tried so I forget to put that in when I am replying to someone on here. If one can afford it or paid for it seems most on here don't have many side effects from it. At least spiro is a million for 5 bucks....okay maybe not that cheap but it's cheap.

From: <jclark24p@...>Subject: Spironolactone - Is It Right 4 U - Ladies?hyperaldosteronism Date: Wednesday, May 2, 2012, 8:56 PM

Since I decided to give Cortisol a rest I got bored and decided I'd see what "extras" Spironolactone might be doing for the ladies, didn't have to look far!Hypoactive sexual desire disorder in premenopausal women: case studies.http://www.ncbi.nlm.nih.gov/pubmed/22314119Do you really need less Androgen?

May 3, 2012

When I treat pts with no insurance who have to buy meds they prefer to DASH AND try Spiro first due to cost differential and I would say most stay on it May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn May 2, 2012, at 21:20, <jclark24p@...> wrote:

My point exactly, . This was not a push for surgery but another reason someone might be able to justify eplerenone to insurance. I still say eplerenone should be the first choice for MCB treatment of PA with spironolactone as an option for the PTN. I hate insurance companies! (My pension is secure!)

>

> From: <jclark24p@...>

> Subject: Spironolactone - Is It Right 4 U - Ladies?

> hyperaldosteronism

> Date: Wednesday, May 2, 2012, 8:56 PM

>

> Ã‚

>

> Since I decided to give Cortisol a rest I got bored and decided I'd see what "extras" Spironolactone might be doing for the ladies, didn't have to look far!

>

> Hypoactive sexual desire disorder in premenopausal women: case studies.

>

> http://www.ncbi.nlm.nih.gov/pubmed/22314119

>

> Do you really need less Androgen?

>

May 3, 2012

The study in women was an observational one. Need trials showing increasing test makes a Group healthier. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn May 2, 2012, at 22:00, <jclark24p@...> wrote:

Okay, I understand that is no longer important in your life - how about bones and less fat?

source:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070250/?report=printable

Higher Serum Free Testosterone Concentration in Older Women Is Associated with Greater Bone Mineral Density, Lean Body Mass, and Total Fat Mass: The Cardiovascular Health Study

>

> Since I decided to give Cortisol a rest I got bored and decided I'd see what "extras" Spironolactone might be doing for the ladies, didn't have to look far!

>

> Hypoactive sexual desire disorder in premenopausal women: case studies.

>

> http://www.ncbi.nlm.nih.gov/pubmed/22314119

>

> Do you really need less Androgen?

>

May 3, 2012

The study in women was an observational one. Need trials showing increasing test makes a Group healthier. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn May 2, 2012, at 22:00, <jclark24p@...> wrote:

Okay, I understand that is no longer important in your life - how about bones and less fat?

source:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070250/?report=printable

Higher Serum Free Testosterone Concentration in Older Women Is Associated with Greater Bone Mineral Density, Lean Body Mass, and Total Fat Mass: The Cardiovascular Health Study

>

> Since I decided to give Cortisol a rest I got bored and decided I'd see what "extras" Spironolactone might be doing for the ladies, didn't have to look far!

>

> Hypoactive sexual desire disorder in premenopausal women: case studies.

>

> http://www.ncbi.nlm.nih.gov/pubmed/22314119

>

> Do you really need less Androgen?

>

May 3, 2012

No Spiro occupies but does not activate estrogen and test receptors. If you had PA Earlier when u took Spiro u prob felt better related to better K but eed more details. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn May 2, 2012, at 22:18, Virginia Wall <virgwall@...> wrote:

So spiro acts like excess testosterone? It's a steroid right? Does excess aldosterone effect any of these things? All I understand fully is the control of the K and Na levels. It's ironic but being on the spiro for almost 2 years (2009 & 2010-prior to my diagnosis) seemed to actually help my libido whereas I've been wondering if it's been the aldosterone that has caused issue for several years without me realizing it. You're the one who brought it up so no fair saying TMI lol. Also when I was on spiro before I gained about 10-15 lbs and I never had any success losing the weight although I tried valiantly. So that seems to go along with your second thought there. VirginiaSent from my iPhone On May 2, 2012, at 10:00 PM, " " <jclark24p@...> wrote:

Okay, I understand that is no longer important in your life - how about bones and less fat?

source:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070250/?report=printable

Higher Serum Free Testosterone Concentration in Older Women Is Associated with Greater Bone Mineral Density, Lean Body Mass, and Total Fat Mass: The Cardiovascular Health Study

>

> Since I decided to give Cortisol a rest I got bored and decided I'd see what "extras" Spironolactone might be doing for the ladies, didn't have to look far!

>

> Hypoactive sexual desire disorder in premenopausal women: case studies.

>

> http://www.ncbi.nlm.nih.gov/pubmed/22314119

>

> Do you really need less Androgen?

>

May 3, 2012

There have been studies in bus drivers (San fran) And air traffic controllers Both high stress jobs looking at stress and BP. They were not able to find any effect last time Iooked. Would be good to look at ER FOLKS AS WELL I would think. If repeats busts of ACTH lead to adrenal bumps then ER WOULD BE GOOD place to look. Need to do your story for a PA MAG or ER and see how many others there are out there like u. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn May 2, 2012, at 22:46, Bingham <jlkbbk2003@...> wrote: