October 29, 2010

One Month on Finasteride

Sorry for the lateness. Whew, what a week! I thought I knew what I was going to post this week, but the topic put me on some tangents that were too distracting to actually get anything done. So instead, just a quick update.

Been on Finasteride for a month now. Refilled my prescription the day before yesterday, and with no weird looks or admonitions not to get pregnant. It was a girl who gave it to me this time, though. I'm used to being on a pill now, so emotionally I don't have the same challenges as I did when I started the Spiro. But because of the various other things going on this month, I've still been particularly stressed, which I'm thinking is the reason my stomach is off a lot. I know stomach upset is not a big side effect of the Finasteride. It's certainly more consistent with days of high stress than with taking the pill. I haven't noticed any results yet, but I likely wouldn't, it's still early days.

Still haven't heard back about the ultrasound results, and I did go in for the blood test to check my liver function on Tuesday. Hopefully I'll hear back soon. I've been taking my cellphone absolutely everywhere with me. The call's gonna come at work, I just know it. It always does.

My other challenge this month has been finding a dress for a party (I've honestly been too overwhelmed to sew one). Why do so many cocktail dresses have plunging necklines? For once I'd like to have a go-to dress for a special occasion without worrying whether or not it's going to be a bad hair day on my chest? There's so many other things for a girl to worry about. Seems a little like shooting one's self in the foot, buying a dress to show off cleavage when you're going to cover the displayed area with razor bumps anyway.

I found an absolutely perfect dress at an outlet store. The fit and construction and fabric were just bang-on what I wanted, and it was a great price. But it really put the puppies on display. I mean, really. Even if I didn't have to worry about shaving my chest, I would have felt vastly uncomfortable walking around the party on the verge of popping out. So I left it on the rack (the clothing rack at the store) and ended up finding a similar dress with an elegant and understated boatneck. Just for twice the price.

Gah, the things we do for modesty. :)

October 20, 2010

One Step Closer

Had my ultrasound today. I'd never had one before, so other than movies involving pregnancy, I had no idea what to expect.

I drank my four 8 oz. glasses two hours before the appointment, promptly felt like I was going to burst, gave in and went to the bathroom--it didn't help I had a puppy walking on my stomach. Then I started all over again with half the amount of water, and spent the ride to the clinic thinking of nothing else but how full I was--and how bumpy the roads have gotten. I walked so fast into that clinic, sat in the waiting room for an agonizing couple of minutes, then was called into a change room to put on one of those fashionable open-back gowns. I sat there waiting to be called again, too tense and uncomfortable to read my book, knees jiggling desperately as I listened to other women finish their scans and go into the washroom. I started to loathe that flush sound. Oh, how it mocked me.

When the cute young ultrasound technician brought me into a dark, quiet room, I could barely lie in the examination chair with my legs straight. She asked me questions about past pregnancies and such, which I can only vaguely remember through the painful awareness that I was about to explode. I think I may have explained Finasteride, for her to understand why I wasn't quite sure when my last period was. A quick spurt of gel and a pass with transducer and it was determined that yeah, I was so full I was making the image blurry.

Once we resolved that issue, it was really just like I expected, squelching the transducer through the blue goo. The only sound was the beeps of an image being taken. I watched the reflection of the screen in the frame of a flat-screen tv used for displaying babies in utero, but it all looked like gibberish to me. Still, I wished I could have watched. Those were my insides on that screen, and I thought that was just incredible.

The endo had warned the exam would be transvaginal, and so I treated today like some women might treat a "date night." Let's just say, I was especially well-groomed for the occasion. But after pressing around on my stomach for a while, the technician brought the scans to a doctor, then said I could go. I was half relieved, trusting that was all she needed, and half simply unable to find the words to say, "Miss, I think we were supposed to go to third base, here." I can't account for where my mind goes in stressful medical situations. It wasn't until I had dressed and was on my way home that I realized I might not have done the right scan. I know you certainly can look at ovaries with a transpelvic exam, but I don't know if you'd see the whole picture that way. I guess if the endocrinologist gets the results back and thinks there's something missing, she'll let me know.

I feel like an enormous mug for not asking while I was naked from the waist down and covered in goo. But, the upside is, if I have to go back for another one, at least I know how much not to drink.

October 12, 2010

A Final Word on Spiro

When I learned that there were some oral medications that might help me, I wanted to know A: What are they? and B: Do they really work?!

I was on 100 mg of Spiro for six months (bar a couple weeks to flush it out of my system for the ATCH/CAH test), and on 200 mg for four months and a little over a week. (Can I just say how difficult it became to remember to take that second pill for the past four months? Man!) So let's call it ten months.

For the first couple weeks, the emotional stress of being on a medication took its toll on my stomach, but eventually I got accustomed to the idea. I would think twice about any potassium rich foods I ate, but I still ate them with caution not to overdo it. I never noticed a reduction in blood pressure that was enough to make me dizzy. I did sometimes have a sudden urge to "go" after taking a pill, and if I took it too late in the day, I'd be waking up in the night to pee.
The biggest impact it had on my life was the havoc it wreaked with my cycle. Sometimes it would be bang-on 28 days. Most of the time, it ranged from two weeks to two months. And as soon as my dosage doubled, I started having mid-cycle spotting at least once, sometimes twice with a longer cycle. It was annoying, but if you're vigilant enough, it doesn't catch you off guard. It was something I could have lived with, if the pill had worked well enough for me.

Now, I knew I'd probably have trouble tracking my progress. When it's something that reportedly takes months to notice, I knew the changes would be subtle. So I made photographic documentation before every endo visit to help me gauge the changes.

I thought long and hard about doing this post, mainly because it would reveal, in a whole new graphic way, my deepest darkest secret. Anyone who lands on this blog learns in short order that I have mucho excess body hair. But has anyone ever seen it? No. :P

However, this is the sort of thing I dearly wished other women had done. When they say what they used "worked" or "sorta worked" or "worked better than something else," what exactly do they mean? Well, let me show you what I mean...

This is my stomach, which displays the most noticeable change, from the day I started Spiro on the left, to the day I doubled my dose, to the day I stopped Spiro altogether. The photos are not great, but you can sort of see how the hair grew less coarse after six months on 100mg, and then became much more sparse after four months on 200mg. It's really hard to see in the last picture how much is still there, so you'll just have to believe me when I saw that there's still enough. But overall, you can see a difference. It did something, at least on that part of my body. Breasts, chest and thighs all show something similar, though not to the same extent, but my face gives no evidence of change in the hair that I can see. The only thing I can tentatively say is that the beard grew a little slower, which only served to make it more imperative that I shaved around the same time each day, or else took a day off when I didn't have to go out, to prevent irritation.

I can also assert a reduction in blemishes, though I didn't think to document that, and images of my chin were not all that successful. And it turns out I wasn't imagining the increase in breast size, either, though I'm afraid there's no way I'm showing empirical proof of that. *lol* Let's just say, it wasn't anywhere close to a cup size, but it was noticeable enough in pictures.

Bottom line, though, was that I still had to remove hair every day. And my dream is to be able to wake up in the morning without having to go through that ritual. If a drug doesn't improve my overall quality of life, I'm not going to keep putting it in my body, and so I said goodbye to Spiro. Now, some women on this medication don't have such good results. And some apparently have even better results. There's a lot to take into account, so weigh the pros and cons for yourself, and in the end, it's your body and your decision. I just hope I help put it in perspective for you, and show you that you're not going through this alone!

Some previous Spiro posts:
Or you can search for all posts with the "spiro" tag to see all posts mentioning Spironolactone.

EDIT:  It turns out this was not my final word on Spiro, after all.  I went on it again.  Click the "spiro" tag below this post to see what happens next!

October 5, 2010

About Finasteride

A week on Finasteride, and no unpleasant side effects. The nice thing about Finasteride is that it's not a diuretic, nor meant for blood pressure, so the extra peeing and the possibility of dizziness are no longer there. Neither is the risk of potassium build-up.

So, I wanted to do a post about the drug, and as always, this is for general information purposes only. Never try to self medicate; always speak to your doctor and get a prescription.

Finsteride (aka Proscar, Propecia, Finast, Fincar, etc.) was first designed for men with benign prostatic hyperplasia (enlarged prostate), and a few years later was approved for male pattern baldness. Like Spironolactone, it affects the male hormones in the body which cause these concerns. But it does it in a different way.

Spiro in the body competes with androgens for spots on the androgen receptors in the body. When Spiro attaches itself to the receptors on the skin and hair follicles, the androgens can't get in there to stimulate the cells to produce dark, terminal hair.

Finasteride in the body inhibits an enzyme called 5-alpha reductase which hangs out in places like the skin and turns testosterone into the much stronger dihydrotestosterone (or DHT) which really goes to work on the androgen receptors, causing hair growth on the body (and hair loss on the scalp). So rather than block the hormones themselves, it works to prevent their conversion. But like Spiro, this is not a cure. About the same amount of women find it works as they do with Spiro, and men who have stopped taking it usually find their symptoms return.

As with most things to do with hormones, it takes months to see results. Most of the reported side effects are for men, regarding reduced sexual desire and performance. Some drug sites report that this effect is the opposite in women. However, this drug is definitely not recommended for women who are pregnant, breastfeeding, or who may become pregnant, as it can harm a male fetus. I'd heard that with Spiro, too, but they even go so far as to tell pregnant women not to handle broken or crushed Finasteride pills. People on Finasteride cannot donate blood, and as with many drugs, there is a slight chance of liver toxicity. I'm going in for a blood test to monitor that at the end of the month.

Your doctor may prescribe you 1 to 5 mg of Finasteride. I'm on 5 mg a day, and the pill is very little. And blue. Which I joke about a lot. Being on a generic brand of the medication, I only noticed a price increase of a few dollars--my insurance covers 80% of the cost of prescriptions. I was paying about $45 for a month's supply of 2 pills a day of Spiro, so a month of Finasteride would have probably been around $55 without insurance.

The endocrinologist warned me I might get a few odd looks at the pharmacy for picking up a drug well-known for "male problems," but when I dropped off the prescription order, a male pharmacist assisted me, and I didn't notice him do a double take. When I returned to pick it up, he asked if I was warned about this drug, and I assured him I had, thinking about the liver toxicity. He didn't look convinced, and said, "Pregnancy? Absolute no-no while on this." When pregnancy is that far from your mind, it kind of takes you aback. I must have looked blankly at him for several seconds before it clicked that yes, I'd been told that, too. Felt a little foolish after that.


It's not easy to find sites that discuss its use in women with hirsutism. Usually, any reference to women is in the category of female hair loss, which sometimes does go hand-in-hand with hirsutism, but isn't well discussed. Some sites say Finasteride doesn't work at all for women. That seems to be because the studies in hair loss were with post menopausal women, so their hormonal make-up would be a little different from a young woman with male pattern hair growth.

Finasteride is mentioned for women with hirsutism on the Hormone Help Center site which I've had on my sidebar for ages. I've actually just bought the doctor's book to see if it can provide anything else enlightening on my situation. (I'll be sure to post a book review.) It's also mentioned on Hirsutism.com. And a study comparing Finasteride and Flutamide in women with PCOS and idiopathic hirsutism is discussed in a paragraph on the European Journal of Endocrinology site.

But in the end, it's never going to help every woman. Let's just see what it does for me. Worth a try, isn't it?