Many of you here take spironolactone as an anti-androgen to promote breast growth, but that's not the only indication for the drug. I take it to control my hypertension.

I suffer from primary hyperaldosteronism (PH). In addition to other hormones, the adrenal glands produce aldosterone, a steroid. With PH, my baseline aldosterone is too high. This in turn caused persistently high blood pressure. And it was not easily diagnosed. I was fortunate that my physician at the time was a bright, young researcher who thought outside the box and went looking for it.

Spironolactone works by reducing the effects of aldosterone as a hormone, but it's also a potassium-conserving diuretic (or "water pill"). This was highly effective in reducing my hypertension. However, it also has had the side effect of me growing a pair (I'm about at a B-cup now.) I know that's the main reason most of you take it who do, but for me it's been a problem. Still, so long as my blood pressure remains normal, my "girls" can stay. After all, some 50% of the world have breasts so I'll deal with it. Besides, I regard myself as more androgynous than TGed (unless you include androgyny in the TG spectrum), and my feminine self likes them, although they don't quite look right with the beard. :-)

Anyway, it was the potassium-sparing properties of spironolactone and hydrochlorothiazide (HCTZ), another diuretic I was taking along with it, that fed the feedback loop of hyperkalemia. This is why you should not be on spironolactone without supervision. Your potassium quite simply must be monitored while on this drug .