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#21 Kelly

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Posted 12 June 2004 - 05:20 AM

I go for my ultrasound on Wednesday and i get my bloodtest results back on Friday so i'll let you know.
It's strange because in the last couple of weeks i've seemed to notice more hairs on my arms but i'm not sure if that's just psycosomatic because i'm thinking about it more rolleyes.gif

I'm definetely going to give the diet and supplements a good go before i might take spiro though otherwise i wouldn't know what was working.

Would you say that after 6 weeks on the diet and supplements i should expect to have a good idea if it's working? :smile:

#22 Kelly

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Posted 14 June 2004 - 02:17 PM

Sweetjade;
does spiro basically work as a low carb diet would work?

Thanks,Kelly

#23 Kelly

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Posted 17 June 2004 - 01:08 PM

Sweetjade;i've been for my ultrasound and was told that my ovaries have many follicles rather than the normal main one follicle sad.gif From my research i think this is an indicator of PCOS.I get my bloodtest results back tomorrow so they should tell me more.I'm really worried though.

I've also had my food intolerance test results back and it was negative.Apparently i had no IgG antibodies in my system.

#24 Kelly

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Posted 21 June 2004 - 12:42 PM

Sweetjade;
here are my bloodtest results.Apparetly they are normal and don't point towards PCOS!I'm really confused now :blink:

Glucose: 4.5
Lutrophin:0.0
Follitrophin:0.2
Oestrodiol:29
Prolactin:191
Testosterone:0.6
SHBG:>180 This is infact higher than normal when in PCOS it should be lower than normal!
Free androgen index:<0 this is lower than normal which in fact should be higher than normal in PCOS.

I do not have a clue now!!!HELP!!!!!!!!!!!!!!!!!!!!!

#25 SweetJade1980

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Posted 28 June 2004 - 02:33 PM

Kelly,
I responded to you on the other board, but from what I know those cysts can't be formed with those kinds of test results. Can you post the reference ranges (or units - nmol/L, ng/L, etc) for your tests? If they are listed, they would be something like

Testosterone
Female: 10 - 32
Male: 40 - 60
(made up numbers).


Anyway here's my thoughts on your results:

Lutrophin:0.0 - LH needs to be higher than FSH to produce cysts
Follitrophin:0.2 - FSH
(Varies depending on your stage in the menstrual cycle)

Prolactin - this would be High

SHBG - This would be Low (I've never had this test done, lucky gal) for PCOS, etc. It Needs to be higher in order to prevent Free Testosterone, Estrogen (BC) raises this as does Low Carbing.

Testosterone - This may represent Total Testosterone and will include Free Testosterone in here. If SHBG is Low, then this will be higher. If you have cystic ovaries, this would also be higher. This can be lowered, through various means such as by using anti-androgens (estrogen, SHBG, Diet) and DHT inhibitors (to prevent DHT).

Free Testosterone/Androgen - You can have normal testosterone levels, but within that amount have a Higher amount of Free Testosterone. Taking a seperate test that looks only for the Free Testosterone will help you see if that is true. From my lab, the Ref. ranges for a female were 0 - 1.4, mine was a 10 (males: 4 - 26)! The BC, dropped that down to a 5 after 3 months, and the addition of Spiro dropped it down to a 2, but that was still not enough.


DHEA - This is another indicator, particularly for hirsutism as it can convert to DHT. DHEA-S is the bound form, so you are looking to find out your unbound (DHEA) levels.

Cholesterol - did they do a lipid profile? this may also be an indicator if you are high normal or above normal. In fact, your other hormones can be on the high normal end (Ex: 30 out of the ref. range of 10 - 30) and that can still cause problems.


So my question is, are you taking a Birth Control and are you using any DHT inhibitors? You mentioned Dianette on the other board, and it contains both, which would throw off your test results. It's a good thing though because now you know how effective it is, but it's a bad thing because you don't know what levels your body normally produces w/o these medications (a Baseline) and that's essential for a proper dx.

Compared to my Baseline, my test results were much better while on BC and Spiro, yet they still didn't bring me in the normal ranges. I'm assuming altering my diet brought me even closer to my target since my skin improved so dramatically, but I've found out that medication or supps plus diet are now what's needed for hirsutism control.


http://www.keratin.com/ab/ab012.shtml (some ref. ranges but your tests ref. ranges may vary).

http://jcem.endojour.../full/82/9/2821

Take care

#26 evigrex

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Posted 28 June 2004 - 04:13 PM

Careful with the zinc. If your acne is in any way hormonally related it will get worse, since zinc increases testosterone and dihydrotestosterone levels.

#27 evigrex

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Posted 28 June 2004 - 04:19 PM

Good lord. Females SHOULD NOT USE DHT inhibitors because it does, in fact, increase testosterone levels and increase skin oiliness - do a search on google
groups for proscar (which is a prescription dht inhibitor) and acne - tons of people
reporting increased acne.

The other problem is testosterone will be higher when DHT is inhibited, because
the process of converting a certain percentage of testosterone to DHT
is stopped. So there is more testsoterone that is unconverted
Again, females should not use this unless they have a problem
with facial hair or something...(DHT is associated with frontal hair loss,
facial hair and libido in men....but not acne.)

#28 SweetJade1980

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Posted 28 June 2004 - 11:53 PM

Evigrex,
Thanks for the warning, but usually it's not a huge concern. Yes you will definately have a back up of Free Testosterone due to aromatase inhibition, but if you take BC or use other supplements that encourage this to convert into Estrogen it's not a problem. Even if you don't do this, and there are many who don't, FT is not as bad as DHT. Not to mention, for over 20 years plenty of men and women have found success with using DHT inhibitors to treat not just androgenic alopecia, hirsutism, but also acne (w/decreased oiliness).

Of course there are a rare few that have found that (Duatasteride), Saw Palmetto or B6, Zinc broke them out (allergy or wrong DHT inhibitor maybe?), but the majority find this not to be the case. Since the problem is with DHT interacting with our follicles, we need to find ways that prevent this from happening. There's various ways to do this, and for those that don't want to inhibit aromatase (those that are susceptible to cancer may though), there are other forms of attack:

preventing the buildup of excess androgens (decrease overall hormone synthesis or increase estrogen conversion)

preventing the conversion of DHT (bind Free Testosterone, decrease/block DHT enzymes)

prevent DHT binding activity on Androgen/follicle receptors (use of DHT Binders such as Equol -soy isoflavone)

prevent DHT from binding to Androgen/follicle receptors by blocking them (use of DHT anaolgues such as Green Tea - ECGC, Beta Sitosterol, Curcumin)

encouraging the break down of excess hormones (estrogen, Calcium D-Glucarate, Curcumin)

encouraging the elimination of excess hormones (Glutathione, Calcium D-Glucarate, Curcumin, etc)


That's all I can think of for now, any other suggestions?

Thanks =)

#29 Kelly

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Posted 29 June 2004 - 01:14 PM

My cholestrol levels were normal too.They did print the reference ranges on the sheet too and it showed that my hormones levels were normal other than the SHBG being higher than normal and the free androgens being lower than normal!!!That actually looks good and i'd think that by looking at my hormone levels i couldn't have acne!!!!!!!!!!!!!!!!!!!!

Dianette must be helping my hormone levels although i still have acne!That is really puzzeling me!Dianette when i first started using it completley cleared my skin and has been the only thing that has done that so far.It must still be helping to some degree.

I'm doing the low carb diet and i'll try to stick with it because it makes sense with the insulin/hormone thing.I'll carry on taking the supplements to see how they go.I might start to use spiro if i need to.

By using spiro along with the dianette;could that be what i need?

While researchin spiro i read that acne,hirtuism are rarely caused by high or low hormone levels.It's the fact that oil glands and hair follicles are over-sensitive to normal levels of the hormones.Spiro blocks the male hormones from effecting the skin right?So,even though my hormone levels are normal it could still work yeah?

#30 evigrex

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Posted 29 June 2004 - 02:08 PM

QUOTE(SweetJade1980 @ Jun 28 2004, 10:40 PM)
Evigrex,
  Thanks for the warning, but usually it's not a huge concern.  Yes you will definately have a back up of Free Testosterone due to aromatase inhibition, but if you take BC or use other supplements that encourage this to convert into Estrogen it's not a problem.  Even if you don't do this, and there are many who don't, FT is not as bad as DHT.  Not to mention, for over 20 years plenty of men and women have found success with using DHT inhibitors to treat not just androgenic alopecia, hirsutism, but also acne (w/decreased oiliness).

Of course there are a rare few that have found that (Duatasteride), Saw Palmetto or B6, Zinc broke them out (allergy or wrong DHT inhibitor maybe?), but the majority find this not to be the case.  Since the problem is with DHT interacting with our follicles, we need to find ways that prevent this from happening.  There's various ways to do this, and for those that don't want to inhibit aromatase (those that are susceptible to cancer may though), there are other forms of attack:

preventing the buildup of excess androgens (decrease overall hormone synthesis or increase estrogen conversion)

preventing the conversion of DHT (bind Free Testosterone, decrease/block DHT enzymes)

preventing the binding of DHT on follicle receptors (use of DHT anaolgues such as Green Tea - ECGC, Equol -soy isoflavone, or Beta Sitosterol)

encouraging the break down of excess hormones (estrogen, Calcium D-Glucarate, Curcumin)

encouraging the elimination of excess hormones (Glutathione, Calcium D-Glucarate, Curcumin, etc)


That's all I can think of for now, any other suggestions?

Thanks  =)

DHT inhibition does not surpress acne. It was once thought that DHT being the
"super" androgen was directly responsible for acne, but this is really not the
case. If it was, there wouldn't be so many people reporting increased acne
due to prescription DHT inhibition use. In fact, I can't find one person
on google groups that reports lessened acne from using an anti-DHT drug.

My theory is that Avodart and proscar both signifigantly
reduce DHT, but in the process it raises free testosterone so high that
it activates androgen receptors in skin cells - which of course increases acne.

Believe me...I tried avodart for a bit to reduce breakouts, and I was horrified
with the nastiest whiteheads i've ever seen on my face 1 week later -
the worst part is that avodart stays in the system for up to 6 months. Talk about
a PAIN IN THE ASS to get that under control

#31 SweetJade1980

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Posted 29 June 2004 - 08:37 PM

(repeating some of this from the other board)

Kelly,
LOL I too have normal cholesterol levels (dropped below normal when I changed my diet...gasp). I am also underwieght, plus I've never missed a period in my entire life! Sometimes I've had more than one period in a month, but that's happens maybe 2x a year. Those two things alone make me an anamoly for PCOS, so I usually say I'm Insulin Resistant to strangers (it sounds less horrible too).

My theory about the cholesterol and the underwieght is that my body chose to convert those fats that could have gone to my thighs or butt, (oh well) into those special steriod hormones that love to induce in me acne acne and acne and body hair! Uggh, anyway, based on the ultrasound they did on me twice I don't have any cysts. To me that makes sense, because, from what I know, the only way you would get cysts in your ovaries is if you didn't fully complete the menstrual cycle.

Since taking Dianette, you've had menses, correct? Yet if you stopped, you may continue to get cysts. How regular were your periods before Dianette? I was under the impression all cysts that would be considered polycystic, but I guess that's why it's called a syndrome because you (should) have addititional symptoms. From what you've told me you've got at least 4 symptoms of this disorder. Look over this list and see what else. I myself have 6 or 7 of these symptoms.

"Signs and symptoms
PCOS is said to be heterogeneous — patients may experience a wide variety of different symptoms to a greater or lesser degree. Women often go to their doctor because they are having menstrual irregularities, experiencing infertility, and/or are having symptoms associated with androgen excess. They may have:

Abnormal uterine bleeding

Acanthosis nigricans which is the darkening and thickening of the skin around the neck, underarms, and skin folds (sometimes, due to hyperinsulinemia)

Acne

Amenorrhea , [Dysmennorrhea]

Decreased breast size

Deeper voice (rare)

Enlarged ovaries

Hirsutism involving male hair growth patterns such as hair on the face, sideburn area, chin, upper lip, lower abdominal midline, chest, areola, lower back, buttock, and inner thigh

Obesity, especially upper body obesity

Skin tags in the armpits or neck

Thinning hair, with male pattern baldness "



Tests
PCOS is to some extent a diagnosis of exclusion. There is not a specific test that can be used to diagnose PCOS and there is not widespread agreement on what the diagnostic criteria should be. Your doctor will do tests to rule out other causes of anovulation and infertility. He will usually order a variety of hormone tests to help determine whether hormone overproduction may be due to PCOS, an adrenal or ovarian tumor, or an overgrowth in adrenal tissue (adrenal hyperplasia). Ultrasounds are often used to look for cysts in the ovaries and to see if the internal structures appear normal.

Your doctor will be looking for a combination of laboratory results and clinical findings that suggest PCOS. If you are diagnosed with PCOS your doctor may order tests such as lipid profiles and glucose levels to monitor your risk of developing future complications such as diabetes and cardiovascular disease

Laboratory Tests

FSH (Follicle Stimulating Hormone), will be normal or low with PCOS

LH (Lutenizing Hormone), will be elevated LH/FSH ratio.
This ratio is normally about 1:1 in premenopausal women, but with PCOS a ratio of greater than 2:1 or 3:1 may be considered diagnostic

Prolactin will be normal or low

Testosterone, total and/or free, usually elevated

DHEAS (may be done to rule out a virilizing adrenal tumor in women with rapidly advancing hirsutism), frequently mildly elevated with PCOS

17-ketosteroids (urine metabolites of androgens, used to evaluate adrenal function) elevated or decreased?

Estrogens, may be normal or elevated

Sex hormone binding globulin, may be reduced

Androstenedione, may be elevated

hCG (Human chorionic gonadotropin), used to check for pregnancy, negative

CMP (Comprehensive metabolic panel)

Lipid profile (low HDL, high LDL, and cholesterol, elevated triglycerides)

Glucose, fasting or a glucose tolerance, may be elevated
Insulin, often elevated

TSH (Thyroid stimulating hormone) some who have PCOS are also hypothyroid

Non-Laboratory Tests
Ultrasound, transvaginal and/or pelvic/abdominal are used to evaluate enlarged ovaries. With PCOS the ovaries may be 1.5 to 3 times larger than normal, and characteristically have more than 8 follicles per ovary, with each follicle less than 10 mm in diameter. Often the cysts are lined up on the surface the ovaries, forming the appearance of a "pearl necklace." These ultrasound findings are not diagnostic. They are present in more than 90% of women with PCOS but they are also found in up to 25% of women without PCOS. (Guess that answers part of that question you had)

Laparoscopy may be used to evaluate ovaries, evaluate the endometrial lining of the uterus, and sometimes used as part of surgical treatment."

http://www.labtestso...tions/pcos.html

http://www.wdxcyber.com/npain10.htm (discusses other types of cysts)

Don't you looove being special?

#32 SweetJade1980

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Posted 29 June 2004 - 09:37 PM

QUOTE(evigrex @ Jun 29 2004, 01:55 PM)
DHT inhibition does not surpress acne.  It was once thought that DHT being the
"super" androgen was directly responsible for acne, but this is really not the
case.  If it was, there wouldn't be so many people reporting increased acne
due to prescription DHT inhibition use.  In fact, I can't find one person
on google groups that reports lessened acne from using an anti-DHT drug.

My theory is that Avodart and proscar both signifigantly
reduce DHT, but in the process it raises free testosterone so high that
it activates androgen receptors in skin cells - which of course increases acne.

Believe me...I tried avodart for a bit to reduce breakouts, and I was horrified
with the nastiest whiteheads i've ever seen on my face 1 week later -
the worst part is that avodart stays in the system for up to 6 months.  Talk about
a PAIN IN THE ASS to get that under control

Evigrex,
OK, what would help me understand your situation more is if you told me whether you were a male or a female ;-) That right there could make all the differenc in your experience with DHT inhibitors. In fact, you mentioned inhibitors that are more associated with Males, Proscar and Avodart, so are you a male?

Somewhere around here there may be a post listing a variety of DHT inhibitors from topical retinoids (retina, azelex), natural supplements, oral prescriptions, and dietary changes. However, I've never mentioned those two specifically (or their generics) for improving one's acne. In fact I've heard a few reports about Proscar, inducing acne and I've also heard the same for avodart. I've also heard that they can improve one's acne too, but it's not widely talked about because we have Spironolactone and Flutamide (more side effects) to treat acne and hirstuism, and the other reason is probably because they aren't as effective.

On the other hand, the type of acne you described was what I recall hearing about on a body building forum while I was researching into Avodart. The males said that it either helped their acne, made their acne worse, or gave them acne when the didn't have any before. Of course, since they're body builders they are probably already doing things that will boost testosterone levels so that might account for one form of variation in conjunction with avodart use.

Something else they mentioned was that it raises your estrogen levels. This is something that other males also find when they take DHT inhibitors, but with avodart it wasn't supposed to be as prolonged. So these are really odd drugs. ;-) In fact, they mentioned something called Estrogen Inflammatory Acne. Basically they were saying that there was another message board where males were talking about how Avodart was causing them to breakout due to the extra estrogen.

I've done a search (not a wide one) and I've never heard of such a thing. Estrogen is what gives males nice & smooth skin and breasts if they take enough. Estrogen is what raising our SHBG which binds that Free Testosterone so it won't convert into DHT or wreak it's own havoc. However, SHBG and Estrogen will be lower in the presence of Excess Testosterone. One checks the other. Yes when you take a DHT inhibitor you will be reducing your amount of Testosterone that is converted into Estrogen, thus a higher level of Free Testosterone, but if you're a female, you will still produce more estrogen (compared to a male).

Once again, you can always check that possibly irritating imbalance (haven't heard such complaints on these boards about Spironolactone from males or females, incl. my own use of it for 6 years) by altering your diet to boost SHBG, or taking BC or phytoestrogens, etc.

I'm sorry that happened to you. Have you tried other form of anti-androgens or DHT inhibitors? There are more out there than you think. ;-)

Take care

#33 Kelly

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Posted 01 July 2004 - 02:02 PM

You know i really don't understand why i have a higher than normal level of SHBG yet i have acne!!!How the heck?!Surely all of the free androgens should be binding to those hormones and not causing acne?!That is actually probably why i have lower than normal androgen levels.But i still have acne!!!

#34 SweetJade1980

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Posted 01 July 2004 - 03:34 PM

LOL it's because you are both:

A) STILL taking Dianette and

B ) probably sensitive to what "normal" levels of androgens you have left.

It's been awhile, but do you think that Dianette is starting to wear off as in you are getting more acne, or irregular periods?

#35 SweetJade1980

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Posted 01 July 2004 - 03:50 PM

OOOOH, another thought is that MAYBE your dietary & supplemental changes further positively altered your test results!

How long prior to getting your hormones tested did you start your dietary & supp regimen?

Sufferers have said that dietary changes improved/cleared their acne within 2 weeks, 4 weeks, or 6 weeks, while others it took several months. Maybe while your skin isn't showing it yet, your body has already begun responding. If that's true then give Dianette, Diet, and Supps a few months before thinking about something else.

HTH

#36 Kelly

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Posted 02 July 2004 - 01:45 AM

I definetely think dianette's effects have worn off because in the beginning my skin was completely clear from it but i do think that dianette helps to some degree.

I started the diet and supps AFTER the bloodtest so it can't be that.

My hair follicles and oil glands must be over-sensitive to the androgens i do have.I think i will try spiro and i will carry on with the diet and supps(even though my bank balance may disagree with me! lol.gif )

#37 Kelly

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Posted 03 July 2004 - 11:20 AM

Something strange has happened :huh:

I have come on my period two days earlier than normal.Dianette has ALWAYS kept me regular since taking it for the last 4 and a half years,so for my period to come early is really strange!!!
I'm not bothered it just struck me as something different happening with my body,which is normally so regular with dianette;and i'm wondering why it's happened like this,this month.

It could be that i missed a pill in this last pack but then again i have done that a couple of times before and my period has still arrived on the expected regular day.

Maybe,it's the diet and supplements and they are effecting my hormones.Hopefully in a good way!!! :pray:

What do you think,Sweetjade?

#38 SweetJade1980

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Posted 04 July 2004 - 04:26 AM

Hey Kelly,
Just up doing some laaate night research into natural DHT inhibitors and thought I'd post some stuff for you about Spiro:

DHT Inhibitor Effectiveness
http://www.ncbi.nlm....t_uids=14583916

DHT Inhibitors & Antiandrogens
http://www.ncbi.nlm....t_uids=12196847


Spiro
http://www.ncbi.nlm....t_uids=12866746

Spiro Long Term study
http://www.ncbi.nlm....t_uids=12219252

Spiro's DHT Inhibiting abilities
http://www.ncbi.nlm....st_uids=8491989


"Acne: effect of hormones on pathogenesis and management.

Shaw JC.

Division of Dermatology, University of Toronto, Toronto Western Hospital, 355 Bathurst Street EW 8-517, Toronto, M5T 258 Ontario, Canada. jc.shaw@utoronto.ca

In the pathogenesis of acne, androgen hormones play a crucial role. In the treatment of acne, hormonal therapies provide valuable alternatives to standard modalities in selected women. Although numerous factors contribute to the development of acne, the requirement for androgens is absolute and is one that allows for effective treatments in women through inhibition of androgen expression. The two prerequisites for androgen expression at the level of the pilosebaceous unit are the presence of androgen in the form of either testosterone [Free Testosterone] or dihydrotestosterone [DHT]; and functioning androgen receptors. A third component may be the metabolism of androgen precursors to active androgens within pilosebaceous units [90% of acne suffers]. Hormonal treatment of hyperandrogenism (acne, hirsutism, androgenetic alopecia) such as that seen in polycystic ovary syndrome, centers on reduction of circulating androgen levels and androgen receptor blockade. Combination oral contraceptives [estrogen] represent the primary treatment modality for reducing circulating androgens from ovarian and, to a lesser degree, adrenal sources. Newer formulations may also have clinically significant androgen receptor blocking and 5alpha-reductase inhibiting effects. Newer oral contraceptives have high safety profiles and are used widely internationally for this purpose. Androgen receptor blockers [DHT Inhibitors] currently in use include spironolactone, cyproterone acetate [CPA - Dianette], and flutamide. Androgen receptor blockers are frequently combined with oral contraceptives to achieve optimal results in selected women [Dianette]. In women with adrenal hyperplasia, low-dose corticosteroids [Dexamethasone] may be added to reduce adrenal androgen precursors [DHEA converts into DHT] . Inhibition of enzymes of androgen metabolism in the pilosebaceous unit remain largely investigational in the treatment of acne, although the benefit of 5alpha-reductase (type 2) inhibition is established in androgenetic alopecia in men. This article reviews the essentials of hormonal influence in acne pathogenesis, discusses the hormonal therapies most utilized in the treatment of acne, and the pre-treatment evaluation of women in whom hormonal therapies are being considered."
http://www.ncbi.nlm....t_uids=12358558


As far as the periods, I would say that it's odd seeing as how BC should keep you regular, but it seems natural. When I went off of BC my periods started coming a day or two earlier every month (on Avandia). I figured it was because my body was readjusting itself. When I went off of Avandia my periods continued to come 1 - 2 days earlier. My periods never came as if I was taking a pill pack, but they always came after 3 weeks time.

Now that I've been off of Spiro (for toooo long) my periods not only come 1 - 2 days earlier but they seem a bit heavier and last for 7 - 8 days. Wow I haven't had periods like these for 6 years now (amount of time I was on Spiro). Not to mention, you can probably deal with a few months off the meds, but I've been off if it for 6 months and I've realized that what it did MOST for me was prevent the other forms of hirsutism that I never experienced. So now my plan is to go back on spiro with the 1 - 2 weeks of doses left (I need to see a new endocrinologist to get a new prescription) at either 100mg - 200mg, plus take the Mega Folic Acid Therapy (still waiting on the Folic Acid) and perhaps after I've done that awhile add a natural DHT inhibitor into it. If the hair reduces dramatically, I'll try taking the lowest effective dose possible of spiro (most women do well on 50mg) if I can't replace it entirely with natural supps.

It's rather odd, Spiro helps most women with acne, but for me it was much more effective at reducing and preventing hirsutism. According to one of those studies, it is more effective than Finasteride (which is supposed to be more potent, but more dangerous) and Cyproterone (in Dianette). So if you get to your breaking point, ask for the Spiro

HTH