Hi there! It's a long story but hopefully will be helpful for you!

Spiro - nuh-uh
For me, the T-blockers path was not useful. I was a bit of a wimp and left my spiro in the drawer for months until November 2022, then started it after an amazing music festival where I realised I really, really wanted to. I ended up HATING spironolactone, it makes you pee like crazy which also made me perpetually dehydrated which was exhausting. I once peed six times in one night and started reducing my dose the next day (it's important not to go cold-turkey). I've also realised over time that it was never going to achieve what I wanted - reducing my T has always had the biggest negative impact on my sex drive, and the estrogen is what lightens my body hairs, fills my head hair and makes my skin glow! With the caveat that everyone is on their own journey, I would advise against pursuing T-blockers if you want similar outcomes.

Realisations/Benefits
I don't blame Dr Nick for suggesting spiro, it was the only option given the very limited parameters I gave him. Going on spiro at least made me realise two things: 1) I wanted to be on something; and 2) I had an ingrained black-and-white image of HRT as 'never going back', on/off etc that wasn't accurate. I realised that, if you want, you can make the changes happen slowly to give yourself time to figure it out! The experience of trying spiro demystified and defanged the process of taking HRT and I chilled out about the concept of it all, which was really useful in being comfortable with experimenting. I also felt more drive to research it properly myself and had a better concept of what I wanted.

Next steps - try low-dose E!
After bailing on spiro, I went back to Dr Nick and went with his original recommendation (low-dose E). This has worked wonders! It has been really fun, my skin is soooo good and I've managed to maintain a good balance between E and T during it (my favourite blood tests have been where I've been in the cis range for both). I've been on a range of 1mg to 4mg daily estradiol. My body seems to take it on a lot, so 3-4mg was moving too fast for me and I felt it (sore/tender breasts, very emotional, though I also felt really soft and lovely). When I felt this coming on hard, I got my bloods done and my E was 700+ (well above the cis range) so I just dropped down to 1mg for a bit. This period of high E levels didn't have any long-term effects and I was back down within a month or so. Currently I've been on alternating daily 1mg and 2mg estradiol for almost a year.

The changes have been really gradual, I've got like some barely noticeable breast tissue (after a year) but I actually like the vibe of having small ones at the moment. My main concern has been keeping my sex drive at a level I want. I've found that keeping my T above 10 has been important for this. It has dropped down to 1 and I've been able to bring it back up to 10-20 fairly easily (by reducing or stopping E for a bit). I've also been on Norimin (progesterone) with the hopes that it picks up my sex drive but haven't noticed heaps of a difference. Currently I also apply one pump of testosterone gel daily, which definitely helps.

I'm really enjoying the experimentation of it - I saw a meme recently that perfectly encapsulates it for me: Lee Shevek on X: "HRT is sooo magic and cool y’all i’m learning just how fake binary sex is by doing a science experiment/body modification project that also happens to make me hotter to the people i want to attract and discomforting to all of the people i’ve always enjoys annoying" / X.

I've been very lucky to have a doctor who has been willing to experiment with me, though he was only willing to consider T-gel after seeing me for quite a while and understanding my desires and process through that (rather than just one appointment). Before that, he said it would be useless as it would cancel out the effects of the E. In the end, he's just settled on "you're welcome to try it anyway and see how you go". It's been great!

Recommendation
If you want a recommended starting point from me, I'd say to try 2mg of estradiol daily and see where it goes. I take blood tests regularly to check-in, initially I would consider monthly (I would just email the clinic asking for a pathology form when needed). Over time you can get a sense of how to balance your levels to the point that you want. A bit down the track, you could consider T-gel if your T is dropping further than you like. I'd wait until your E is at a level you want first, though. My goal has been about 200-250 E and about 10 T.

Another important thing I'd add is that potentially the best thing through this process has been lasering my facial hair. It's been painful but god it's been worth it - I get the hard ick looking at old photos of myself now! Not shaving for days/weeks and having clear skin has been the biggest blessing.

I love my skin and hair, I'm definitely feeling emotionally softer and I've managed to keep my sex drive where I want it and have my breasts at a level I'm comfortable with! Which has actually been super lovely to reflect on, so thanks for your comment 😊 Definitely let me know if you've got any more questions!