I get it, I do. It's that may or may not that makes the difference. Pcos is enough of a health risk of its own that the drawbacks of spironolactone are generally worth it, and when combined with other hormonal supplementation, can end up with a net improvement in overall health. But it takes monitoring for it to be fully safe.

We're not talking about minor dizziness and such. It's the liver and kidney damage that's the main factor in making it a poor choice for unmonitored use. By the time you catch the effects without regular testing, the damage done can be life threatening.

And, if it jacks up your potassium levels, you might not even get that much warning. People do go into cardiac arrest from it. It isn't common, but it happens.

My sister was on it for a while, for pcos, and it caused long term problems despite being monitored. It's a great drug with careful use, it saves lives as a diuretic. Or at least prolongs them. But it is most definitely not something to self administer.

Something like flutamide is way safer, and has less side effects in general. But, again, without knowing pcos is in play, you've got a really high chance of wasting money you could put to other treatments, or getting second or third opinions to determine what is in play.

It's a numbers game. What is going to give you the best results with the least risks, for the least resources used. The estradiol at least has minimal short term risks, so I can see the equation shifting to trying it to see if it helps. No telling if the probability of that is high or low without knowing what traits are unwanted that you're trying to shift, but at least it won't kill you in the process if things go wrong. Well shouldn't, since bodies can have some weird shit happen sometimes, but it's not a significant risk.

If I was being a patient advocate for someone in my life, I'd be steering them towards other options even if they were being monitored medically. It's my opinion that the only real benefit of spiro for DIY hrt is the price/availability factor. It's usually affordable, and easier to get. And, for someone transitioning or dealing with something like prostate cancer, it would make sense because of the higher androgen production. For a cis woman, even with pcos, I just couldn't advise it in good conscience.

But, to be clear, I totally support self care when the system fails. The issues you're dealing with are significant and important. I just really think you'd be better served with a different plan of action.