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Ideally we’d like to use an androgen synthesis inhibitor. These stop the production of testosterone, but those drugs are either breathtakingly expensive or still in development. The one that’s approved is fifty thousand a year.”“That’s worse than the histrelin,” Glenn replied.“Exactly. Instead we start with an androgen antagonist. These block the action of the testosterone she produces, and are quite reasonably priced. Our first line is spironolactone. It’s a daily pill, available as a generic and costs only about twenty dollars a month.”“That’s quite a bit more reasonable,” Glenn remarked. “If it’s generic, there’s no co-pay. The insurance will cover it all.”“It’s well tolerated, however the drug’s primary use is to treat congestive heart failure or fluid buildup. Its anti-androgen properties are actually side-effects we exploit.”“So, the drug’s primary purposes become side-effects,” Glenn remarked.“I like to start patients like Jackie with a strong estrogen dosage, to jump-start. "Olaf nodded his head and said, "None of us is all that smart. Poor Barson, here, is a little slow upstairs, but he claims to have had an idea or two in his lifetime. He says that he's still waiting for me to have an idea, but I seem to recall having one when I was a little kid. So you can imagine our confusion when Albert came to us for advice about what to do with so many folks. Our poor little heads just about over heated trying to figure out why he came to the two of us."Sid chuckled at the direction Olaf was taking the story. Laura was trying hard not to laugh, but was not entirely successful. Sid said, "I'm well aware of how the two of you seem to have a penchant for slightly twisted thoughts that are almost ideas. I can imagine what happens when the three of you get together." So you can understand that when the three of us put our heads together we kept getting these slightly twisted thoughts on how to use all of those men. Well, we talked the matter over with Peterson and he.
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