My endocrinologist and family doctor, both like to monitor Prolactin level to keep an eye on the pituitary gland (in your brain). Here's an article from recent talking about a study. https://www.mdmag.com/medical-news/hormone-therapy-for-transgender-patients-potentially-safer-than-previously-thought

As for HDL, CPA shows to have a minor negative effect on HDL level.

So it's not like CPA is bad, I'm switching to it from Spiro and hopeful, it's just it still seems Spiro is first choice. Not by very much though. The need for 400mg a day and peeing constantly is brutal. Can't be effecting day to day life negatively. That carries a lot of weight in my eyes.