Exploring The Hormonal Route. Hair=life.

JaneyElizabeth

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I find Dr. Will Powers to be lackluster. He has Aspergers and is brilliant but it isn't science. There is little to no evidence that indicate any benefits of the "Powers" program. MtFs with crummy breast growth, which is most, worship him like a rock star. I have corresponded with him on his own forum. Once I went through methodology and his lack thereof, he disappeared and discontinued the debate. He is also not an endocrinologist. He is a family doctor with a specialty in treatment of MtFs (mostly since all the FtMs only use one thing before they become bald immediately). I mostly hang out on the DIY and AskMtFHRT sites and he is widely ridiculed. That doesn't mean that everything that he says is wrong; far from it but much of it is based upon conjecture and his own internal processing of "results". Yes, lots of folks are sucking on pills now, even @bridgeburn, but not me. I don't like it and I can afford parentheral ingestion methods and pills for swallowing.

Thank you for responding to what I wrote. My style is often to be provocative in the hope of getting everyone's else best on here and your knowledge of Dr. Powers shows that you have a facility with some of the most prevalent issues in MtF HRT. I will try to answer your more practical questions in the next reply.

Update: I watched Dr. Powers' Youtube presentation and my opinion of him has gone up. He appears to be stronger orally then his writing comes through. He has what is to me a highly recognizable personality and is able to recall copious amounts of interesting observations which are much less jarring "in person". As I said, many of his beliefs are mainstream but also such as his liking for bicalutamide, dislike of spironolactone and alpha reductase inhibitors there are preferences not recognized by wpath or the endocrine society. His presentation about breast growth is a bit less on solid ground and delves into interesting conjecture about correlative factors but without causative link. For an overview in two hrs of the entire field, this is recommended.

Goddess bless.
 
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JaneyElizabeth

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@JaneyElizabeth thanks for your in depth posts. I've run into you on Reddit a couple times before.

So to make sure I'm not misrepresenting your position: low E2 levels = breast growth with little hair growth; high E2 levels = hair growth with little breast growth? is this correct?

What do you think about Dr. Will Powers who has his transgender MtF patients maintain E2 levels far above WPATH guidelines? He reports that high E2 helps them grow breasts better than on the WPATH guidelines.

Also, on the topic of breast growth, Dr. Powers also claims that Spironolactone can lead to premature fusing of the breast ducts and inhibit further breast growth. Obviously very bad for trans women, but could be a benefit for cis men wishing to avoid gyno. But spironolactone also comes with a host of side effects. I've also read @pegasus2 write that spironolactone's effect of blocking aldosterone is beneficial as well, independent of its ability to block androgens.

Can spironolactone be used topically? I've read some people claim that spironolactone has to be metabolized in the liver before it can be effective. I have no idea if this is true. (but as I think about it, that doesn't sound correct at all...)

Again, you are well versed in the breast debate in the MtF community. I think your comment about spironolactone being productive for males by shutting down breast growth is in the ballpark but we don't have enough data to indicate this. To my knowledge, this is the consensus:

Low dose E, titrated upwards at regular intervals is the best for initiating a period of HRT if one wants to mimic cis-female adolescence as closely as possibly. I might have lucked into this as non-binary but this is as close to an algorithm as we can currently state. Cis-males and MtFs tend to be tinkerers. So what? Well, we refuse to believe that a certain protocol can't be "improved" even though current evidence seems to indicate that besides starting slow (which Powers agrees with) and going forward with titrated dosages, all methods seem to work the same in terms of emulating cis-female breast growth which to me, indicates that cis-males are limited for some reason in terms of achieving comparable breast growth even in an MtF context.
Could Estrogen used without an anti androgen still be effective? I know that using exogenous estrogen will decrease Testosterone levels, but not completely block the effect as an AA would. This could allow more sexual function. What about using exogenous estrogen with a topical anti androgen? I'm guessing that will also result in less sexual dysfunction than an oral anti androgen?

Finally, what is your position on using raloxifene to prevent gynocomastia? I understand that raloxifene by itself can lead to hair shedding, but another user on this forum had success cycling between E2 and switching to ralox whenever he started developing gyno. I'm also curious whether taking ralox simultaneously with high levels of E2 could work for hair growth without gyno.

Currently, I'm just using topical estriol (E3) and a topical anti androgen (RU55841). Though I found a source for oral estriol so I'm considering adding that as well, and I would also consider switching to a different topical AA. I'm going to give it a few months to see if a topical AA + E3 will be enough or if I need to upgrade to an oral anti androgen and/or E2.
 

JaneyElizabeth

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@JaneyElizabeth thanks for your in depth posts. I've run into you on Reddit a couple times before.

So to make sure I'm not misrepresenting your position: low E2 levels = breast growth with little hair growth; high E2 levels = hair growth with little breast growth? is this correct?

What do you think about Dr. Will Powers who has his transgender MtF patients maintain E2 levels far above WPATH guidelines? He reports that high E2 helps them grow breasts better than on the WPATH guidelines.

Also, on the topic of breast growth, Dr. Powers also claims that Spironolactone can lead to premature fusing of the breast ducts and inhibit further breast growth. Obviously very bad for trans women, but could be a benefit for cis men wishing to avoid gyno. But spironolactone also comes with a host of side effects. I've also read @pegasus2 write that spironolactone's effect of blocking aldosterone is beneficial as well, independent of its ability to block androgens.

Can spironolactone be used topically? I've read some people claim that spironolactone has to be metabolized in the liver before it can be effective. I have no idea if this is true. (but as I think about it, that doesn't sound correct at all...)

Could Estrogen used without an anti androgen still be effective? I know that using exogenous estrogen will decrease Testosterone levels, but not completely block the effect as an AA would. This could allow more sexual function. What about using exogenous estrogen with a topical anti androgen? I'm guessing that will also result in less sexual dysfunction than an oral anti androgen?

Finally, what is your position on using raloxifene to prevent gynocomastia? I understand that raloxifene by itself can lead to hair shedding, but another user on this forum had success cycling between E2 and switching to ralox whenever he started developing gyno. I'm also curious whether taking ralox simultaneously with high levels of E2 could work for hair growth without gyno.

Currently, I'm just using topical estriol (E3) and a topical anti androgen (RU55841). Though I found a source for oral estriol so I'm considering adding that as well, and I would also consider switching to a different topical AA. I'm going to give it a few months to see if a topical AA + E3 will be enough or if I need to upgrade to an oral anti androgen and/or E2.

I actually read on this thread which is like War and Peace in length, earlier today that topical spironolactone might not be effective since it's the metabolites from the liver that make it effective. To be honest, no one seems to be reporting amazing hair growth on topical spironolactone.

Estradiol-only is sort of a new slogan of MtFs. Of course, we don't really mean only. Where's the fun in that? But some gals are touting injections of E2 together with progesterone as "being better". Of course they aren't, but injections are far cheaper. Hey, if it works for heroin, it must be true for E as well. Bring out the syringes. With respect to tomoxi and raloxi, I just try to read all of the non-binary posts. I get the impression that using either of these might significantly deflate breast growth but they are mostly used for cancer so we just don't have much but anecdotal evidence in terms of using them to avoid breast growth and maintain erectile capacity but I have corresponded with several people who say that they are effective.

I think that your potential protocols are interesting and we need folks trying different things and reporting back. I started off on estriol and now that I have made my peace with my big tits, I think that might be why. Looking at my Amazon orders, I have ordered Life-Flow menopausal blends roughly 100 times going back to the end of 2013. Why? It was easy to get and reasonably cheap and I could hide it from my wife. Later, I didn't even care and I had hormones in our underwear drawer and she still claims that she was clueless.
 

JaneyElizabeth

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Hair Remedies that Don't Work for Anybody Seeking Hair Regrowth

Beyond the foibles of transgender females being taken advantage of regarding non-hormonal breast growth, we have another type of products that tend not to work at all, salon hair products, special shampoos and hair supplements. Except for conditioning hair, none of these salon products work at all for anyone who doesn't have a severe nutritional deficiency.

Often, if not always, the "organic" substitutes cost far more than real estrogen; accordingly these pseudo-hair products are often very expensive.

Back in the olden days before minoxidil, one used to see exactly the same products advertised by health food chains, promoting useless treatments for male pattern baldness that usually were very expensive and if they worked at all, it was due to the massaging needed to work them into the scalp. Massaging water into the scalp would have worked just as well. Massaging for both men and women can have tiny results but is highly unlikely to be cosmetically significant.

But now it appears to be the cis-females who already got all the good hair, lol, getting snookered, and not just cis-males and transgender females.

Many good-natured cis-female acquaintances of mine keep touting biotin to me and I nod and thank them politely but that is one of the supplements that have been around forever touted to "regrow" hair back in 1983 and even before. Biotin is no secret.

Biotin may promote healthy nails but it doesn't grow hair or stop hair loss except for possibly people malnourished to the point of starvation. Biotin was the first thing that I used at age 20 and it did nothing, and the second thing that I added were B vitamins and they did nothing. These supplements won't hurt anyone unless taken in huge quantities but they won't improve hair.

In the absence of hormonal manipulation, and that can still be difficult and can take a long, long time, even when using estrogen and T-blockers, hair is absolutely in my experience is the hardest cosmetic attribute to change, i.e. improve, for both males and females.

And it gets worse.

Not only is not possible to regrow hair with these products except the one containing minoxidil, and not only do none of these products even slow hair loss in any visible way, but even aside from their having zero effects on growth or hair loss:

There are no non-hormonal products that even improve hair in terms of sheen, length, consistency, brittleness, smoothness or any of the other aspects that we find so fetching in the hair of certain lucky cis-females except for dandruff shampoos, and they too operate similarly to Nizoral by reducing fungi in the scalp.

Beautiful hair is largely genetics and gender-based, and the other significant aspect is age-related.

Here is a site that is really an extended advertisement that claims that they know14 things (actually) effective for hair regrowth: https://www.whowhatwear.com/best-hair-growth-products/slide11

This page seems to come up a lot when I research products that simply do not work and that are a waste of money for everyone, males, females and transgender individuals of all stripes.

To rip off the old song, "To all the woman, I've loved before", I sing instead, "to all the baldness cures I've tried before...." If I am emphatic, it is because I have wasted hundreds and hundreds of dollars on such "hair growth" products. I am with you, not against you.

Let's see, then.

Here's one of our big 14 products:

Biotin Shampoo Hair Growth B-Complex Formula: "Love this! I have thinning hair due to genetics; huge amount of hair fall. Since using this shampoo, the hair fall has significantly decreased and I can feel stubblies (is that a word?) on top of my head," a reviewer named Carol says.

I assume that stubblies is intended to mean new little hairs growing in, but until using spironolactone last summer, I have never seen any sort baby hairs coming in at my hairline even when when using the legitimate previously-mentioned products that have been double-blind tested that work to stop hair loss for cis-males.

Sorry, I am rooting for you, but no you don't see stubble, not from Biotin shampoo or B vitamins.

Here's another one with someone touting hair vitamins. Such supplements come up again and again and they are nothing new:

"My hair was falling out in clumps and getting super thin in the front," explained one reviewer Cyferguson. On the recommendation of my hairstylist, I ordered these vitamin gummies and now have tons of new hair growth. I'm so pleased".

If this is true, this woman just needed to eat because unless she was in a starvation state, sorry, no you do not see tons of new hair growth from vitamins. Before anything, she should have been in the dermatologist's office instead of sourcing gummy vitamins from her stylist.

Here someone touts another type of hair vitamins:

"I started to see a difference in as little as 2 weeks!" exclaims Antoinette Castillo on Amazon. "My hair was no longer falling out as much in the shower, and I began to see baby hairs growing in where my hair was thinning. I'm glad to have found a product that actually works. Even other people are noticing that my hair is growing back which definitely gives me a confidence boost."

Same thing, unless this person was suffering from serious malnutrition, there was no regrowth. I used to trick myself into thinking I saw things as well by using multiple angles and different types of lighting. What she likely sees are non-pigmented non-growing vellus hairs. I know. I know. The truth hurts.

Yet again, here is someone else touting yet another vitamin formulation with biotin: "I finished my first bottle, and I'm ordering another one!" satisfied reviewer KristinaM confesses. "The most noticeable effect I noticed during the first month is not the hair growth but the reduction of hair loss. I lose about half the hair I used to lose in the shower since taking Hairfluence." Yeah, right.

Below this "ad", there is a picture of Jennifer Anniston but I am not sure why, Ms. Anniston does have great amazing but it doesn't come from popping vitamins.

And another:

Combining pivotal ingredients like a whopping 5000 MCG of biotin in addition to helpful side hustlers like vitamin C and other B vitamins, these coated caplets from Nature's Bounty are a slam dunk for expedited hair growth says the article."I have Systemic Lupus Erythematosus," one Amazon reviewer disclosed. "Because of this disease, I have some hair loss, plus, thanks to all the biologic drugs I have to take, I had massive bald spots. My hair was falling out in the handfuls, so I was referred by a friend to take these vitamins. I started taking them and within 2 months had lots of new growth in my bald spots. I have continued to take the vitamins and my hair is full and beautiful."

Unless this person was literally in a state of starvation from her ailment or suffered instead from alopecia areata, that's just crap. Alopecia areata often does clear up spontaneously but I have only met two person my entire life suffering from this type of baldness which often involves patchy hair loss not thinning hair loss. If someone's hair is falling out in clumps, they need to go see a dermatologist right away.

I know whereof I speak. My hair actually did come out in clumps last summer and it was due to estrogenic hormonal influences. I have pictures. One should either see a dermatologist or an endocrinologist like I do.

Some women do experience highly concerning diffuse thinning but guess what is most likely to help: substances that manipulate hormones. Spironolactone is widely prescribed for cis-females when this happens and I am convinced that such diffuse thinning does respond to hormone-altering medications like spironolactone. It is right there in the medical literature.

Now here's a product at least mentioning something that could actually work in the right context.

It's called Propidren by HairGenics DHT Blocker & Hair Growth Supplement ($40) and the person touting it says: "I am a breast cancer survivor in remission. I am thrilled to add this to my regimen for the regrowth of my hair. THANK YOU SO MUCH FOR THIS WORKING FORMULA! Glad to see my results," says Amazon reviewer Crystal Ly.

So DHT inhibitors such as finasteride and dutasteride are DHT-blockers but when I look at the ingredients of Propidren, they are just the same useless things touted to "treat" male pattern baldness forever, thrown together in hopes of achieving synergy:

Ingredients. Biotin, Zinc, Iron, Saw Palmetto, Beta-Sitosterol, Horsetail Extract, Fo-tu, Pygeum Bark Powder, Green Tea Extract.

Been there done this.

Several of the above ingredients are claimed to cause feminization akin to Estroven while saw palmetto and pygeum bark theoretically could work because they are a bit like finasteride and dutasteride in that they mop up a tiny bit of DHT perhaps, but I have used them extensively and they did nothing. Propidren purchases are wasted money especially when cis-females have estrogen and t-blockers that they can take without side effects, unlike males.

40 bucks for this? Rogaine monthly is much cheaper than $40.

Remember our sad rule of thumb that applies to cis-males, cis-females and transgender individuals:

With respect to growing hair or stopping hair loss, the only treatment that even remotely works without manipulating hormone levels in the body or scalp is minoxidil, and it barely works even to prevent or even slow hair loss if not used with medications that are androgen-blockers.

It makes absolutely no sense for any cis-females to use these 14 products. Had I been able at age 19, I would have been taking both oral estrogen and spironolactone but they refused to prescribe it for males and we didn't know back then if temporary use of female hormones could interfere with male procreative processes unduly. I would have taken small breasts in a second, even presenting as male, over male pattern baldness but then again, I am transgender so it's a chicken and egg thing, sort of.
 

JaneyElizabeth

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Part 2:
Moving on:

Here's a product geared towards taking advantage of black females:

The Roots Naturelle Virgin Hair Fertilizer Conditioning Treatment ($16)

"Claims the blurb/ad, "Any product that reads "hair fertilizer" immediately piques our interest. Ideal for African American hair types, this deep conditioner is meant to heal hair that's been damaged due to braiding, heat, and chemicals. Essentially, it utilizes key power players like proteins, vitamins, olive oil, shea butter, and oils from peppermint and sweet almond to treat and restore weak and brittle strands. Just look at the below happy review for proof.

"100% works!! Warning, it does feel like an Icy-Hot on your scalp. The first time it was kind of a shock, but it hasn't bothered me since, and it has definitely helped my hair grow double what it normally would. I usually use it every other day, and I'll leave it on for about five minutes in the shower. It has definitely helped to heal the damage in my hair."

Nope, not either although this ad is less misleading than others.

In terms of breakage and frizziness, the races might be ordered Asians, Native Americans, Whites and African-Americans. That doesn't mean any sort of hair consistency is "better".

Moisturizing products might help excessive breakage but no product is likely to hair grow double, even if only in reference to hair volume merely through conditioning. This could possibly be a great conditioner for blacks, but it isn't going to double the volume or anything even close to that. Nor is this product any sort of hair fertilizer. Hair is not grass and none of the listed ingredients do anything except to coat the already existent hair shafts.

And wait a minute, what the heck does the "virgin" reference in the product name mean? Does it restore virginal hair? And it is naturelle, which must be lots better than natural.

Then there's Easy Hair Growth Oil, now only $19:

It contains castor oil, caffeine, rosemary oil, and biotin, purportedly to infuse both scalp and strands with essential omega-6 fatty acids, minerals, proteins, and vitamin E.

These are just different things that men have been trying to regrow hair or prevent baldness forever. All of these are referenced on the Perfect Hair Forever site.

Unless someone has a nutritional deficiency, this is a conditioner and nothing more except a bunch of different things thrown together that balding males who refused to use finasteride or dutasteride hope will work. They don't.

$19 dollars for a really good conditioner or hair treatment could be worth it for some people but you can get several effective such products at Amazon for about $8.

Reviewer Erin Graham on Amazon continues :"when I find something that is exceptional, I have to rave about it. I started using this oil about three weeks ago. Since then, I have been religiously using it every night. I can tell the difference in the health of my scalp. It feels nourished and healthy and it is evidenced in the rapid growth of my hair. This is a definite keeper in my arsenal of products for natural hair."

Yeah, yeah. Theoretically caffeine might accelerate growth slightly but it does not cause rapid regrowth in males. Possibly the female pathways differ but just soak your head in coffee and save the bucks. The Perfect Hair site discusses caffeine and it is a waste of time unless you refuse to try spironolactone or estrogen.

I do agree with her. on one thing. When I find a treatment that is exceptional, I try to tell all of my female friends about it. Try spironolactone! Try estrogen! Go get a prescription tomorrow or order Biestro just to see.

Even if you are not balding, these hormonal medications might substantially improve the quality of your hair, allowing it to grow longer, thicker or shinier without breakage, sort of like Jennifer Anniston's.

Look at all of the young cis-females and their pictures on google images or youtube, say under 25 years old or even 30 years old. All of them use estrogen and spironolactone and they tend to all have exceptional hair. Check these pictures of transgender females before and after:

https://www.reddit.com/r/transtimelines/

Things that impact hormonal levels are the only things that regrow hair or that even stop hair loss or even improve hair for anyone, male or female but I can't even get my sister to listen to me.

I fail to understand at all, the bias that some women have against estrogen supplementation. Any dermatologist is going to hand you a script for either estrogen or an anti-androgenic medication after five minutes and then shoo you away unless there is something extremely rare going on, like alopecia areata going on.

There's not even any point in fretting about cis-female hair loss unless and until said female tries spironolactone first! It should be automatic in these situations just as it often is for teenage girls with acne. Remember DHT causes all of these terrible afflictions like acne, baldness, dermatitis, rashes sores and so on.

It's rather cis-males who have to twiddle their thumbs and think before using anti-androgens because except for dutasteride and finasteride, in large enough quantities, every single thing that regrows hair makes erections difficult or impossible, and impacts fertility and makes them physically, much, much weaker if used to approximate cis-female hormonal profiles.

Oh well.

Then we come to Viviscal, which is the only one along with Keronique even with a reputation for growing hair, meaning that I have heard of this particular brand name. It is ultra-expensive and contains the following ingredients: Amino Mar Marine Complex, Horsetail (Stem) Extract, Millet Seed Extract, Vitamin C (from Acerola Cherry and as Ascorbic Acid), Niacin (as Niacinamide), Biotin, Iron.

Once again, this is just a warmed over vitamin concoction plus Aminomar Marine Complex, which appears to be nothing more than protein. They have a vegetarian version that replaces the Marine Complex with Biotin. This one is a major, major rip-off. Virtually all the articles that refer to it are advertisements that link to each other in a looping fashion.

There are no non-hormonal supplements that do anything to affect hair significantly, either positively or negatively for either males or females. Otherwise, I would be taking fist-fulls of any vitamins that worked. All of these over-the-counter products intentionally mislead by saying something like,"studies indicate that hair growth isn't possible at all without supplement X", let's say Biotin.

What they don't say is that, what is logically and inevitably true is that no hair grows in the complete absence of circulating biotin. But again, virtually everyone already has more than enough of biotin circulating within them than is necessary for hair growth. Just downing more biotin does zero. The same goes for Vitamin C, niacin, keratin, iron and virtually every other mineral--unless you are in a starvation state, additional vitamins and minerals do nothing for hair at all.

The other thing is that all of the above users are self-reporting which virtually always involves the placebo effect or hoping against hope under a lighted mirror which I am more than familiar with. For me, polysorbate 80 was like this. None of the listed ingredients that I have seen work at all except for saw palmetto, and dutasteride and finasteride are far, far more effective than saw palmetto.

I have used saw palmetto. Theoretically it could have tiny effects to diminish DHT but it won't regrow hair, just as neither dutasteride or finasteride regrow hair. I reviewed a brand new review of double-blind studies last night and all of the products I have previously mentioned, minoxild, Nizoral, dutasteride, finasteride, i.e., products that do not induce feminization, are unable to regrow hair. These products all do work, however at stopping hair loss, at least a little. Start early with them.

Only estrogen, flutamide, spironolactone, cypreterone ,and other similar acting drugs that bind to the androgen receptors regrow hair and even they might not completely work for former cis-males in transtion.

The supplement-based "treatments" don't prevent hair loss. They don't prevent frizzy hair. They don't regrow hair. They don't make hair thicker. Except for the conditioning types that, well, condition the outside of the hair, basically there are no effects good or bad.

I can't cut hair without using a bowl but all of these products that claim that they are touted by the best hair stylists--that is just fatuous. Under the "ad/blurb" the person touting Viviscal states: I've talked to scores of hairstylists who recommend Viviscal tablets.

Oh really?

Have these hair stylists examined the latest medical literature where double-blind statistically significant testing has been done? Do hair stylists have special training in statistical analysis? My rule of thumb is again never purchase any hair products, particularly that cost more than $10 at a cosmetic salon unless you just want to do so, sort of as a tip since the stylist may get a cut of proceeds.

Number 13 on our "effective" list of products that "actually" make hair grow reads:

"I love and swear by countless products from Hum Nutrition (specifically Flatter Me, $25; Beauty Zzzz, $10; and Ripped Rooster, $40), but these hair-boosting gummies are by far my fave, and I swear on my life to anyone who will listen that they've completely transformed my hair in the past year since I've started taking them. They taste great (but I recommend eating them with food because they contain zinc), and my hair has never looked so thick or grown so fast".

This sounds like rank plagiarism from one of the products above. Just think, fellow transgender females, all we need are vitamins to cover our balding areas and completely transform our hair.

Last and possibly least comes:
Nutrafol Core for Women ($79):

"By addressing multiple causes for thinning strands and poor hair health, Nutrofol has basically designed the holy-grail hair supplement that scientifically works to boost thickness, length, and overall hair happiness. Powered by plants and a bounty of nature's best hair healers, the impressive ingredient list includes things like ashwagandha, saw palmetto, hydrolyzed collagen, tocotrienols (vitamin E), a special form of curcumin extracted from turmeric, among other antioxidants, vitamins, and minerals".

Aarggh! What the heck is "hair happiness?" $79! I have tried French products with placenta factors. Nutrafol has botanical factors and is "powered by plants". They too have a phony study.

Keranique is another product that I am slightly familiar with which may stop hair loss but this is only because one of the five factors or whatever that they tout is minoxidil. All the other steps simply add volume and coat the hair strands. If the price is decent compared to buying minoxidil and separate shampoo and conditioner, then go for it. At least this one has the capacity to slightly grow vellus hair and thicken strands.

This is a fair better and more truthful article about options for women: https://www.allure.com/story/hair-loss-treatment-plans that actually mentions going to the dermatologist and some new treatments that show promise but it still claims that Nutrafol is a good purchase.

It does mention dandruff shampoos which may work like Nizoral but not as effectively in terms of slowing hair loss so that's true.

I go to a clinic that has literally scores of anti-aging treatments that actually work for cis-females and transgender females, like derma-rolling, botox, chemical peels, filler, collagen injections, etc. and they still try to pawn off special shampoos or conditioners as you go out the door. Some shampoos and conditioners do make a person's hair more manageable or shiny but they do not grow hair or prevent hair loss and none of them are worth more than $10.

I know that many, many transgender females don't have access to anyone to prescribe for them or are afraid of unnatural hormones, and phytoestrogens do act in some ways similarly to prescribed estrogenic hormones but they do so too weakly so that on a bang for the buck basis, they aren't likely to provide effects worth paying for in my opinion. Been there, done that. You know, like eating tofu for every meal....

But cosmetic salons or hair salons are great, as long as no one gets fooled. Different types of hair styles that might be more manageable, also heat and coating treatments that may make hair shiner, more manageable, less frizzy, less likely to break off and other nice cosmetic effects, and for many, many females these hair treatments "work" and are worth the expense and it is a nice bonding experience. Just don't buy any of their products thinking that you are going to reverse hair loss.
 

JaneyElizabeth

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There is probably a better way of doing this but I am a newbie and an enby:

John Difool said:
When you let yourself go the Estrogen Progesterone and strong AA blockers route at castration level and female range, you are playing a totally different game than most folks on this forum who complain getting gyno on Finasteride. So no wonder you like @bridgeburn post since he decided to use hrt just to keep his hair. In that situation you almost have no excuses no to regrowth some hair minus a few exceptions. But for most folks here it's like keeping their male attributes while regrowing their hair using one magical topical lotion which scammers are happy to offer or some futuristic treatment they will never be able to access. No wonder most of the conversations are boring to your liking.

JaneyElizabeth said:

I didn't say that it was boring but I might try to distinguish the two types of extreme protocols folks, i.e., those whose primary goal is avoiding gyno at all costs versus those who just titrate upwards as long as they keep seeing hair improvement. You are right that younger MtFs tend not to struggle with this since "male" hair is easily transformed into XX hair for those who never bald, but for older MtFs, there is nothing assured about regrowth at all from what I can discern and there have been several people who have tried fairly extreme MtF HRT protocols with lackluster results. I have always had more or less full coverage but I had diffuse thinning even on the sides. Right now, my interest has to do with the need for maintaining hormonal levels at adult female levels for six to 12 months before hair improvement might be noticeable. Because of my own situation leading to a hopeful crescendo, I hope to sort of provide real-time pictures and feedback because I never before even bothered with targets because all of my other HRT results were so uncanny but my hair was lagging somewhat. I also had a shed to full baldness last year and I have photographic evidence to show that such HRT sheds might be benevolent unlike other sheds that seem intertwined with male pattern baldness/Telogen Effluvium. Goddess bless.
 

JaneyElizabeth

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Exploring the Hormonal Route:

I am interested in what appear to be two different approaches to cis-male hair regrowth via hormonal manipulation. We have one group that is composed of people who don't fear gyno at all and may even welcome it versus what seems to be the majority, those who make all of their hormonal medication decisions with respect to always avoiding gyno. What are the relative success rates of these two different approaches?

It appears to me from going through the thread that people who let the gyno issue primarily inform their medication decisions, often appear frustrated with their lack of substantial results and tend to experience multiple sheds and little to no cosmetically significant hair regrowth. The same appears to be true for people who use topical hormonal medications, except for Estrogel.

Group A, which might be called the HRT group appears to have far more success not only in regrowing hair but also in terms of being able to grow their hair long and in terms of having scalp hair that others find "attractive". Group B, the gyno-avoiders might see thickening or some amelioration of hair loss but none (few?) seem to be achieving cosmetically significant hair regrowth. Group A, however, often experience restoration of juvenile/pubertal hairlines that are astounding in terms of cosmetic improvement.

In terms of goals, then, these two groups appear to have little or nothing in common. Many males find Tom Selleck-type hair without loss in the crown to be all that they want and the ability to grow their hair long appears not particularly important. Group A, however, finds these type of male improvements in coverage to be all but useless and cosmetically unacceptable. AntyDHTor had results that many, many folks on here have mentioned as being excellent; I find his "results" to be simply horrible. He looks far less attractive in his after pictures and his hairline is way, way too low. Coverage for the sake of coverage is pretty meh from my point of view.

So is there any way to bring these two groups together or are we wasting each other's time? I tend to browse rapidly the comments except for @bridgeburn because the no-gyno at all costs folks appear to never report back with anything remotely cosmetically significant; they appear to suffer incessantly from sides that MtFs don't seem to encounter and they whine a lot. I have tried something similar to the avoid-gyno approach and it simply went nowhere. Among caucasians, XX hair and XY hair are so fundamentally different that for me, with respect to XY improvements, meh. I maintained for decades on minoxidil/finasteride but it still was crappy hair that wouldn't grow long and that the wind destroyed. I never ever saw any regrowth but since my thinning is diffuse, that could be why but my expectations are far higher in terms of what my erstwhile locks look like.
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JaneyElizabeth

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@JaneyElizabeth Thank you for your productive, thorough, and insightful posts. You are one of the few who understands the hair loss methodology inside out.

Struggling for hair loss for 10 year now has been debilitating. I have more than 400 studies saved on my desktop. Trying to connect all the dots.

My conclusion after suffering from many painstaking trial and errors: without sufficient estrogen, you won't regrow hair!

Probably the most insightful study I came across was https://academic.oup.com/edrv/article/27/6/677/2355194. Just read the title. Hair Follicle as and Estrogen Target And Source. That explains it all.

If you further read the researchers main points you'll find that estrogen is the one primary hormone that upregulates hair growth modulators further proliferating the genes necessary for hair growth to commence.

I am talking about WNT pathway, IGF-1, FGF-7, etc.

Just to give you some perspective of my hair loss story similar to @Itsnoahkennedy, whey protein isolate was the main offender. It took me 6 years to realize this was the case.


I was taking 4 scoops of whey protein isolate for 1.5 years 5 days weekly trying to build muscle mass. It lead to diffuse thinning with major recession,

My hair loss looks like leprosy especially when it is wet. I don't recognize myself anymore in the mirror. A similar type of hair loss pattern happened to @Itsnoahkennedy and he too took whey (noah correct me if I am wrong here, but I remember you telling me this a while back).

So my question Janey is: If one simple "natural" supplement can destroy my hair because of a hormonal turbulence why can't we find a "natural" supplement that can regrow our hairs?

Have you remotely considered soy isoflavones (they have to be a specific kind of supplement not the ordinary soy milk, soy protein, or the a generic soy) with capsaicin? There was a study on this and the results do look promising.

Soy isoflavones are the closest "natural" estrogen remedy. Soy isoflavones consist of genistein and daidzein. Genistein binds to estrogen beta receptors similar to E2 and these receptors are known to influence hair growth. I am not talking about the estrogen alpha since it has no direct impact on hair growth.

Read the study I posted above if not already to better understand estrogen beta. I also have compiled a couple of noteworthy studies on soy and their effects on various receptors.

I don't mind posting those here only if you are interested.

Thanks again. You are a legend and a rockstar. We appreciate your generous and meticulous feedback. Very few people have the cognitive skillset and keen observation to fully grasp the hair anatomy. You happen to be the few. :)

JaneyElizabeth:


My, my.... Thanks so much for the nice comments but you know more about signalling pathways than I do. I fail to see why whey protein would hurt one's hair but I do recall now seeing a posting in this thread related to that. If you want to explain more your thoughts on how this permanently harmed your hair, that would be an interesting post.

This topic fascinates me because most mammals appear to produce hair with testosterone mediating, such as mice. It's the male mice and rats that seem to have better "hair" growth than the females. But there is something similar among many male animals upon reaching adulthood, be it manes, or antlers or horns that are sexually dimorphic and related to, from what I can tell, DHT and its effects in terms of "masculinizing" such animals. If so, and this again is much more of a caucasian issue, then we are truly swimming upstream against something that seems hardwired into white males who also generally have the best beard growth and experience more body hair growth compared to Siberians or Asians or Native Americans.

So beard growth in Europe appears to have played significant roles in terms of differentiating people even when viewed from a distance. As an aside, this is why it is so important to have beard removal for MtFs who want to pass. Females, through the ages among whites and Semites, have used the beard or stubble as a protective way of avoiding unknown males that might be dangerous.This is probably also true for other primates/apes as "baldness" appears in these groups as well.

With respect to herbal supplementation, I started out eating soy all of the time and other isoflavonoids. There is much less baldness in Asians, so it was easy to think that it might help. I would like to see your postings related to this. One thing is that we spend a lot of time in the MtF community trying to steer people away from herbal "estrogens" because we fear folks getting disappointed or experiencing temporary placebo effects but it could conceivably set someone up for better results during HRT. The problem is though that phytoestrogens might actually be competitive with human estrogen and they might occupy receptors where we want estradiol or estriol to be occupying. The issue of Serms, even with respect to Premarin is related to this because Premarin has many types of natural estrogens that are non-human in nature and some of them might be working at cross-purposes. Some meds have divergent effects on different receptors and if there is a baldness cure for males, it might involve raloxi or tamoxi but I honestly don't think any "cure" is coming because this is the way that caucasians are wired. Women get the hair on top and men get the hair below the lashes.

So in this sense, people obsessed with not getting gyno are sort of right because the effects of estrogen clearly make a person less able to work, hunt or defend him or herself in a non-modern context. Beards are highly protective in cold climates while baldness might serve as a form of heat regulation. Beards are also highly protective during fist fights, and against scratches by bushes or thorns. My skin now tears and bruises much more easily. Nature giveth and nature taketh away. So why the differences in scalp hair among white males and females? It might just be random as a mutation but it still seems conceivable that white females had an advantage in terms of carrying infants and toddlers because the hair was down and available for the child to hold onto, and thus promotes the ability to handle tasks with a child in tow.

If you want to message me privately or ask about different protocols, please do and I will look forward to your posting again. I have fought baldness for 36 years and you name it, I have tried it or used it but for many males, it is such an uphill battle.

Trying not to be mean here but for MtFs, the idea of FtMs deciding to go bald intentionally is very difficult to contemplate and for some reason, they all continue to be shocked that that baldness/recession but especially poor hair quality is now the reality of their life. And what do they post typically? "I can't be going bald; none of my relatives who are male are bald...."

Been there, done that and half the posts on tresses on reddit are related to that. Baldness is shocking it appears regardless.
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JaneyElizabeth

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Are you trans or cis? 6mg is a transition sized dosage, 2mg E along with duta, 50mg bica and maybe even some oral min should be enough for hair regrowth. If you are trans i apologize.

I am kind of down on oral minoxidil without even drinking any since I use foam. The issue is that I keep seeing people with hair growth artifacts from oral minoxidil that look unnatural or that are literally creating hair where hair should not be. AntyDHTor is foremost among these on this thread. I would much rather be bald than his after picture. He was an attractive man with recession that was arguably not cosmetically significant. I have used topical minoxidil since 1988 and I have never seen hair growing where it should not be. This was the main issue reported by Upjohn in the 80's and was why they opted for topical medication instead of oral, if I recall correctly.

Where are the data indicating that Loniten is innocuous? I recently saw a study indicating that even ten percent minoxidil isn't as effective as 5% which makes sense because wouldn't Upjohn be selling ten percent Rogaine otherwise? I know our inspiration @bridgeburn was using Loniten but I never felt that he had any real basis for using it compared to regular minoxidil. Loniten is not something to my knowledge that most successful MtF's in terms of hair regrowth/improvement either typically use or need.

Next, 2 mg of estradiol is far different when swallowed compared to when used sublingually or buccally. People get confused here. Buccal and sublingual usage are much more efficient in terms of delivering estrogen into the bloodstream but this does not mean that they "work" better as a component of HRT or for hair regrowth purposes. MtFs have very little to offer here since our entire protocols revolve around maximizing breast growth, not hair growth, which is stupid since cis-females have no means of maximizing breast growth. Why would MtFs? Anyway, it doesn't work. So, if this individual is swallowing 6 mg, that is far less in terms of serum estradiol than taking three different 2 mg dosages buccally.

I am currently using Climara patches as my main estrogen source which is a pretty expensive but also pretty foolproof way of delivering estrogen that is steady state. But where I think that you guys are missing the point is that estrogen dosage in mg means little or nothing unless a person is being tested. Like @bridgeburn, I rarely tested in the past because I just judged feminization and attractiveness with my mirror and I knew that I was ramping up for a long second puberty as we call it. But dosage of these different meds is barely relevant for regrowth purposes, from what I can discern, unless you folks are hitting adult female targets as per Wpath and you are able to do this consistently, month after month.

You know your own situation and bica has an excellent reputation for growing hair but 2 mg seems puny to me, even with Bicalutamide in terms of HRT directed towards substantial regrowth without titration.

Without testing, or titration upwards, how do any of you know how much to use? I mean you could judge by your mirror but none of the folks using less than 4 mg of estradiol from what I can tell are getting any substantial regrowth and many guys are now putting a toe into the estrogen waters but I just don't think that it is going to work. I tried using 0.3 mg, 0.625 mg, 1.25 mg, and then 2.5 mg of Premarin and I wasn't coming close to the Wpath targets and while I saw improvement, especially in my forelock, it was just not cosmetically significant while except for hair, i was feminizing incredibly well on these small amounts of estrogen. Right now I am not even using an AA although I might incorporate bica so that I don't have to always use the patch and can go back to estradiol pills if I want to.

Strangely enough though, for cis-males starting HRT, 2 mg is more or less a perfect initial starting dosage in order not to disrupt breast growth but you almost have to literally beg these women not to start off on 8 mg sublingual or whatever which is far too much in terms of cis-female pubertal estrogen levels. Then a year later, the same gals are posting about how they haven't gotten any breast growth and how they wish that they had not started out on high doses of E and an AA.

Goddess bless.
 
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ali.talebi1994

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This is for all the HRT haters.
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very beautiful hair :rolleyes: i'm jealous of it :D
i want to switch from CPA to Dutasteride because my liver is very sensitive and cant tolerate it...
currently my CPA dose is 12.5mg/d and i've been on it for 2 months by now, and i've got some red hives on my body and pain in my liver area :(
i've also been on finasteride 2mg/d for 7 months and i've got some regrowth on my crown but idk whether it is from finasteride or addition of CPA to my regimen which i did 2 months ago o_O anyway... i have to stop CPA because of my liver...
 

Androgenic Alpaca

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very beautiful hair :rolleyes: i'm jealous of it :D
i want to switch from CPA to Dutasteride because my liver is very sensitive and cant tolerate it...
currently my CPA dose is 12.5mg/d and i've been on it for 2 months by now, and i've got some red hives on my body and pain in my liver area :(
i've also been on finasteride 2mg/d for 7 months and i've got some regrowth on my crown but idk whether it is from finasteride or addition of CPA to my regimen which i did 2 months ago o_O anyway... i have to stop CPA because of my liver...

CPA and dutasteride are completely different medications with different methods of action. They aren't interchangeable.

Also, pain in the liver sounds very serious. Please see a doctor as soon as possible.

And yeah, CPA is supposedly tough on the liver. It's not prescribed in America. Bicalutamide is supposedly easier on the liver. But if you are having liver issues, it'd be best to consult a doctor before starting any new medication
 

ali.talebi1994

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CPA and dutasteride are completely different medications with different methods of action. They aren't interchangeable.

Also, pain in the liver sounds very serious. Please see a doctor as soon as possible.

And yeah, CPA is supposedly tough on the liver. It's not prescribed in America. Bicalutamide is supposedly easier on the liver. But if you are having liver issues, it'd be best to consult a doctor before starting any new medication
yeah i know they are totally different anti androgens but i think dutasteride is the best in terms of safety...
plus, i've got auto immune hepatitis syndromes like finger joint pains :(
i searched it on the web and i found that it is one of the possible side effects of CPA that will disappear after discontinuation...
i decided to stop it forever...
this wednesday i'm going for a blood test, i will share the results and we'll see what CPA has done to my liver
 

JaneyElizabeth

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AA's without estradiol:

I am curious about folks using spironolocatone, cyproterone acetate or bicalutamide without estrogen.

Is anyone experiencing regrowth or clear and substantial hair improvement merely by using an AA? I have heard of prostate cancer victims spontaneously regrowing hair on flutamide but I am uncertain to what extent and whether it was cosmetically significant. I remember there was a senator in the 1980s who died of prostate cancer but sadly (rip) his hair really improved during his final months in Congress but I don't think he regrew a full head of hair.

This is how bad the science of hair regrowth is. I don't think any of us are even sure and so everything is more or less derivative of MtF HRT practices but MtFs tend not to be interested in these medications unless they improve "results", meaning increase breast size.

Many/most take them but rarely if ever do I see anyone discussing these AA's solely in reference to hair regrowth on the Reddit boards. I try and try to ask other MtFs but there is a shocking (to me) lack of interest in hair growth among MtFs. I just went over to AskMtFHRT and DIY HRT to answer questions for folks who haven't received answers yet or who are being given outright misinformation by other MtFs, and every single question was about lackluster breast growth. Many of these questions are simply heartbreaking and I have survivor's guilt since I was mostly in it for the hair and got the results that few others seem to.

This issue is seemingly on the way out for MtFs as folks transition at younger and younger ages and they don't sweat the hair thing since they still have all or most of their "male" hair, and we are going to lose one of our main resources for cis-males fighting baldness willing to take some risks and trying to figure out what risks are "worth" it and which are not, as well as the probability of success.

I do have to say that there are some really cute wigs that cost very little so that is what I have been using the last year since my spironolactone shed and you do sort of forget about the hair issue since a wig doesn't have to grow down to your shoulders before you are "ready" for others to see you. I have gotten a lot of compliments and most males are so clueless they don't even spot wigs but they can spot a toupee at 200 meters.

They're real and they're spectacular

 
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John Difool

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There is an interest in hair regrowth. Most girls on reddit will assume that their hrt will take care of it.
 

Androgenic Alpaca

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AA's without estradiol:

I am curious about folks using spironolocatone, cyproterone acetate or bicalutamide without estrogen.

Is anyone experiencing regrowth or clear and substantial hair improvement merely by using an AA? I have heard of prostate cancer victims spontaneously regrowing hair on flutamide but I am uncertain to what extent and whether it was cosmetically significant. I remember there was a senator in the 1980s who died of prostate cancer but sadly (rip) his hair really improved during his final months in Congress but I don't think he regrew a full head of hair.

This is how bad the science of hair regrowth is. I don't think any of us are even sure and so everything is more or less derivative of MtF HRT practices but MtFs tend not to be interested in these medications unless they improve "results", meaning increase breast size.

Many/most take them but rarely if ever do I see anyone discussing these AA's solely in reference to hair regrowth on the Reddit boards. I try and try to ask other MtFs but there is a shocking (to me) lack of interest in hair growth among MtFs. I just went over to AskMtFHRT and DIY HRT to answer questions for folks who haven't received answers yet or who are being given outright misinformation by other MtFs, and every single question was about lackluster breast growth. Many of these questions are simply heartbreaking and I have survivor's guilt since I was mostly in it for the hair and got the results that few others seem to.

This issue is seemingly on the way out for MtFs as folks transition at younger and younger ages and they don't sweat the hair thing since they still have all or most of their "male" hair, and we are going to lose one of our main resources for cis-males fighting baldness willing to take some risks and trying to figure out what risks are "worth" it and which are not, as well as the probability of success.

I do have to say that there are some really cute wigs that cost very little so that is what I have been using the last year since my spironolactone shed and you do sort of forget about the hair issue since a wig doesn't have to grow down to your shoulders before you are "ready" for others to see you. I have gotten a lot of compliments and most males are so clueless they don't even spot wigs but they can spot a toupee at 200 meters.

They're real and they're spectacular


I also have to wonder about the effectiveness of an oral anti-androgen, especially without estrogen. It seems like the dramatic regrowth some trans women get and that Bridge and Noah got was from the estrogen supplementation. If a topical AA is effective, then there's really no need to take CPA or bica or spironolactone orally and have the side effects. I suppose the question is whether a topical AA like RU is strong enough or if some other topical is needed.

It seems like the main point of an AA is to prevent further loss, whereas estrogen does the real regrowth.
 

John Difool

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There are other anecdotes on hairloss forums of folks who regrew on Fina Duta spironolactone Bica monotherapy. E monotherapy can suppress T without any needs for AA. If you monitor your hormone levels you can rebuild an environment where hair follicles will thrive. It's unfortunate @bridgeburn had no blood work done while taking an hrt mtf treatment. His goal was to "get hair or die trying" and what he did was like ridding a motorcycle at 100mph blindfolded. Obviously not a strategy many folks on this site are ready to adopt.

It's paradoxical that transwomen who are taking a very risky treatments full of side-effects are being called "sissies" by some macho dudes who chicken out when they are suggested to take a long term FDA approved hairloss drug with low risk factor.
 

JaneyElizabeth

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There is an interest in hair regrowth. Most girls on reddit will assume that their hrt will take care of it.

For the younger folks, I get that but many MtFs are still coming out in their 40's and 50's and 60's even and I get the impression this is far from automatic for folks with significant hair loss. I have corresponded with folks who didn't go on blockers who are suffering from significant baldness and I get the impression that regrowth is far from automatic even for some people in their early 20's. That's why the notion of hair growing from slick bald scalp is so important conceptually because none of the treatments for males can grow hair at all and I don't believe it is possible for males to regrow cosmetically significant amounts of hair without doing what we are trying to do.

Every time I go over to Tresses, I am simply flabbergasted by the lack of perspicacity in terms of refusing to use finasteride. If a male is not going to use finasteride or do what we are doing, then what's the point of obsessing and yet, they all still do. When minoxidil was available in 1988, bam, I went on it and I didn't worry about minoxidil-dependent follicles, which I don't think exist anyway. When finasteride was available to me in 1998, I leaped on it and I didn't say, "oh poor me. I am going to have to use these meds for life". I was thrilled and when duta came out, bam I went on that. Today there was a fellow claiming that he was going to use castor oil in place of a reductase inhibitor. They are all sitting around thinking science is going to resolve this
it’s alright man don’t sweat it, there’s plenty of other anti androgens that will work to replace CPA and still yield improvements.
Nobody ever mentions medroxyprogesterone acetate.
 

JaneyElizabeth

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There are other anecdotes on hairloss forums of folks who regrew on Fina Duta spironolactone Bica monotherapy. E monotherapy can suppress T without any needs for AA. If you monitor your hormone levels you can rebuild an environment where hair follicles will thrive. It's unfortunate @bridgeburn had no blood work done while taking an hrt mtf treatment. His goal was to "get hair or die trying" and what he did was like ridding a motorcycle at 100mph blindfolded. Obviously not a strategy many folks on this site are ready to adopt.

It's paradoxical that transwomen who are taking a very risky treatments full of side-effects are being called "sissies" by some macho dudes who chicken out when they are suggested to take a long term FDA approved hairloss drug with low risk factor.

Sides? What are sides?Sheds, What are sheds? Except for spironolactone. That one made me feel weak and fatigued and I had the shed of the century. Starting out on 200 mg was not a good idea. So now Climara and Estrogel. I just ordered four more tubes of estrogel from Amazon4Health today and I slather it and luxuriate in it. Some days I gets these estrogen highs and the Goddess guides me.
 

JaneyElizabeth

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People might say this about me someday but some of those last pictures of @bridgeburn, he was looking a bit small and frail to me. Of course I am 5' 6 and 135 pounds. His face really feminized. It looked those those two were having fun and maybe a cute couple.

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JaneyElizabeth

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One of the things that that really drew me into all of this was I started out on piddling amounts of estrogen. I was on Premarin 0.30 mg starting out and nobody believes me. After six months, we titrated upwards to .625 mg. I was non-binary and still had hopes that my wife might come around, eh but I was trying to not get too big in the breast department so that I could still have deniability. Then I went up to a whopping 1.25 mg and 100 mg of spironolactone at the end of the one year mark. Then 2.50 mg Premarin and 200 mg of spironolactone until May of this year. Plus I had three years of DIY while I was stil married using menopausal creams. Everyone on the MtF boards is saying that is not enough but it was plenty. I had big honking breasts and I swear I didn't mean to. MtFs never grow good ones. Now I know that starting off with tiny amounts of E titrated really gradually is the gold standard for breast growth not that it works for everyone.
The other MtFs are all starting off on 6 mg sublingual and an an AA and it's too much. Pubertal girls have very little estrogen and it appears that the best approach for breast growth was tiny amounts titrated gradually upwards. I swallowed my pills too. I am not a sucker.
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