I was on dutas until last month, so about 21 months on it after 12 months of USDA propecia. I just switched to USDA avodart since my insurance is paying for it, making it slightly cheaper than buying dutas. God it feels so dumb that we can't talk about doses on finasteride/dutasteride, they're all over the bloody internet. A 'full' dose of avodart is five times the standard dose and that means FIVE TIMES THE BILL. If you can afford that, just have an orchi. I seem that I've gained more hair by doubling my dose, but I had another shedding phase when I doubled it so it's hard to tell... and the spiro increase, and then now estrogen. Shedding phases can really ruin your hair so I don't want to experiment stepping up or down. If I had even realized that it would cause shedding, I wouldn't have changed the dose. Now I feel stuck with the doubled cost because no one really knows what happens to a TS on HRT who steps down their avodart.
I've spent... many hundreds per year on dutas alone. You know, I really wondered why I couldn't seem to save money... probably because of the $1000 HRT bill every year. My doctor didn't alter my avodart dose or my spiro does when I went legit, he just changed my estrogen to estropipate which is a time release with much better results according to him.
So I can't say I've noticed a difference switching to avodart from dutas yet, but there was a significant improvement over propecia by switching to dutas. For most people dutas should be more effective.
My estrogen is $10, dutas is $40, spiro is $20 on insurance but I don't buy it. I'm going to continue with overseas spiro and progesterone probably, I am afraid of poking the insurance company too much.