Endocrinologist HRT Regimen question

[Lara1969]

To answer one question: yes some women have too much DHT ans therefor they experience hair loss. Usually they have a higher testo level but sometimes in the upper range of women.

Lara

[A]

Uhm, the way I see it, women tend to lose their hair in a very different way than men do, and what I've heard is that DHT is responsible for MALE-pattern baldness. That is, baldness that starts at the forehead and top of the head, which I've honestly never seen in a woman. A cis woman, that is.

[JLT1]

You are right but please do not forget that DHT is by far the strongest Androgen in your body and responsible for your malish look and feel. Without DHT a young boy will look like a women when he becomes an adult. It also docks to rezeptors in the brain and may influence our feelings. To look more feminine it important to block the conversion from test to DHT. Testo is responsible for your fertility and your muscles. Normally with some estrogen your testo levels dropps sharply but even with low testo your DHT levels can be quite in the range of a male.

Lara

DHT is about 5X more potent than testosterone.  I cannot find normal levels of DHT in men fro a reputable source.  Saw a couple putting it at about 20X less in concentration than T but always question the units and that doesn't quite make sence given clearance rates.  If true, the level of T being so much higher than corculating DHT would still make T the big one.  Not sure there....

DHT plays a role in formation of the male sex organs in the fetus. Boys who are born without the ability to convert testosterone into DHT are born with ambiguous genitalia, malformed penises (pseudohemaphrodites). During puberty, DHT is responsible for the emergence of body hair (including beard), penis growth, development of the libido and sexual function and prostate. In pseudohemaphrodites these functions do not develop fully at puberty, despite having a normal level of testosterone. They only develop male musculature, with little body hair and their sexual organ is between a micro penis and an overdeveloped clitoris. However, they never develop baldness.  In the adult, it maintains the health of the prostate. (Plagiarized but checked)

There does also appear to be some minor functions relating to estrogen levels.  I did find that when conversion of testosterone is blocked, the result is low DHT, elevated estrogen, and increased progesterone.  Some studies suggest hypogonadism (effects the testicles).

Given that there is some increase in estrogen and progesterone, there may be more of an effect that I had originally thought. If a person could get enough E, that would drop the T while the progesterone stays up. 

I believe that regular blood tests would answer any potential concern and end the debate. 

[A]

To be honest, I would probably just see two enemies and want to destroy both of them, and give both spironolactone/cyproterone and finasteride/dutasteride, haha.

Though JTL1, you make me wonder... Assuming that despite my low testosterone, I might still have relatively high DHT, does that mean my body hair problems would have a chance of being helped by getting on a DHT blocker? That sounds freaking advantageous. I doubt I'll be able to convince my endo, but now I really feel like asking him to add DHT to my next blood test.

[kelly_aus]

IIRC, about 5-7% of T is converted to DHT, so if your T level is low, your DHT is quite likely to be low as well..

[Bea]

My endo doesn't check for T levels, he says it is a waste of time because the high dose estrogen I take causes the T to drop. My E levels are always right where he wants them, whatever that means.

So I think it may be correct to say that the endo is counting the anti-dht effects of the Avodart to squash what little he thinks I have.

My next appointment with the doc is going to be interesting....I have allot of questions...

[A]

Waste of time is a big word considering you need to go for a blood test anyway. My endo only stopped caring so much about my testosterone levels once they were stable and very low. Because estrogen can't do its job right if testosterone is in the way, initially checking testosterone was his first priority.

But yeah, your endo does have a pretty special approach. And I doubt it's utter nonsense. Though extra information, like testosterone levels, can't hurt, can it?

[Bea]

I think the utter excitement of being on HRT sort of blocked my Intelli-vision.

I do recall my endo asking me in the beginning, how fast do I wanted to go. I wasn't sure what he meant, but I told him I wanted to take my time. I was going though a nasty divorce with massive child custody issues at the same time and wanted to keep everything low key during the court hearings.

So everything may make sense if it holds true that he put me on a special-brew of HRT that is slower per say. I do know a few other ladies whom have used the same doctor and they were put on spiro, not avodart....

[A]

That's odd, though. The antiandrogen isn't something that you change to go "slow", normally. It only blocks testosterone, and as such slows/stops further masculinization, and opens the way for estrogen. But it doesn't cause any real feminization by itself. If you wanted to go slowly, the first choice that comes to mind is to block testosterone as completely as possible with a good antiandrogen, and start with a very low dose of estrogen, not reduce the antiandrogen's potency.

Sorry, but I don't think that's your explanation. You really will have to ask him, I think.

[JLT1]

To be honest, I would probably just see two enemies and want to destroy both of them, and give both spironolactone/cyproterone and finasteride/dutasteride, haha.

Though JTL1, you make me wonder... Assuming that despite my low testosterone, I might still have relatively high DHT, does that mean my body hair problems would have a chance of being helped by getting on a DHT blocker? That sounds freaking advantageous. I doubt I'll be able to convince my endo, but now I really feel like asking him to add DHT to my next blood test.

I think there are problems with getting good data on circulating DHT and understanding exactly what those numbers mean.  In individuals who have a prostate, DHT is produced in the prostate and the skin.  Once out of the prostate or skin, it gets eliminated from the body fairly rapidly so blood levels are relatively low. 

The role DHT has in hair growth is interesting as well.  It is the primary hormone that promotes initial hair growth while at the same time; it is also the primary cause of most hair loss as people age, in both women and men. My little corner of the world of the endocrine system is to understand the effects of zenobiotic compounds on the endocrine system, particularly in regards to reproduction.  I assume that all other things being equal, both hairy and hairless people can reproduce so I am unfortunately out of my limited knowledge.     

So while your question is a good one, I think it is beyond what is currently understood about the dual roles of DHT.  However, if your seeing the doctor already, questions are free.

[A]

Sad thing is, I have the answer in advance. "It doesn't matter." Yush, helpful endo.