Progesterone and hairloss

[Lauren1]

I am MTF and just entered my six month. My endo increased my spiro (which should put me at near zero T levels). I am on an estrogen and DHT blocker as well. I also just got the depo shot.

Now I know the effects of anything take time... but I immediately noticed a surge in hair shedding since last week. Now 2 things happened at this appt, 1) spiro increase, 2) progesterone shot. I wouldn't suspect a drop in testosterone doing this, actually I would suspect even less shedding than I was experiencing with less evil T.  That leaves the depo shot, which actually does have hair loss on the side effect. I can't really find any more info on this.

So community experience... is this normal? Are these just hairs in their telegenic phase dropping out (and being replaced with more awesome hair), or is this just normal male hair loss with hair growing back weaker and thinner? Does anyone have any experience here?

[teeg]

Testosterone still plays a role, so watch out that your levels don't go too low.

Which type of hair are you referring to?

[Lauren1]

Testosterone still plays a role, so watch out that your levels don't go too low.

Which type of hair are you referring to?

Scalp hair. Its shedding to what it was pre-finasteride. Progestins aren't all they're cracked up to be!!

[KayXo]

First of all, Depot-Provera is NOT progesterone. It's a progestin with progestogenic properties but with also very different properties than progesterone. Contrary to progesterone, it exerts mild androgenic effects which could explain the hair shedding, it increases DVT and breast cancer risks, tends to oppose estrogen's beneficial effects on lipids (i.e. HDL) and may cause depression/irritability/anxiety in some. It is not used in women who are pregnant to prevent miscarriage due to its androgenic potential whereas progesterone IS used because it has no androgenic effects.

It does have strong anti-androgenic effects as far as suppressing the pituitary gland's LH production and thus testicles's production of androgens BUT if you are already taking Spiro and estrogen and a DHT blocker that all inhibit androgen, then the addition of Provera, is, IMHO, not necessary.

You should raise these concerns with your doctor so that a proper course of action can be put into place to remedy the situation.

[Hideyoshi]

Maybe ask to be put on medroxyprogesterone instead? I got put on oral medroxyprogesterone acetate after my T level wouldn't get below 200-300 after a year and a half of HRT, and now it's at high female range (freaking finally) after 4 months on P and my boobs are exploding in growth. No hair loss either after starting P, but I wasn't suffering from hair loss before HRT.

[teeg]

Maybe ask to be put on medroxyprogesterone instead? I got put on that after my T level wouldn't get below 200-300 after a year and a half of HRT, and now it's at high female range (freaking finally) after 4 months on P and my boobs are exploding in growth. No hair loss either after starting P, but I wasn't suffering from hair loss before HRT.

Does that mean you're not on anti-androgens like Spiro, etc.? As in the progesterone is helping to lower your testosterone? I'm curious as I'm interested in asking my endocrinologist about adding progesterone to my regimen.

Back to OP's topic though, I don't mean to distract. 

[Hideyoshi]

Does that mean you're not on anti-androgens like Spiro, etc.? As in the progesterone is helping to lower your testosterone? I'm curious as I'm interested in asking my endocrinologist about adding progesterone to my regimen.

Back to OP's topic though, I don't mean to distract. 

Sent PM

[Lauren1]

Maybe ask to be put on medroxyprogesterone instead? I got put on that after my T level wouldn't get below 200-300 after a year and a half of HRT, and now it's at high female range (freaking finally) after 4 months on P and my boobs are exploding in growth. No hair loss either after starting P, but I wasn't suffering from hair loss before HRT.

Depo Provera is a medroxyprogesterone, a progestin. My doctor doesn't add it as part of the regimen, but he's not opposed to it. He said some of his girls swear by it, others not so much. In your case, it sounds like you swear by it. For me its too early to say but the hair shedding is a bit disheartening (I'm not a victim of MPB to begin with). For all I know that has something to do with the extra T drop and might level out. My hair is also more oily too... weird.

[KayXo]

Maybe ask to be put on medroxyprogesterone instead?

Depo-Provera is medroxyprogesterone acetate.

[KayXo]

Does that mean you're not on anti-androgens like Spiro, etc.? As in the progesterone is helping to lower your testosterone? I'm curious as I'm interested in asking my endocrinologist about adding progesterone to my regimen.

Back to OP's topic though, I don't mean to distract. 

Please, it's important to make the distinction between bio-identical progesterone (what is naturally produced in our bodies) and other "progestins" intended to duplicate the progestogenic effect of bio-identical progesterone but have very different effects on the body which I explained above.

If you take what she is taking, Depo-Provera (medroxyprogesterone acetate), then yes, it will strongly reduce your testicle's production of androgens but it is also mildly androgenic at the receptor level, and has a host of potential undesirable side-effects noted in several studies.

If you take bio-identical progesterone, the anti-androgenic effect will be very weak so not worthwhile for that effect. But, can be beneficial for breast growth and other stuff too.

[KayXo]

For me its too early to say but the hair shedding is a bit disheartening (I'm not a victim of MPB to begin with). For all I know that has something to do with the extra T drop and might level out. My hair is also more oily too... weird.

Increased scalp hair loss and sebum (oil) production is a typical ANDROGENIC effect caused by testosterone, DHT and medroxyprogesterone acetate since it derived from testosterone as well. I would be seriously concerned and share this with your doctor if this persists or even ASAP.   

[Hideyoshi]

Depo Provera is a medroxyprogesterone, a progestin. My doctor doesn't add it as part of the regimen, but he's not opposed to it. He said some of his girls swear by it, others not so much. In your case, it sounds like you swear by it. For me its too early to say but the hair shedding is a bit disheartening (I'm not a victim of MPB to begin with). For all I know that has something to do with the extra T drop and might level out. My hair is also more oily too... weird.

A bit about your fears of medroxyprogesterone acetate (I neglected to check the drug name of depot provera so that was my b) causing androgenic effects:

As mentioned above, MPA is a potent full agonist of the androgen receptor. Its activation of the AR has been shown to play an important and major role in its antigonadotropic effects and in its beneficial effects against breast cancer.[15][19][20] However, although MPA does have the capacity to cause androgenic side effects such as acne and hirsutism in some patients (especially women),[21][22] it seldom actually does so, and when it does, the effects tend to be only mild, regardless of the dosage used.[15] In fact, likely due to its suppressive actions on androgen levels, it has been reported that MPA is generally highly effective in improving pre-existing symptoms of hirsutism in women with the condition.[23][24] Moreover, MPA rarely causes any androgenic effects in children with precocious puberty, even at very high doses.[25] The reason for the general lack of virilizing effects with MPA, despite it binding to and activating the AR with a high affinity and this action playing an important role in many of its physiological and therapeutic effects, is not entirely clear. However, MPA has been found to interact with the AR in a fundamentally different way than other agonists of the receptor such as dihydrotestosterone (DHT).[12] The result of this difference appears to be that MPA binds to the AR with a similar affinity and intrinsic activity to that of DHT, but requires about 100-fold higher concentrations for a comparable induction of gene transcription, while at the same time not antagonizing the transcriptional activity of normal androgens like DHT at any concentration.[12] Thus, this may explain the low propensity of MPA for producing androgenic side effects.

If you're having abnormal hair loss I'd get to the doctor and get the levels checked. I know before P, my T levels would rise and fall from 400 to 200 and my feminization was slow, but since I don't really have the genes for baldness (just a slightly higher hair line all my life) I didn't experience any shedding.

I don't -swear- by it, as I can't prove 100% that it was just the P that tanked my T, but I can tell you that it didn't masculinize me. I can't say that it will happen that way with other people, but with the reading I've done and how powerfully assertive my endo was that it was the right medication to take in conjunction with E, I can say it's definitely worth a try. How long was it since your MPA shot? A week? Why not give it a month? Stressing about it surely isn't good for hair loss

I take the mpa orally, so I don't know the differences in effects/dosage/etc.

[KayXo]

Hideyoshi,

Thank you for this information. But, in my opinion, even if MPA is unlikely (but still has the potential in sensitive individuals?) to cause androgenic symptoms, it does raise DVT and breast cancer risks, and has known to affect mood quite negatively in some (not all). For these reasons, I personally wouldn't take it. Progesterone seems to neither raise DVT risk, oppose oral estrogen's beneficial effects on lipids or increase breast cancer risk, as noted in several studies. It may however make some depressed while having the opposite effect in others and also reduce anxiety due to its sedative effects which medroxyprogesterone doesn't have. It's also the same molecule that is produced in our bodies.

I think for all these potential risks associated with MPA, it is not given to pregnant women especially for risk of virilizing female fetus.

In the end, it's the patient and doctor's call. But, it's important to be aware of this.

[teeg]

Please, it's important to make the distinction between bio-identical progesterone (what is naturally produced in our bodies) and other "progestins" intended to duplicate the progestogenic effect of bio-identical progesterone but have very different effects on the body which I explained above.

If you take what she is taking, Depo-Provera (medroxyprogesterone acetate), then yes, it will strongly reduce your testicle's production of androgens but it is also mildly androgenic at the receptor level, and has a host of potential undesirable side-effects noted in several studies.

If you take bio-identical progesterone, the anti-androgenic effect will be very weak so not worthwhile for that effect. But, can be beneficial for breast growth and other stuff too.

Which progesterone medication is bio-identical progesterone? I'd like to know to be certain my endocrinologist prescribes me the, "correct" progesterone. It's really unfortunate there's so much confusing information about this.

[Lauren1]

Increased scalp hair loss and sebum (oil) production is a typical ANDROGENIC effect caused by testosterone, DHT and medroxyprogesterone acetate since it derived from testosterone as well. I would be seriously concerned and share this with your doctor if this persists or even ASAP.

Yes, I get that MPA may be androgenic. But it was an injection and my doctor would just tell me to let it run its course. I just won't get another one if it persists, and at least for natal females (from what I read) this reverses when the injections stop. I was just hoping to get other trans peoples experiences to see if they had anything similar. I know its potentially androgenic and hair loss is listed as a side effect... just wanted to see how bad it was for other people to see if I should worry or not.

I'm not at any apparent risk for DVT and don't suffer from depression in general (the two most noted risks) so I thought why not give it a try.  It will continue to wear down over the next 11 weeks. Its whatever. Just want to see other's reactions to the shot.

[Hideyoshi]

Hideyoshi,

Thank you for this information. But, in my opinion, even if MPA is unlikely (but still has the potential in sensitive individuals?) to cause androgenic symptoms, it does raise DVT and breast cancer risks, and has known to affect mood quite negatively in some (not all). For these reasons, I personally wouldn't take it. Progesterone seems to neither raise DVT risk, oppose oral estrogen's beneficial effects on lipids or increase breast cancer risk, as noted in several studies. It may however make some depressed while having the opposite effect in others and also reduce anxiety due to its sedative effects which medroxyprogesterone doesn't have. It's also the same molecule that is produced in our bodies.

I think for all these potential risks associated with MPA, it is not given to pregnant women especially for risk of virilizing female fetus.

In the end, it's the patient and doctor's call. But, it's important to be aware of this.

Estradiol is unlikely to cause liver disease, but the risk is still there. There are risks with every medication that changes the chemistry of your body.

The fact that there isn't any requirement for packaging information, regulation, etc for BHRT is the reason I wouldn't take BHRT. It's a form of alternative medicine. I am ashamed to admit I bought into the whole alternative medicine/organic/holistic deal in my late teens/super early twenties. I know the urge to believe the claims of those who promise little to no side effects with equal results, but the science just isn't there.

[Lauren1]

A bit about your fears of medroxyprogesterone acetate (I neglected to check the drug name of depot provera so that was my b) causing androgenic effects:

If you're having abnormal hair loss I'd get to the doctor and get the levels checked. I know before P, my T levels would rise and fall from 400 to 200 and my feminization was slow, but since I don't really have the genes for baldness (just a slightly higher hair line all my life) I didn't experience any shedding.

I don't -swear- by it, as I can't prove 100% that it was just the P that tanked my T, but I can tell you that it didn't masculinize me. I can't say that it will happen that way with other people, but with the reading I've done and how powerfully assertive my endo was that it was the right medication to take in conjunction with E, I can say it's definitely worth a try. How long was it since your MPA shot? A week? Why not give it a month? Stressing about it surely isn't good for hair loss

I take the mpa orally, so I don't know the differences in effects/dosage/etc.

Regarding that excerpt you posted. I'm trying to understand the end point. So MPA does bind to the androgen receptors that DHT bind to. But it says they need to be in higher doses to even match DHT? A 3-month injection would start at that higher level. But it also sounds like MPA has the ability to tie down the AR, which would block other androgens from binding.

[Hideyoshi]

Regarding that excerpt you posted. I'm trying to understand the end point. So MPA does bind to the androgen receptors that DHT bind to. But it says they need to be in higher doses to even match DHT? A 3-month injection would start at that higher level. But it also sounds like MPA has the ability to tie down the AR, which would block other androgens from binding.

It's saying roughly that in order for MPA to have androgenic effects at the equal potency of DHT, that there would need to be 100x as much, but it still doesn't behave as normal androgens do. As far as occupying the places that other androgens use, I don't know enough about molecular biology to comment on it.

[Lauren1]

I'm just going to try to stop worrying. Back to my original logic, its given as an AA for some girls. If it does have an androgenic effect, I'm on other AA's if this (by one bad stroke of luck) gets converted to Testosterone. I've read horror stories from FTM's that this shot made them more womanly in appearance.

I'm intrigued as to hearing everyone's results if they were on this.

[Hideyoshi]

I'm just going to try to stop worrying.

Good plan