Hello,
I had such rapid hair loss and thinning last year that I almost wanted to die. Indeed, hair loss was what made me say I could no longer wait to transition, despite great financial risks. Within 8 months mostly last year, I went from having what looked like almost a full head of hair to being partially bald on top and seeing much of my scalp throughout the front. Extreme genetic sensitivity to DHT runs in my family, so I am now on a combination of 3 medications to bring my DHT level as low as possible. Within one week after starting the dutasteride (in June), my number of detached hairs decreased significantly. I have had more new growth this year than any other year since 2009, and these new hairs have been as thick as my old ones. However, I still lose far more strands than I regrow. The main effect of the dutasteride seems to have been a dramatic thickening and darkening of my remaining hair, so that I see much less scalp now despite having fewer strands.
The doctor told me that blocking T and DHT should stop the hair loss and that taking estradiol would do almost nothing. I continued to shed hair in frightening quantities. Since starting estradiol, I have found it to be very helpful in controlling stress, another major cause of hair detachment. However, I also think the estradiol is incredibly habit-forming and that maintaining the steadiest level possible is necessary to prevent the mood swings that can trigger my hair loss. If I go off the estradiol for a day, I suffer from morbid shedding and extreme anxiety. However, estradiol itself is considered a weak blocker. My personal experience has been that even minor fluctuations in DHT can cause major hair loss for me, so I see no alternative to staying on dutasteride given my unfortunate genetic profile.
While I do get the baby hairs on the front below my existing hairline, they seem to disappear every time I wash my hair. Transplanting works for people with thin and thick spots; my hair density has declined all over. I have no hope for an improved hairline. 🙁