Is it possible to continue to experience male pattern baldness on HRT?

[ShadowCharms]

Before I went on HRT, I had some balding going on at my temples. I had not noticed any balding at my crown. My dad went totally bald, but most of my other male relatives have not gone bald. My sister (who is cisgender) has experienced a fair amount of hair loss at her temples. I am 29, and my sister is 24. When my dad lost his hair, he was about our age. I am now 14 months into HRT, and just recently, I think I have noticed hair loss on the crown of my head. I thought that I had read that male pattern balding completely stopped for people on HRT, so I'm confused. I have been taking Spiro and Estradiol in typical doses, as well as taking finasteride intermittently. I have even noticed some hair returning at my temples, which I took as a sign that my hair loss was finished as long as I stayed on HRT.

Does male pattern baldness continue for some transgender women who are on HRT? Is there anything I can do about it?

[Leila]

It is possible and would depend how sensitive your body was to DHT. A small amount of testosterone would still be created in the adrenal glands and be converted to DHT.

You could ask your doctor to prescribe you dutasteride as an insurance against hair loss if as you say there is history of hair loss in your family.

[Jill F]

Finasteride can cause shedding initially before it sprouts new hairs.  I'm not sure about taking it intermittently- you might not get the usual results.   I never had an ozone hole, but I was getting thin on top and in front.  Finasteride definitely worked, finasteride + E was better, and dutasteride + E worked even better yet.  I had an orchi 6 months ago and now it seems I have a lot of 3-4 inch shorties on top.   My temples are getting better and my hairline has advanced slightly.

[Steph34]

Does male pattern baldness continue for some transgender women who are on HRT? Is there anything I can do about it?

Sadly, my hair loss has continued. While most of my hair loss on HRT is likely due to a stubborn yeast infection on the scalp (made worse by the HRT), some of it still appears to be MPB, indicated by strands that become thinner until they disappear. I am incredibly sensitive to DHT. Several men in my mother's family went bald in their twenties, and many women on both sides of the family also had severe hair loss. Dutasteride helps a lot even while on HRT. It should also help to make sure the E dose is high enough, as E has been known to help prevent MPB by affecting androgens in several ways. Ironically for me though, the female hormone actually makes my hair fall out by aggravating the yeast infection, even while it thickens my remaining strands by blocking the effects of DHT. I seem to have no hope no matter what I do, but I do think the dutasteride is helping and would recommend it because it works better than finasteride; it did for me. Since dutasteride has a long half-life, it is okay to miss a dose. Dutasteride is very expensive, though. If one uses finasteride, it is important to take it consistently and frequently enough to compensate for the drug's short half-life; intermittent use of finasteride is often ineffective.

[mmmmm]

Ask GP for dutasteride-Avodart (if you have an insurance it should be for free) take it regularly and forget about all hairloss related things. Stress is as much of a factor when it comes to hairloss as anything else. I experienced a little shedding from finasteride when I started it along with my HRT, and a little more shedding again when I switched to dutasteride about 4-5 months later. Its all just a silly long-gone memory now. Save your worries for more important things in life 

[Joanne Feliz]

I never had an ozone hole, but I was getting thin on top and in front.

I have an ozone hole developing and receeding hairline. I just started taking Finastride to prevent any more ill effect of DHT.  Im 39 so I have had a pretty good innings so far.  I feel your pain though.  Is very stressful seeing this shell of a body, a body that you dont even feel too comfortable in slowly betraying you. 

My Endo said that Finastride is like poison and can adversely effect your personality/mood etc...Is this the same with Adovart?

I may dump the Fin as soon as I get on the Estrogen etc...

I see many women also who are balding but I find that distressing.

[Chelsey]

My hair regrew big time on estrogen spiralactone and finasteride and minoxidil like insanely grew back... but its looking disgracefull now and i'm keeping a positive thought process on it constantly and hoping it comes back! I've dreamed in the past it regrew and i sooo didnt want to wake up! Next option is wigs which isnt ideal but feasible with the proper knowledge and right styles...

[Jill F]

My Endo said that Finastride is like poison and can adversely effect your personality/mood etc...Is this the same with Adovart?

I had zero negative reaction to either.  My endo even told me that Avodart was the trick to get rid of the DHT nasties and to let the estrogen do its thing.  Some forum members here have had serious issues with finasteride though, so it's yet another YMMV situation.

Of course, for me, once I got rid of the source of the problem, the clouds parted and the rainbows came out for good.

[StrykerXIII]

I'm going to have to keep an eye on this thread. While my father was already balding at 24 (my current age), and I'm not, I have had my hairline recede at the temples quite a bit. I was wondering about this.

[Steph34]

Ask GP for dutasteride-Avodart (if you have an insurance it should be for free) take it regularly and forget about all hairloss related things. Stress is as much of a factor when it comes to hairloss as anything else. I experienced a little shedding from finasteride when I started it along with my HRT, and a little more shedding again when I switched to dutasteride about 4-5 months later. Its all just a silly long-gone memory now. Save your worries for more important things in life 

There is nothing more important in life than hair.

Dutasteride is unlikely to be free. Most insurance plans have a co-pay, and some will not pay at all for off-label use. (Dutasteride is not FDA-approved for pattern baldness despite being safe and effective.) It costs me a fortune, but I would rather be poor than bald.

All too often, it seems easier to blame stress than to find and accept the true cause of one's hair loss. I lost most of my hair due to DHT and denied it for years because my other features were not masculine; I blamed it on stress. Then, on dutasteride, a T blocker, and low-dose E, I lost most of my remaining hair due to a fungal scalp infection, again blaming stress until it was too late. Stress rarely causes severe hair loss, and hair lost due to stress usually grows back.

My few remaining strands have thickened nicely since starting HRT and biotin, but I have fewer and fewer every week. I see much of my scalp when the hair is wet. I envy those who say they regrew hair by transitioning. I seem to be among the 1% of hair loss sufferers who can't stop the problem by blocking T and DHT.

My hair regrew big time on estrogen spiralactone and finasteride and minoxidil like insanely grew back... but its looking disgracefull now and i'm keeping a positive thought process on it constantly and hoping it comes back! I've dreamed in the past it regrew and i sooo didnt want to wake up!

I refuse to give up despite having so little right now as to make passing even harder. I started minoxidil yesterday as a last resort, having tried everything else and gotten little or no regrowth. Since I am under 30, lost a lot of hair recently, and still on dutasteride and HRT, I *should* respond well to the minoxidil if I can tolerate it without scalp irritation or excessive flaky buildup, which could reignite my fungal infection.

I had zero negative reaction to either.  My endo even told me that Avodart was the trick to get rid of the DHT nasties and to let the estrogen do its thing.  Some forum members here have had serious issues with finasteride though, so it's yet another YMMV situation.

I also had no adverse response to finasteride or dutasteride. I did, however, have severe side effects from spironolactone and progestins... they may be good for hair, but they made me feel as bad as I did on endogenous T.

I'm going to have to keep an eye on this thread. While my father was already balding at 24 (my current age), and I'm not, I have had my hairline recede at the temples quite a bit. I was wondering about this.

I think the gene for DHT-sensitive hair follicles usually comes from the mother. My father was not balding until after 40, but I started to lose large quantities of hair from DHT at 23, which is more consistent with my mom's family members.

Some people report good results from applying minoxidil to a receding hairline.

[Mariah]

Yes it's possible that it will continue, but often it will slow, if not eventually stop, after being on at least HRT and or something that blocks DHT. Genetics and stress along with other things can cause the loss to continue to. Secondly Dutasteride or finasteride can help. Dutasteride isn't cheap since there is no generic, but in some cases your doctor's office might have samples of it available keep the cost down for you. My doctor has been doing that since I started it without my even asking her to do it sine she knew how expensive it is.
Mariah

[mmmmm]

Dutasteride is unlikely to be free. Most insurance plans have a co-pay, and some will not pay at all for off-label use. (Dutasteride is not FDA-approved for pattern baldness despite being safe and effective.) It costs me a fortune, but I would rather be poor than bald.

I get it for free (I'm from europe though).. All my GP wanted is that my endo wrote a suggestion for Avodart on a regular report. So its basically part of my prescriebed HRT regimen, and therefore it's free.

[Wynternight]

I started dutasteride at the same time as I started estradiol and spiro and I can assure you that it is not free in the US. I can also say, and this is strictly anecdotal, that I have had no adverse effects from it.