Susan's Place Transgender Resources

Hi guys, so i recently been considering stopping my HRT because im currently with a partner who loves me the way i am and he is getting frustrated with the libido loss i get from my HRT. In terms of physical aspect i am  more or less completely passable even before i began my HRT so stopping is more an issue of deciding to potentially postpone by decision to do a full transition. Currently on Progynova and spironolactone.

Anyway i have hair loss issues. Recently going through a telogen shed phase and i have male pattern baldness.. Im wanting to stop Spironolactone and go on Dutasteride. Does anyone know which is more effective against hair loss? Im sure Spiro helped a little to stop my hair loss but nothing significant. I do get the libido loss as side effects which im hoping Dutasteride would make me experience none or at least less libido loss, for my partner's sake.

Does anyone have any experience on this? Anyone been on spiro but didnt notice it helped your hair condition and then switched to or started using dutasteride too and noticed it worked better for hair loss?

Any advice wil be much appreciated :)

Spironolactone will block the Testosterone receptors but not necessarily reduce your T blood levels. This means that any available T in your blood can be converted to Dihydrotestosterone which is the real cause of hair loss. Finasteride and Dutasteride block this conversion of T to DHT. Low dose Finasteride is commonly used to stop hair loss. High dose Finasteride is used for prostate issues. Dutasteride is not available in the US in an equivalent low dose for hair loss. The available doses for Dutasteride are indicated for prostate issues only.

Oh thanks so much for your input. Do you know if datasteride has more libido loss as side effects than spirono?

Quote from: Pengola on May 29, 2018, 11:35:01 PM
Oh thanks so much for your input. Do you know if datasteride has more libido loss as side effects than spirono?

A well know side effect of Dutasteride is loss of libido, while Spironolactone lists erectile dysfunction as a side effect. To me, this is really two sides of the same coin.  :(

How any drug effects you is really a try it and see what happens sort of thing. We can make predictions about how a given drug effects a large group of people, but then there is so much individual variation that the side effects for any one person is not predictable. Be aware of possible side effects and give it a try and see what happens.

Just a note to keep in mind, some people on Spiro will experience the issue I'm dealing with, the free testosterone in the blood may all be converted to DHT in a feed back loop, it's your body's way of dealing with the low levels of T. My current T levels are .6, pretty awesome, but my my DHT levels are ridiculously high, I'm currently playing games with my insurance company to get Dutasteride covered since they refuse to cover finestride for any reason.

Spiro was enough to help me start to regrow my hairline and also stop future loss.

Spiro blocks both DHT and T. ;)

Quote from: KayXo on June 03, 2018, 10:33:26 AM
Spiro blocks both DHT and T. ;)

No, Spiro does not block DHT from forming, it inhibits the binding of androgens and receptors that may result in a reduction of DHT through a cause and effect process; low T may lead to a lower DHT, it does not block it in any direct way, there is a big difference. This action on DHT is weak since Spiro has no direct effect on DHT production and for those of us with a DHT sensitivity is not enough, to make matters worse in some individuals Spiro causes a bio feed back loop triggered by low T levels causing the body to convert what little T is in the body to DHT.

The only way to block DHT from forming is through the blocking of the Alpha 5 reductos receptors.currently only two drugs in the US (can not speak for over seas) finasteride in it's various brands, and Avodart aka dutasteride.

Quote from: Cassandra B on June 03, 2018, 01:15:53 PM

No, Spiro does not block DHT from forming

That is why I only said it blocks it, never mentioned anything about inhibiting/reducing its formation. I am well aware that spironolactone blocks both DHT and T at the site of androgen receptors as spironolactone binds these receptors and hence blocks androgens from binding to them. Whether it blocks DHT (and T) sufficiently will be known based on the individual's response after taking spironolactone for several months.

Science and medicine have very specific meanings and terms, unfortunately, you are using them incorrectly; this means you aren't saying what you think you are saying.

Meaning of Block: to prevent, not allow.
Spiro does NOT block DHT from forming it only blocks T from forming.

Meaning of inhibit: to disrupt, to interfere, to impede.
What you are referring to is inhibiting. Spiro can inhibit the formation of DHT, it can not block it, I clearly laid out in my previous post the only possible way to block DHT is through the Alpha 5 Reductos.

Spiro partially blocks both DHT and T. It prevents/does not allow T and DHT to bind at those receptors where it is binding. ;)

There is no such thing as partially blocked, the term is called inhibits.

It has no direct effect on DHT or the receptors DHT binds too, only T.

Not a single peer reviewed study supports your statement.

Quote from: Pengola on May 28, 2018, 05:35:13 AM
Hi guys, so i recently been considering stopping my HRT because im currently with a partner who loves me the way i am and he is getting frustrated with the libido loss i get from my HRT. In terms of physical aspect i am  more or less completely passable even before i began my HRT so stopping is more an issue of deciding to potentially postpone by decision to do a full transition. Currently on Progynova and spironolactone.

Anyway i have hair loss issues. Recently going through a telogen shed phase and i have male pattern baldness.. Im wanting to stop Spironolactone and go on Dutasteride. Does anyone know which is more effective against hair loss? Im sure Spiro helped a little to stop my hair loss but nothing significant. I do get the libido loss as side effects which im hoping Dutasteride would make me experience none or at least less libido loss, for my partner's sake.

Does anyone have any experience on this? Anyone been on spiro but didnt notice it helped your hair condition and then switched to or started using dutasteride too and noticed it worked better for hair loss?

Any advice wil be much appreciated :)

Hi Pengola,

I've been on dutasteride for 3 years and low dose E for the last 2.  I also took spiro prior to E for a year.   I found spiro or higher amounts of E much more of a problem with erectile dysfunction.   Dutasteride has never given me this problem.  But remember everyone reacts differently.

With both finasteride and dutasteride erectile dysfunction can be a side effect but I believe this only happens with a small percentage of those who take them.  The other thing to remember is that these drugs stop most DHT formation.  Because of this you may actually have more regular T in your body.

Take care,
Paige :)

Quote from: Cassandra B on June 04, 2018, 01:17:12 PM
There is no such thing as partially blocked, the term is called inhibits.

It has no direct effect on DHT or the receptors DHT binds too, only T.

Not a single peer reviewed study supports your statement.

Since spironolactone binds to androgen receptors and both DHT and T also bind to androgen receptors, spironolactone does indeed block both T and DHT. This has been confirmed in studies. I will PM you the studies.

Sent you a reply, unfortunately what you sent does not support your position, please take note of the term used in those quotes; inhibits

Other studies do however use the word block when referring to DHT and spironolactone.

Quote from: Pengola on May 28, 2018, 05:35:13 AM
Hi guys, so i recently been considering stopping my HRT because im currently with a partner who loves me the way i am and he is getting frustrated with the libido loss i get from my HRT. In terms of physical aspect i am  more or less completely passable even before i began my HRT so stopping is more an issue of deciding to potentially postpone by decision to do a full transition. Currently on Progynova and spironolactone.

Anyway i have hair loss issues. Recently going through a telogen shed phase and i have male pattern baldness.. Im wanting to stop Spironolactone and go on Dutasteride. Does anyone know which is more effective against hair loss? Im sure Spiro helped a little to stop my hair loss but nothing significant. I do get the libido loss as side effects which im hoping Dutasteride would make me experience none or at least less libido loss, for my partner's sake.

Does anyone have any experience on this? Anyone been on spiro but didnt notice it helped your hair condition and then switched to or started using dutasteride too and noticed it worked better for hair loss?

Any advice wil be much appreciated :)

Well, there are several options to explore:

1). Spironolactone will help some with hairloss.  While I've been on it (30 months), I hadn't noticed any Libido issue.  Just an overactive bladder.

2). Finasteride is slightly more effective than just Spironolactone (from my experience).  If you're having a loss of Libido, you will have to watch out with Finasteride.  It is one of the potential side effects and it sounds like you may be more susceptible.

3). I have not tried Dutraside, so I cannot speak to it's effectiveness.  However, it will inhibit the formation of both types of DHT.  Which may or may not be what you want, as DHT is supercharged testosterone and will inherently increase your libido.

4). Micronized Progesterone.  Since you mentioned that you're on HRT, Progesterone (not to be confused with synthetic progestins), is also a 5a redux inhibitor as well.  It will help with keeping male pattern baldness under control.  It also helps improve Libido.  Progesterone is one of the reasons pregnant women get a crazy full head of hair, and also have to up their leg shaving regimen.  It will boost your body hair growth rate as well.  Not causing new hair, but what's there will come back faster.  So it's a double edged sword.

I'm currently on Progesterone, Spironolactone, and Estradiol Valerate IM.  I haven't had any issue with further hairloss, and I have actually grown some back.  I got some thickening of my hair on the crown from my time on Finasteride (I was on it for about 18 months), which was started 3 months after Spironolactone.  I got off Finasteride as a personal choice after starting Micronized Progesterone, because I don't like taking excessive ammounts of medications.  I have zero libido issue since adding Progesterone.  I'd say my Libido is about on par with pre-hormone therapy (running on Testosterone).

Hope that helps!

Quote from: Harley Quinn on June 08, 2018, 01:22:46 PMSince you mentioned that you're on HRT, Progesterone (not to be confused with synthetic progestins), is also a 5a redux inhibitor as well.  It will help with keeping male pattern baldness under control.  It also helps improve Libido.  Progesterone is one of the reasons pregnant women get a crazy full head of hair, and also have to up their leg shaving regimen.  It will boost your body hair growth rate as well.  Not causing new hair, but what's there will come back faster.  So it's a double edged sword.

This has yet to be proven in studies at doses typically prescribed for progesterone or even physiological concentrations seen in ciswomen, during pregnancy or not. The study that showed 5-ar inhibition was at extremely high levels and in-vitro. I suspect the increased head hair growth is due to estrogen, not progesterone, which is very high during pregnancy and prolongs the anagen phase of hair. It also reduces the anagen phase of hairs on the body. :)

QuoteI'm currently on Progesterone, Spironolactone, and Estradiol Valerate IM.

Usually, IM EV suppresses T on its own but if that works better for you, then good. :) To each their own. I am now on just IM EV without the progesterone and wow, what a significant difference. I feel and look significantly better. :) But, again, everyone is different. And you seem to be responding very well too.

Quote from: Harley Quinn on June 08, 2018, 01:22:46 PM

4). Micronized Progesterone.  Since you mentioned that you're on HRT, Progesterone (not to be confused with synthetic progestins), is also a 5a redux inhibitor as well.  It will help with keeping male pattern baldness under control.  It also helps improve Libido.  Progesterone is one of the reasons pregnant women get a crazy full head of hair, and also have to up their leg shaving regimen.  It will boost your body hair growth rate as well.  Not causing new hair, but what's there will come back faster.  So it's a double edged sword.

I'm currently on Progesterone, Spironolactone, and Estradiol Valerate IM.  I haven't had any issue with further hairloss, and I have actually grown some back.  I got some thickening of my hair on the crown from my time on Finasteride (I was on it for about 18 months), which was started 3 months after Spironolactone.  I got off Finasteride as a personal choice after starting Micronized Progesterone, because I don't like taking excessive ammounts of medications.  I have zero libido issue since adding Progesterone.  I'd say my Libido is about on par with pre-hormone therapy (running on Testosterone).

Hope that helps!

I just figured out what's been happening to me! I noticed LOTS of short(er) hairs growing all over my head. It's been crazy, the rest of my hair has been growing for almost a year and lots of hairs are a 1/4 the length too! I started progesterone almost 3-4 months ago. My leg hair has been growing kinda fast and I have 0 problems with libido so far.
Do you think if I stop progesterone I'll have shedding?

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It is quite possible to shed those hairs if you quit progesterone, but why quit progesterone?

Scalp hair loss is a know side effect for some people with Spiro.  It's listed right there in the side effects on drugs.com.

It certainly was for me.  It only took a few days after I stopped using Spiro for significant and mentally depressing  hair loss/shedding to stop. For me hair on my head is VERY important secondary sex characteristic.  Ranking right up there with boobs in importance.

Quote from: Harley Quinn on June 10, 2018, 10:55:45 PM
It is quite possible to shed those hairs if you quit progesterone, but why quit progesterone?

I don't think I will because I'm scared of losing hair... I just wanted to cut back on meds. I was thinking after my orchi I'd be on just IV estrogen. That would be ideal for me

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My only point being that progesterone, like estrogen, is an active transition hormone. Estrogen and Progesterone work in concert to give you female traits. It's less of a blocker and more of a active role.

I'm not sure that progesterone gives female traits or that it is absolutely essential. I question this, based on my own personal experience and just what I know from this hormone which seems essential for pregnancy, yes but otherwise, not certain.

So far, I'm better without it. YMMV, I guess.