What's the best or safer treatment in longterm for baldness in amab and afab people on masculine hormone levels?

DHT causes miniaturization of hair follicles in predisposed individuals so finasteride and dutasteride, by reducing conversion of T to DHT, help prevent this and baldness. Although finasteride is usually not feminizing, it can cause breast growth in a few and result in impotence in a minority of people (around 15-20%, if I remember correctly, the latest numbers). It can also cause depression/anxiety in a select few. So beware...

Please note, the doses of Finasteride used to treat hair loss are much less than the HRT doses.

Other treatments for male pattern hair loss include topical Minoxidil.

In my opinion, the safest and most permanent way to treat male pattern baldness is by transplanting hair follicles from the side of the head to the top and front of the head. Newer techniques do not require bloody surgery to harvest the donor follicles. There are also robotic methods that can be done on an outpatient basis. It does take about 6 months to regrow the hair in the new areas, so expect to keep the transplanted area covered for a while.

General rule of thumb, if there a a hint of even peach fuzz then finesticide will work. Ideally, in conjuction with a full HRT program including Spiro. If its a shiny and no visible hair, even just peach fuzz, then virtually no chance HRT will work and very unlikly that hair will grow with Minoxydil. Then the only solution is transplants. In Bangkok it costs around 30 cents per hair transplant. I had a friend, cis male, who had moderate mpb, he had 2,000 hairs transplanted. Loss rate is 10 to 20 pct. Now some 3 months later it looks good and growing well.

Quote from: warlockmaker on July 25, 2017, 07:25:47 AM
General rule of thumb, if there a a hint of even peach fuzz then finesticide will work. Ideally, in conjuction with a full HRT program including Spiro. If its a shiny and no visible hair, even just peach fuzz, then virtually no chance HRT will work and very unlikly that hair will grow with Minoxydil. Then the only solution is transplants. In Bangkok it costs around 30 cents per hair transplant. I had a friend, cis male, who had moderate mpb, he had 2,000 hairs transplanted. Loss rate is 10 to 20 pct. Now some 3 months later it looks good and growing well.

Oh thx,  I was talking about prevention but this is useful anyway .

Anyway,  people what treatment is best for solo preventing hair loss, and which ones of these have more feminizing effects and which ones make you sterile ?

Quote from: Dani on July 25, 2017, 06:24:04 AM
Please note, the doses of Finasteride used to treat hair loss are much less than the HRT doses.

Not so. They are often the same or even sometimes, some transwomen take much less as in a study, it was noted that even lower doses reduce DHT to about the same extent.

Quote from: warlockmaker on July 25, 2017, 07:25:47 AM
General rule of thumb, if there a a hint of even peach fuzz then finesticide will work. Ideally, in conjuction with a full HRT program including Spiro. If its a shiny and no visible hair, even just peach fuzz, then virtually no chance HRT will work

I'm confused.  You first say that even with a hint of peach fuzz, finasteride will work and then say even if there is just peach fuzz, it will not work. Which is it??


Finasteride/dutasteride can help prevent MPB and the risk of sterility/feminization is lowest with these. HRT will most likely cause sterilization and greater feminization, unless perhaps you only take a small dose of bicalutamide. Please refer to your doctor for this.

Quote from: KayXo on July 25, 2017, 12:00:16 PM
Not so. They are often the same or even sometimes, some transwomen take much less as in a study, it was noted that even lower doses reduce DHT to about the same extent.

I have to disagree with the first sentence, " Not so."

The original post asked about someone who is AMAB...

The lower dose of Finasteride used to treat male pattern baldness is for men who do NOT want to transition to a more female appearance. 

I am not quoting medical studies. I am referring to prescribing guidelines approved by the FDA.
Please note: I am a licenced Pharmacist, not a research scientist.

For long term baldness you could look into Finasteride and minoxidil as others have said, but are you just looking to prevent baldness or are you actually wanting to transition?

For transwomen, testosterone blockers like spironolactone can definitely help prevent and even reverse some hairloss depending on how far balding has progress. Sometimes Finasteride is prescribed at low doses to supplement and specifically target DHT to help with hair, most people who do this, like me, are either suffering from some baldness or are trying to prevent it when they know they are predisposed. Fin can also be used without a testosterone blocker at higher doses when someone can't or doesn't want to use a full anti-androgen for whatever reason, but it can have an effect on the libido and can cause some minor feminization like gynecomastia.

Typically, a regular HRT regimen of estradiol and spironolactone should prevent baldness in most cases if it isn't onset, but you could discuss adding the fin if you and/or your doctor deems it necessary.

For transmen on testosterone, they can definitely experience genetic baldness just like cismen. They can use the same tricks like minoxidil & Finasteride but will be more prone to baldness like cismen as opposed to ciswomen.

Quote from: Dani on July 25, 2017, 06:26:05 PMThe lower dose of Finasteride used to treat male pattern baldness is for men who do NOT want to transition to a more female appearance.

The higher dose is for men with BPH so if it did feminize, it wouldn't be prescribed to men in the first place. From studies alone, the difference between the lower and higher dose appears to be quite small, in any case as far as suppression of DHT levels go, in tissues, in serum (blood).

Kinda off topic , but is there anyway to de-masculinize without feminizing?  Is that a  safer option ?

Quote from: Undead Cat on July 25, 2017, 10:12:12 PM
Kinda off topic , but is there anyway to de-masculinize without feminizing?  Is that a  safer option ?

Not that's safe.