Hello all,

I am hoping someone here will be able to help me. I am a 33 year old post-op trans woman. Currently, I am taking estrogen injections and nothing else in regards to HRT. My hormone levels seem to be the same as they were when I was pre-op and taking Spiro, which is to say very low testosterone and average estrogen.

However, I am experiencing thinning on my scalp, growing bald spots, and my hairline seems to be receding even more. Someone in a support group I am in suggested I add progesterone to my regime. I had asked my doctor for this before I had the surgery and he refused to prescribe it to me, so I gave it up. I did more research and found synthetic progesterone can cause more hair loss. I have not found anything suggesting non-synthetic progesterone can stop or reverse hair loss though, so I am not sure if it is worth pushing for this again--especially since, again, my doctor already turned me down once. Moreover, I am uncertain how the surgery is playing into my hormone regime and hair loss either. My surgeon, frankly, has been less than helpful since the operation.

This is a huge issue for me though. The hair loss is a bigger trigger for my dysphoria than anything else has ever been, and I am finding myself in a downward spiral that I cannot escape from. I'm desperate for help. So if anyone out there can do that, I'd be forever grateful.

Hi SaphirBlue 🙋 Welcome to Susan's!  I'm Jessica, I'm afraid I don't have an answer for you but I'm certain someone here may.  I see you new so I'll post some links to help you get acquainted with the site. 

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Welcome to Susan's Place. Sometimes the stress of surgery can cause temporary hair loss for some people. If you surgery was recent, that could be the problem. Otherwise, you should discuss this with your doctor. There are other reasons for hair loss such as skin conditions or medical issues and your doctor would be in a better position to diagnosis the reason for your hair loss. There are medications that can aid hair regrowth other than progesterone so you should discuss those with your doctor as well.

You didn't say weather or not you're taking finasteride, but I know cis women are prescribed it to help with hair loss maybe that will help. Have you had you DHT level checked? Also, I second that it could be a result of the surgery.

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If you stopped Spiro, it could be that androgenic effects post-op are *temporarily* greater because even though T and E are the same, Spiro also blocked some T and now that blockage is gone. Just a thought...along with post-op stress...

Please discuss this with your doctor. Hopefully, things will settle soon and you find a solution.

I am unsure of how the thinning is, but I have way less shed on my scalp with progesterone than without.  Progesterone may help the hair loss.  It thickened up my hair on the crown and I shed maybe 8 hairs in the shower.  (yes I count, as I recently quit finasteride.). When I forget to take the progesterone, I lose triple that (or more).

Thank you everyone for your input. I plan to reach out to my doctor again next week. Has anyone had any experience with over the counter topical progesterone creams and oils? Someone else suggested a bioidentical progesterone oil applied to my scalp once a night.

Quote from: Elli.P link=topic=233162.msg2077951#msg2077951 date=1hours 516422672
You didn't say weather or not you're taking finasteride, but I know cis women are prescribed it to help with hair loss maybe that will help. Have you had you DHT level checked? Also, I second that it could be a result of the surgery.

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Elli, I am not taking finasteride. I want to ask my doctor about that as well. I also do not recall my doctor ever checking my DHT level. He seems to just do the basic stuff instead. I do not think he has been helping trans patients for very long. he is really nice and all, and the only doctor that prescribes HRT for trans patients within reasonable distance, but his approach is very cookie cutter and it seems difficult to convince him to stray from it.

Quote from: SaphirBlue on January 19, 2018, 05:33:36 PM
Hello all,

I am hoping someone here will be able to help me. I am a 33 year old post-op trans woman. Currently, I am taking estrogen injections and nothing else in regards to HRT. My hormone levels seem to be the same as they were when I was pre-op and taking Spiro, which is to say very low testosterone and average estrogen.

However, I am experiencing thinning on my scalp, growing bald spots, and my hairline seems to be receding even more. Someone in a support group I am in suggested I add progesterone to my regime. I had asked my doctor for this before I had the surgery and he refused to prescribe it to me, so I gave it up. I did more research and found synthetic progesterone can cause more hair loss. I have not found anything suggesting non-synthetic progesterone can stop or reverse hair loss though, so I am not sure if it is worth pushing for this again--especially since, again, my doctor already turned me down once. Moreover, I am uncertain how the surgery is playing into my hormone regime and hair loss either. My surgeon, frankly, has been less than helpful since the operation.

This is a huge issue for me though. The hair loss is a bigger trigger for my dysphoria than anything else has ever been, and I am finding myself in a downward spiral that I cannot escape from. I'm desperate for help. So if anyone out there can do that, I'd be forever grateful.

Hi,
From my experience and from what I learned and know about hormones, estradiol injections (took them as well) cause high (meaning too high) levels of E which, in turn, cause spike in Prolactin, other hormone, which then might be processed into DHT-male hormone causing hair loss and male pattern baldness. That might be the case, at least mine was that. Once prolactin levels went down I stopped losing so much hair and now its fine now, hair is regrowing, although I regret the injections and messing with estrogen dominance and estrogen:progesterone ratio. Hope this helps.
Ps. I know levels in pregnant women go up to 75,000 pg  but I don't care, I just want my hair

I too am Post-op and I still take Finasteride because hair thinning on the top of my head is genetic and I have a significant amount of thinning on top. Even though my Testosterone level is very low, I don't want any DHT in my body at this time.

OK, maybe I am overreacting a bit, but right now I just do not want to chance losing any more hair from the top of my head. My doctor agrees that I am a bit obsessive about this, but she says that since there are so few of us in this situation, there is little data on effectiveness. The safety data seems to indicate no additional risk, so she lets me continue with Finasteride.

I am considering hair transplants as a permanent solution to the thinning hair on the top of my head.

Quote from: lauraf on January 22, 2018, 02:36:43 PMFrom my experience and from what I learned and know about hormones, estradiol injections (took them as well) cause high (meaning too high) levels of E which, in turn, cause spike in Prolactin, other hormone, which then might be processed into DHT-male hormone causing hair loss and male pattern baldness.

As far as I know and read, the conversion from prolactin to DHT is inexistant and there is no such thing. Please double check this info with your doctor.

I was on injections too and my prolactin levels were very high, around 80-130 ng/ml, typical of those observed during pregnancy. My body hair growth slowed and thinned down significantly during that time. Also, there was absolutely no scalp hair loss despite very high levels of estradiol as well, up to 4,000 pg/ml.

If that were the case, pregnant women would experience significant virilization issues which is not the case. In fact, it is often during that time that women have thicker and longer hair.

Quote from: Dani on January 22, 2018, 09:28:47 PM
I too am Post-op and I still take Finasteride because hair thinning on the top of my head is genetic and I have a significant amount of thinning on top. Even though my Testosterone level is very low, I don't want any DHT in my body at this time.

OK, maybe I am overreacting a bit, but right now I just do not want to chance losing any more hair from the top of my head. My doctor agrees that I am a bit obsessive about this, but she says that since there are so few of us in this situation, there is little data on effectiveness. The safety data seems to indicate no additional risk, so she lets me continue with Finasteride.

I am considering hair transplants as a permanent solution to the thinning hair on the top of my head.

I managed to get an appointment with my doctor for next week. I plan to bring up both progesterone and finasteride. I'm not sure he will be willing to prescribe both, or even either, but I really want to try at least one. Thinning runs in my family on both sides too. My mother has the same issue, though her thinning didn't start until later in life (around her late 40s) than mine (early 30s), which is no doubt due to the double whammy that is male pattern baldness. May I ask: do you take progesterone as well?

If you noticed, I posted a similar thread regarding hairloss in another forum section (post operative life) about hair loss as well.

I am also experiencing the exact same thing! My hair is thinning and its been 3 years since my srs. Pre srs my hair was thicker and voluminous but then post srs my hair started to deteriorate. My hair turned into dry and brittle which makes me shed more than before. I still have hair now and still no visible bald spots (and FYI I am only 27 years old). However, my hair is so much thin now than before. I also almost no T in my blood levels whenever I check it and started taking finasteride thinking it maybe the DHT but I stopped it after a week as I noticed more shedding afterwards.

I am also clueless whats happening to my body. I am on HRT for 6 yrs already. Now I am trying to lower my E dosage intake. I noticed that post srs I increased my E intake way way above the normal dosage range due to my mood is messed up if I take lower dose. I read somewhere that high E could also make your hair really dry and brittle so I am thinking that this could be the culprit.

I am taking biotin on the side for 3months now but I haven't noticed any effect from taking it. I am really puzzled by this and I am hoping more and more case like us would appear in this forum so that we could all figure out what was happening.

PS: I also started to dye my hair the year I had my srs until now (always done in professional salon and always do hair treatments). I am also thinking that it could be the culprit too but I also think why others have healthy hair even when they also dye their hair.  Do you dye your hair?

Quote from: chinee on January 23, 2018, 03:39:05 PM
If you noticed, I posted a similar thread regarding hairloss in another forum section (post operative life) about hair loss as well.

I am also experiencing the exact same thing! My hair is thinning and its been 3 years since my srs. Pre srs my hair was thicker and voluminous but then post srs my hair started to deteriorate. My hair turned into dry and brittle which makes me shed more than before. I still have hair now and still no visible bald spots (and FYI I am only 27 years old). However, my hair is so much thin now than before. I also almost no T in my blood levels whenever I check it and started taking finasteride thinking it maybe the DHT but I stopped it after a week as I noticed more shedding afterwards.

I am also clueless whats happening to my body. I am on HRT for 6 yrs already. Now I am trying to lower my E dosage intake. I noticed that post srs I increased my E intake way way above the normal dosage range due to my mood is messed up if I take lower dose. I read somewhere that high E could also make your hair really dry and brittle so I am thinking that this could be the culprit.

I am taking biotin on the side for 3months now but I haven't noticed any effect from taking it. I am really puzzled by this and I am hoping more and more case like us would appear in this forum so that we could all figure out what was happening.

PS: I also started to dye my hair the year I had my srs until now (always done in professional salon and always do hair treatments). I am also thinking that it could be the culprit too but I also think why others have healthy hair even when they also dye their hair.  Do you dye your hair?

I also started dyeing my hair after SRS and this could well be the reason for hair thinning regardless if done at home or at a salon. Estrogen alone makes my hair very dry, gets tangled very easily and brittle. Adding progesterone softens it up significantly, makes it looks shiny and detangles it, making hair much more manageable and less dry. A little testosterone softens it up but also makes it oily faster and I need to wash more often.

My experience!

Quote from: KayXo on January 23, 2018, 09:11:41 PM
I also started dyeing my hair after SRS and this could well be the reason for hair thinning regardless if done at home or at a salon. Estrogen alone makes my hair very dry, gets tangled very easily and brittle. Adding progesterone softens it up significantly, makes it looks shiny and detangles it, making hair much more manageable and less dry. A little testosterone softens it up but also makes it oily faster and I need to wash more often.

My experience!

oh my gosh then! I guess this is why most of the transgirls I know with healthy hair are all have natural hair color and never dyed their hair! I also take progesterone in smallest dose and cycling it 10days a month. I also notice my hair to shed less and feel less dry when I am on it. However, the problem is when I take progesterone everyday (without cycling), I get more fat in abdomen area and kinda defeminizing me in some ways. I ready too much progesterone can masculinize you this is why some pregnant woman gets unwanted hair in their body sometimes.

I tried dying my hair black (my natural hair color) but I feel ugly after and felt more dysphoria / anxious so I dyed it lighter again the next week.

Quote from: chinee on January 24, 2018, 12:55:53 AMHowever, the problem is when I take progesterone everyday (without cycling), I get more fat in abdomen area and kinda defeminizing me in some ways. I ready too much progesterone can masculinize you this is why some pregnant woman gets unwanted hair in their body sometimes.

Progesterone as far as I know, from studies and all, doesn't increase testosterone or trigger androgen receptors. But, it is somewhat anti-estrogenic and this is why it can perhaps "defeminize" as you say. I kinda have a weird relationship with progesterone, love and hate relationship! Still on the fence about it, right now stopped taking it altogether.

Henna can be better, less damaging to hair but it takes longer to dye.

Has anyone tried xstrands from the Hair Club? It's not a permanent solution the way a transplant would be, but maybe it could work long enough for hair to regrow via medication? I've seen a lot of bad reviews though.