Stopping HRT to stop hairloss

[ciacia]

WARNING : Trigger topic

Hello all.
I am writing this post to ask about stopping testosterone.
Here is my story: I am 26 years old and I have been on Nebido shots from July 2012 till December 2018. In January I took one of the two testosterone enanthate I have taken so far, with the second being a month ago. Now I want to stop testosterone completely because it is ruining my hair, something I love too much and I would not like to lose. I also don't want to get any periods.

My question is this:
Would birth control pills be beneficial to me to stop periods while keeping my hair?

I will ask my endo about this, but I would love to read any tips/experiences.

Thanks!

[Dena]

Welcome to Susan's Place. There are progesterone based drugs that will suppress your period without affecting your hair growth. On the other hand, if you're worried about hair loss, there a couple of other drugs that are used by men to prevent hair loss. These are routinely provided to FTMs who feel the same way you do. Explain exactly what you desire to your endo and it should be possible for your medication to be adjust to meet your needs.

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[ciacia]

Thanks for your reply.
I am not sure if I would be breaking the forum rules but I am giving it a go anyway.
I went to my endo today and he recommended Yasminelle. I was a bit concerned about the high risks of this pill and I went to a GP with whom I discussed my fears. She recommended me to get Mirena IUD. However, I am again concerned about an IUD not being able to keep my period away.
Does somebody have any suggestions please?

[Dena]

The problem I see with Yasminelle is that it's estrogen based and might increase your dysphoria. I did a little searching and the one you should discuss with your doctor is Depo Provera. It's an injection and it last about 3 months. Finasteride is a pill that prevents hair loss when you're on testosterone though topical medications like Rogaine/Momoxidil are also things to consider.

Make sure you endo is fully aware of your trans status and how you want to deal with it as that will determine the medication that should be use. If you plan to remain off testosterone, Depo Provera might be the best choice. If you plan on resuming testosterone and wish to preserve your hair line, that will require a different approach.

[skipulus]

As for the Mirena IUD
I have been on it for 14 years since I had my son and it stopped my periods. it is progesterone so won't affect your T vs E hormones.

It is not guaranteed to stop your periods but they will at the very least be greatly reduced.
You could also consider a hysterectomy to stop the whole ovulation system to start up again. That would also reduce the feminisation that will happen from stopping T.

Perhaps you know this but I want to make sure that you are taking it into account that;
stopping T, if E is not blocked, will start a de-transition, i.e. you will start to become more feminised. It won't turn averything around but neither will you just remain static whith the masculinisation that you already have.

[ciacia]

Thanks both for your reply.

Actually detransitioning is not something that I fear. I mostly regret even going on T now, to be honest, and I wish I had stopped before. I never hated my body and I only hated that time of the month as besides identifying as male, it was always very heavy and I used to stain a lot of clothes, not just underwear, which sucks, of course. Surgery is something that I fear so it is not an option for me. Additionally, I am more on the androgynous side and I am personally gay too, so being effeminate is not what I consider the exception in both these worlds. In addition, T did not really change my breast size - they only become more tender but the size is still there. I was also considering means to elimate my body hair forever and I am not too fond of my beard either. I also gained more than 30 kilos while on T, while maintaining the same sort of lifestyle more or less.

I have an appointment with a gynae next week to discuss the options. I am more interested in the IUD and I wish I knew about it before. Saving my hair is my topmost priority right now. I probably will never have the lovely thick hair I had since childhood until I was around 3 years on T but I could save what's left. I also considered the costs and the IUD is way cheaper than Depo Provera and T, of course. I almost spent 4000 Euros on T and I wish I had saved that money.

Additionally T caused problems in my skin and it became very dry as I cannot keep up with the amount of water I have to drink to make up for the amount of sweat lost. In summer I mostly stay indoors and I sweat too much that my eyes often become red. T even made me more anxious and also contributed to having more stomach problems.

Thanks again. I will post updates next week just fyi.

[skipulus]

You are still quite young, I think your hair may still have a chance, since you intend to stop T altogether. There are a lot of products around, I'm no hair expert but the roots could be revivable.

I'm a bit surprised by choosing T mainly to stop periods in 2012?
I went on progesterone UID in 2004 and it was not new then.
I know they often do offer it to young trans men in order to stop periods as a first step before hormones because it is completely reversible. It can also be in a pill or a slow release depot.

That was already being given in the 90s. In fact I was on a progesterone pill in the 90s.
Did none of the doctors, GP, Endocrinologist, etc. suggest that?

[ciacia]

Thanks for your reply and encouragement. I have taken my last shot of T a month ago and I was due to take another one a week and a half ago, so yes, I am off T for a week and a half technically. My hair has receded quite a bit since I started T and most of it is very thin now but I hope I can recover most of it, since the follicles are alive even though the hair is thin.

Unfortunately, the three endos who prescribed me T never gave me other options and actually the first one wanted to put me on T pills instead of shots. I knew from the internet that these could cause liver damage, so he put me on Nebido instead. The first endo also never took any blood tests before prescribing me T and I only had just one session with him before being told to go to a different endo. The second endo ordered several blood tests, ultrasounds and genetic tests through the years but still continued to prescribe me Nebido, without considering other options. The third endo just changed the type of T to enanthate, without doing any blood tests and the last blood tests I took under the previous endo where done five months before.

In addition to not being aware about other options and the whole range of side effects of T, as none of the doctors I went to so far informed me about them, I was suicidal after being on T for around 4 months and I was hospitalised. The same psychiatrist who confirmed I have gender identity disorder visited me at hospital to check my condition, but he never suggested to go off T. Additionally I only had just two sessions with him before he told me to go to the first endo.

The third and last endo I visited was through a specialised service for trans people but he also cancelled a future appointment with him since I went off T. I find this really odd because I think blood tests and general health checks should be provided anyway. To discuss different options to not have my period back I went to a GP who referred me to a gynaecologist. Also, the endos I went to never set up a gynae appoinment. It's odd, really odd.

[skipulus]

It is odd for any doctor to not discuss what a medication is for and the main effects and side effects.

Generally, with HRT it is a voluntary treatment, i.e. it is something that is initiated by the patient rather than the doctor.
An exception is for example if a male is found to have below normal T then the doctor will suggest HRT for him.

When a patient requests something that is life altering then the doctor is under increased or elevated obligation to ascertain that the patient is aware of the possible effects of the treatment. Judging by what you say that should have been the psychiatrist in the first instance and he should have had the initial blood tests done.

He should have made a thorough assessment as to why you wanted to go on T and what you hoped to achieve.
If the only reason you gave was to cease having periods then I would have expected him to send you to your GP in the first instance who could then refer to a gynaecologist if relevant. GPs prescribe Progesterone pills which are the female contraceptive pill that significantly reduces or stops period bleeding. It is how they work, i.e. the Progesterone pill or UID will stop the build-up of the uterus lining by blocking the egg from attaching to it. It is this lining that causes bleeding when it detaches at the end of the cycle.

If the Endos' were told that you identified as a man and wanted to live as a man and have T then I see nothing odd about them continuing to prescribe you T.
If the blood tests and scans all come back with normal stats then they would continue to prescribe T since they had no reason to cease.

On the other hand, if they were told that all you wanted to do was to not have periods, whether by you or the psychiatrist, then I would be surprised if they even wanted to see you and not just referred you to your GP.
If it is the case that you explicitly stated that all you were trying to achieve was to not go on periods then the doctors who prescribed you T for that are liable.

Young women not wanting to be on periods is very common. In fact, most women don't care to have periods except when they are trying to conceive.  This is why the use of progesterone based contraceptive is quite popular by women who can tolerate it and it is quite safe too.

[ciacia]

Thanks for your reply.

I discussed with the psychiatrist that I wanted to live as a man, but I believe that these things would have taken more sessions. As said, I was not aware of the side effects so I believe I should have been informed. I guess that even though is a bit too late to reverse most of the changes, I guess it is better than never. At the time I didn't know about other options so I saw T as means to get rid of my periods more than anything else. I remember seeing videos of other ftms and I totally hated seeing the body hair, something which I also hate on myself, for example.

The psychiatrist never ordered blood tests and in the initial session he just told me that I should write a letter explaining why I would like to live as a man. In the next session he said that I convinced him and he sent me to the endo. Mind, I don't hate living as a man, it is the changes T caused that I hate. I, for example, will still keep my chosen name and gender marker on my documents. However, even after almost 7 years on T, there were instances in which people referred to me as a woman and even sent me to the girls' bathroom, even though I don't express myself as a woman, so I believe T did not increase my chances to pass. Nobody discussed the effects of T with me and the first endo was told that I want to live as a man only through a phone call in my presence.

Thanks for your help. I will keep this thread updated.

[Jared]

Hey,
I can't give advice regarding hormones, I just would like to mention that I was also prescribed Nebido, because it's the only injection I can get in my country. Or pills which I didn't want, and now there's gel.
I also started to thin around the 6 year mark. Now i'm trying gel to save what's left.
I also wasn't informed about the affects of hormone therapy, I had to look it up, or rely on friends experencies.
Good luck to you!

Tapatalkkal küldve az én Redmi 6 eszközömről

[Dena]

What I can add is MTFs sometimes get a surprisingly large amount of hair regrowth once they start on testosterone blockers. In addition, they tend to lose much of the body hair that they have. As you have only been on T for a relatively short time, I would think that you could see much of the lost hair return. It may take between a year or two to determine just how much will return so be patient about evaluating your results.

[ciacia]

Thanks both of you for your input.

@Dena
So far I have no visible bald spots and most of my hair is really thin, even at the back. However, there is a part on the left front on which few hairs grow. Under a bright white light, this area and most of the left side of my head looks horribly thin. I hope that I can get some thick hair back. Do you think that adding low light laser therapy would help me, or should I just rely on my natural estrogen?

I would like to add that:
- my voice still sounds feminine most of the times,
- I still have the medium sized breasts I had pre-T, although they are a bit softer,
- I still have a feminine face with a beard, though. I noticed a thinning beard quite a while ago and I only have to shave once in 10 days more or less.
- I have a bunch of body hair, though I noticed it thinning as of last summer. I found this weird and asked my endo about it. He didn't have a look at at least my thinning leg hair. I read that the thinning is a side effect of steroids but I am not quite convinced. That said, getting rid of most of my body hair is my goal now.

My latest blood test which was taken before a shot of Nebido was due back in August shows that my Oestradiol was at 145 pmol/L and my testosterone at 9.12 nmol/L. Between then and the beginning of March I took 2 shots of Nebido and 2 shots of testosterone enanthate. How long would you think that I can start seeing some femininisation, please? Also, does testosterone alter anything else permanently beside enlarged clitoris (which mine is still relatively small) and facial hair growth? Is the breast tenderness reversible? (I found confusing information about this) Also does T cause changes in bone structure?

Thank you in advance.

[Dena]

I would think at your age, most of your bone growth would have ended. Bone growth can only happen if the bone hasn't capped and that should normally happen in puberty but I had some bone growth into my early 20's. You should be beyond that point. As for feminization, what you will see now will come from fat redistribution. In MTFs it can take a year or so before it starts to become noticeable. In your case, it should be a return to your normal appearance. One exception is T can cause water retention and that may leave much faster.

As for low light laser, that's something that I am relatively new to and I don't know enough to answer your question. If it were me, I would wait to see what happens without it then try it only if needed.

[ciacia]

Thanks so much for your tips.

I have this one last question: would my body be able to lower my testosterone and increase my estrogen naturally, without any initial estrogen boosts?
I am kind of curious to know if my T hasn't gotten any lower, since in three days it will be my third week since I was supposed to take another shot of T, so I think I will ask for a blood test soon.

Unfortunately, even though I went to the gynae earlier this week, I was told that I cannot be examined. This is because trans health care in my country has a separate clinic since late last year but gynae services won't start before summer. Since I still technically fall under the trans clinic, I couldn't be examined at a regional clinic and I therefore have to wait for a while before I get an IUD. (Just a small update).