Darolutamide (odm-201), A Better Topical Than Enzalutamide?

[IdealForehead]

A woman with PCOS, well any woman for that matter on Diane35 is exactly the same as me whilst we are all taking that pill. There's no underlying hormonal activity when you are taking the pill. It totally blocks the release of gonadotropin hormone, so it is ONLY the progetstins and EEs inside your body. All other female hormones are 100% suppressed, so his opinion there is very valid. It wouldn't matter if i had normal hormone production whilst taking the pill. It would be wiped out anyway. There's simply no such thing as having protective natural hormones underneath synthetic hormone replacement.

I do see where you are coming from. I have been doing a lot of research about bodily tissues requiring particularly 17B in order for oestrogen receptors to be properly activated. It's part of why i tentatively decided to try a topical 17b.

I have to apologise as i have been wrong about something. Indeed, prometrium is a low androgen index progesterone, and shouldn't elevate levels of 17-OP. I did read a few studies where women with both adrenal and ovarian androgen over-production took this micronised version of progesterone and saw no negative elevations in serum dheas or 17op. This may indeed be an option for me.

I worry about what cycling the hormones will do to me. I believe that the dosage recommendation is 12 days continuous use 200mg within the 28 day cycle. I remember when i began bleeding again in 2015, my hair would shed EVERY SINGLE TIME it happened. I feel like my body is now just totally ruined and can't respond to hormonal fluctuation normally. It just freaks out. I don't know. There's also the issue of the very minimal dose of oestrogen that i would be taking - 2mg. My gyn said that would be that max i could take, and i would be afraid to go against his word because well quite frankly i don't want to get cancer.

For now, i only have a prescription for progynova and prometrium. I would need to get prometrium from somewhere if i did want to try this, because there's no f*****g way in hell that i am ever touching provera. Else i just come off the pill and let the chips fall where they may, perhaps just use a topical estrogen.

First off that's not entirely true about estrogen levels on the birth control pill. Yes natural estrogen levels will go down, but they will not completely disappear, and should in fact stay in the normal range.

Here is the best research I can freely find available illustrating this:

"Estradiol levels in women receiving oral contraceptives were low, usually in the range of 20-30 pg./ml., similar to those found in the early follicular phase in ovulatory cycles, and significantly higher than levels found in postmenopausal women"

https://www.ncbi.nlm.nih.gov/pubmed/4645131​

This study used mestranol which is an old estrogen apparently but equally potent to ethinyl estradiol:

"Indices and dosages showed ethynylestradiol and mestranol to be essentially equipotent under these experimental conditions"

https://www.ncbi.nlm.nih.gov/pubmed/1146928​

In the first study, they were using 100 mcg/day of mestranol, which is then equal to 100 mcg/day of ethinyl estradiol, ie. Almost three times as much as you're getting from your Diane 35. (From what I read, back in the 60s and 70s the doses on birth control pills were insanely high.)

And yet despite these mega doses, the women still had levels of their natural estradiol within the normal monthly range for healthy women.

So normal women who take birth control are NOT the same as you. You have NO natural estrogens. And that is the problem. NO natural estradiol. NO natural estriol. NO natural estrone.

You are relying completely on ethinyl estradiol while other women who are not menopausal will still have all their regular hormones as well, just in lower baseline levels.

If your gyne has told you "Diane 35 will 100% suppress natural estradiol/estriol/estrone" and that "you are the same as any girl with PCOS taking the pill" your gyne is giving you bad info because that's not true.

As for your concern about cancer, you'd have to clarify what exact type of cancer you are worried about getting. If it is endometrial, that's only a risk if you don't bleed or use a progesterone (IUD or prometrium) to keep the lining thin. If you're talking about breast cancer, or just general cancer in the body being induced by the estrogen, again, the goal is not a given # mg to take a day or to megadose. The goal is to have normal blood levels for your age and gender. Once you have normal blood levels, you are taking the proper amount, and you are at no higher risk of "cancer" than you would have been if you had never gone through menopause already.

The dose conversions for bioidentical hormones can easily be done to compare to 2 mg estradiol. I did them before for you and can do them again. The total dose (# mg) for bioidentical hormones will be higher, because estriol and estrone are so weak, but the total estrogenic effect can be standardized to 2 mg estradiol easily enough if that makes you comfortable as a starting point.

If you don't want to cycle and want the safest approach with the lowest effective systemic progesterone levels, go for bioidentical estradiol/estriol/estrone tablets with the Skyla/Jaydess IUD. Keep the topical antiandrogens if you're worried about the 1.2% of risk of hair loss with the IUD from the very weak androgenicity of the progesterone. Any topical antiandrogen should be able to block something that weak easily.

Again, titrate the dose of the estrogens to NORMAL BLOOD LEVELS that you SHOULD HAVE ANYWAY and you will just be back to being a normal girl hormonally, ie. How you were before menopause. You aren't going to grow tumors all over your body just for putting the hormone levels back to where they were 4-5 years ago. That's where the levels belong.

The fact that your natural hormones are all missing and you are not replacing them properly is almost certainly why you're such a mess.

 

[SteveTabernack]

Hey Guys,

Just thought I'd come back to say hi because I'm about to have my forehead reduction next week and frankly I'm anxious as hell about it! Oh god am I anxious. I've expanded the balloon in my head to 550 mL as of today. Thank god for fedoras. That's what I've been wearing to cover it which has been working well enough. Everyone just thinks I'm being "quirky". I'm hoping for a Bieber-tier hairline after the surgery which should be pretty cool if possible. At minimum a sort of Christian Bale level hairline which is great too.

I've been trying not to think about hair at all the past few months because this has been stressful enough without going on a hair forum where everyone is unhappy and obsessing with hair 24/7. I also haven't really had much to say anyway since for me it's just been "steady as she goes".

Anyway, haven't read all the pages of recent posts. Just read a few posts on this page and I am so surprised anyone is still having trouble with this stuff. This has been a game changer for me and it continues to perform beautifully. If it's any help I can provide some updates and further perspective.

My current composition is:

- 40 mL Kirkland minoxidil 5% (base)
- 80 mg darolutamide
- 2 grams niacin
- 0.4 grams desloratadine

I apply 2 mL at night after showering and 1 mL in the morning.

In the past week I took out the minoxidil because I don't want that on my scalp during surgery (bad for collagen and healing). I have instead been using a custom base of 20 mL propanediol, 12 mL of ethanol, and 8 mL of water instead. My daro dissolves almost as well in that base as it does in Kirkland minoxidil (just noticed a tiny mist of powder at the bottom which never happened with Kirkland). Propanediol is so much nicer on the scalp than propylene glycol.

I also, despite my dislike of minoxidil, have continued taking 2.5 mg oral minoxidil or so on average a day (sometimes 5 mg, sometimes 0 mg) for the past few months to get the max regrowth pre-surgery. Stopped that last week also in anticipation of my final surgery.

Lastly, in the past 2 months, I gave into @bridgeburn 's logic and affection for estrogen at the frontotemporal regions and bought some over the counter estriol cream (this stuff). I've been using it to my temples and corners to stimulate regrowth and also all over my face for anti-wrinkle, anti-eye-bag, and anti-minoxidil-damage effect. There's maybe a very mild sexual side effect from the estriol in this high a dose, but I'm using quite a lot given the area I'm covering. If I just use it at the corners and hairline alone I don't notice any negative effects.

The estriol has been clearly very helpful and encouraging further terminalization of the vellus hairs that have been coming back. I wish I would have started it 6 months ago. Good adjunct for sure. Just realized my bottle is empty so gotta order more. It has definitely helped for the eye bags too from what I can see.

As for darolutamide, at the dose I'm using, I no longer have significant dry skin or eyes. I'm tolerating it just fine. I don't shed hair. My dad who has been doing my expander injections last week said spontaneously to me, "Wow, your hair is so thick," and told me it looks much better than 6 months ago. A female co-worker at work 2 weeks ago, after talking with her about why I was wearing a fedora the past few weeks (I just tell people "I had some scalp surgery" without clarifying), told me it was too bad I was wearing a hat because I have "beautiful hair" and asked me if anyone has ever told me I should shave it and sell it so they can make a wig, and that she would buy it. I laughed of course.

My point is, the stuff is working perfectly for me. I couldn't be happier with it. I don't know why it wouldn't work for someone else unless:

- You do not have darolutamide.
- You are not using enough (my hair loss was never aggressive, took 10 years to get to a real NW2.5 - others might need stronger doses to get the same blockade).
- You are not suffering from androgenic alopecia.
- You have unrealistic expectations and think blocking androgens should magically cause massive regrowth (doesn't work that way).

For me this is now coming up on 5 months of use, and I am fairly certain I will continue using darolutamide until the day I die. On my to do list is just to get a sperm test out of curiosity, and also source some regular testosterone cream to put on my dick to prevent this. I've got a source for the test cream - just haven't got around to ordering it. Will do after surgery.

I also note there are some questions in the thread about purity. I don't know where anyone else had their sample tested or what quality of lab it was done at. I also don't know if anyone else's shipment was as pure as mine.

But I had mine tested at one of the probably top 50 labs in the world using multi-million dollar NMR equipment. It cost me a few hundred dollars. This level of testing would have probably cost thousands otherwise, but it was an academic institution with partial federal funding so I think they have to offer public service at a good rate based on that.

My sample tested perfectly at 98.82% purity. Just FYI, if you are doing NMR purity testing, it is essential you get it done at a very good institution, as NMR purity testing is far more subject to variation and error than HPLC testing with a known standard. Even my test had a +/- 4.7% error and this is using among the best NMR equipment in the world.

To do HPLC with a known standard instead, you can avoid some of this error, but you'd have to order an ultrapure tiny reference sample like from Sigma Aldrich or Cayman Chem for $500+ and use that as a reference. It's not realistic or viable to do, so NMR purity is the best we can assess. My lab's results matched Luo's claims of purity.

Another point to keep in mind if you are getting purity testing done is you must be very careful that you don't introduce any impurities based on how you have handled the sample. My first shipment of daro was opened at the lab I got it tested at. I never opened it before. It was still sealed upon bringing it to the lab. If I were to test the same bag now the purity would likely be much lower because I'm always sticking a tiny spoon in there which likely has been introducing contaminants. So if you get something tested, don't open it use it first. Open it at the lab and use clean/sterile equipment to take out the test sample.

I wasn't planning on testing any further batches after that, especially since everything is going so well for me, but perhaps I'll get it tested next time I order just to confirm there's been no change in the quality of the product. When I first talked to Luo I think the documents he sent me suggested he had a batch of 300 grams, so I presume we are all receiving daro from the same batch and should have the same quality of product.

Just for reference, if anyone's curious, here are a few excerpts of NMR findings from my lab's analysis with the names/dates/location of testing redacted. The full documents are over 25 pages, so I am just posting key points.

Structure was confirmed by both proton and carbon NMR. Here are the carbons:

View attachment 82937

Purity was assessed as follows using a known quantity of pure dimethylmalonic acid as a reference compound (standard technique):

View attachment 82938
Final assessment was 98.82% +/-4.7% pure:

View attachment 82940

I also noticed some comments above where people are still talking about RU. That's fair if people want to keep playing around with RU. But please keep in mind, RU is a joke compared to this stuff in every conceivable scientific way. If you are not succeeding on daro, you need to see the points of concern I listed above. Going to RU is not going to be stronger. RU will never will be nearly as effective. Again, if you question this, refer to the strength and half life comparison here:

https://www.hairlosstalk.com/intera...conversion-of-ru58841-to-darolutamide.109065/

I have 60 or 80 grams of RU sitting in my living room which I will likely throw out as I have no need for it. I would mail it to someone for free but I don't want to be liable for doing that, so sadly it will go in the trash. RU slowed my hair loss down for 2 years but it was still a losing battle. Daro stopped it dead and in company with some good growth stimulants I've had steady regrowth. I've got my sister who has PCOS switched over to daro as well now.

If I have any regrets it's just that I didn't find this regimen sooner and that I couldn't have another 6 months to really max my regrowth at the corners before my final surgery next week. But well, nothing is perfect in life. This is pretty good for me.

All I can say is I hope you guys can all find the same level of success. Be patient and keep trying and hopefully you'll get it under control too.

Hair loss is always treatable and we've never had more agents to treat with than we do now.

So in all you're applying 6 mg of daro a day, correct? I'm not seeing success doing 3 mg but just at this dose the eye sides are quite annoying and not great for aesthetics (eyes become red)

How paramount do you reckon twice daily application is? With the presumed long half life through skin application conventional thinking would have it be redundant.

 

[jonnywalker93]

Just something that popped up in my mind whilst reading through Ideal's post:

Currently, we are all doing very low doses. Given the fact that it works for Ideal and his hairloss is not aggressive at all, one might assume that arresting hairloss with Daro takes longer for guys with aggressive hair loss. Furthermore, we are doing very low doses, so maybe we are just at the point where Daro is has effective as Finasteride (and therefore it may take several months to work).

I had some very concerning side effects the other in day the form of heart pain and a numb feeling in my left arm, so I stopped applying Daro and they disappeared. To avoid any early conclusions, I'll give it another go today to check if it is definitely the Daro or if it was something unrelated.

 

[Georgie]

Just something that popped up in my mind whilst reading through Ideal's post:

Currently, we are all doing very low doses. Given the fact that it works for Ideal and his hairloss is not aggressive at all, one might assume that arresting hairloss with Daro takes longer for guys with aggressive hair loss. Furthermore, we are doing very low doses, so maybe we are just at the point where Daro is has effective as Finasteride (and therefore it may take several months to work).

I had some very concerning side effects the other in day the form of heart pain and a numb feeling in my left arm, so I stopped applying Daro and they disappeared. To avoid any early conclusions, I'll give it another go today to check if it is definitely the Daro or if it was something unrelated.

I’m using the same dose as ideal. Nada. Also get sides.

 

[IdealForehead]

I’m using the same dose as ideal. Nada. Also get sides.

Yes, but as listed above you have also failed to respond sufficiently to a long list of very powerful antiandrogens - cypro, daro, duta, and spironolactone.

This therefore does not represent any particularly unique failure of daro in your case, which just like all the other anti-androgens is almost certainly doing its job of blocking androgens.

The total failure of anti-androgens as an entire drug class in your case suggests again that although you can and probably should certainly still continue some antiandrogens for insurance, androgens are not your biggest problem, and by process of elimination, that leaves your estrogens/progesterones as the most probable primary cause of your ongoing loss.

 

[IdealForehead]

Just something that popped up in my mind whilst reading through Ideal's post:

Currently, we are all doing very low doses. Given the fact that it works for Ideal and his hairloss is not aggressive at all, one might assume that arresting hairloss with Daro takes longer for guys with aggressive hair loss. Furthermore, we are doing very low doses, so maybe we are just at the point where Daro is has effective as Finasteride (and therefore it may take several months to work).

I had some very concerning side effects the other in day the form of heart pain and a numb feeling in my left arm, so I stopped applying Daro and they disappeared. To avoid any early conclusions, I'll give it another go today to check if it is definitely the Daro or if it was something unrelated.

Unfortunately I have nothing to tell you or anyone else about the individually useful dose of daro for other people. Yes, I am applying around 6 mg daro a day and after a while on this dose I have no obvious side effects of any kind.

If you want a baseline for how well an anti-androgen can generally work, I think you should look at dutasteride, which has an almost 100% success rate in stopping hair loss in men and over 90% success rate in stimulating regrowth by the 6 month point.

As far as I know dutasteride should still not be expected to cause magic results within 1-3 months, and most guys will never get massive regrowths like we all fantasize about.

Even after 5 months now in combination with oral minoxidil and other agents my regrowth is nothing to freak out over. The deep thinning thickened up quickly. But when it comes to the nw2 corners which have been dying slowly over the past decade, it's still fine regrowth which is only very gradually terminalizing month by month. I'm not one of those incredible rapid before/afters like the nw5 to nw1-2 examples in 3 months we have on this site. Those people are genetically lucky freaks for whom scalp fibrosis never occurs, and thus their follicles can just spring back to life easily as soon as they start a good treatment. If your follicles are scarred and dead, there is no antiandrogen that will spontaneously cause them to rapidly regenerate. This goes back to expectations which I was discussing earlier.

Just like any antiandrogen, the goal should be ideally cessation of loss within 3 months or so and some mild degree of regrowth of recently lost follicles by 6 months. This has nothing to do with the individual antiandrogen you're using and everything to do with the natural duration of hair follicle growth cycles. If you get more than that faster than that, consider yourself lucky, as you're one of the 5% or so of guys that are "high responders". But that's beyond anyone's control.

As for application the stuff I calculated for scalp half life was all based on a number of assumptions that I cannot truly know to be true or false. So in my opinion, especially at the front hairline, since I don't find application all that arduous, it's worth still doing twice a day to be sure. We have no formal data on this compound for topical use in hairloss. The only way for me to know if once a day truly works as well would be to do once a day for another 5-6 months and compare and I can't take the chance. So for now I continue twice a day.

 

[Georgie]

Yes, but as listed above you have also failed to respond sufficiently to a long list of very powerful antiandrogens - cypro, daro, duta, and spironolactone.

This therefore does not represent any particularly unique failure of daro in your case, which just like all the other anti-androgens is almost certainly doing its job of blocking androgens.

The total failure of anti-androgens as an entire drug class in your case suggests again that although you can and probably should certainly still continue some antiandrogens for insurance, androgens are not your biggest problem, and by process of elimination, that leaves your estrogens/progesterones as the most probable primary cause of your ongoing loss.

You are focusing entirely too much on ONE issue here. Yes, I have hormonal issues, but every single piece of written data I find regarding my condition states that a combined ocp is an adequate treatment. I’m not saying that is is FOR ME, but it should in the very least be helpful. Secondly, most of use use a host of different treatments ie growth stims, AA’s, 5AR’s, estrogens, growth factors etc because ONE treatment alone tends to do nothing, whereas the combination works in synergy to provide best results. So even if my estrogen was a large part of the problem, I would STILL need
to address dht and androgens, and therefore using AA’s and 5AR’s might at least help in some small way. It would be totally stupid of me to think “if I just take some natural estrogen all my Issues will be fixed. No. The issue here is far more complex than I’m just a female with sh*t female hormone production. There is a point at which you must stop dismissing the fact that I HAVE TRIED ESTROGEN which includes topical 17B, and that perhaps this is ACTUALLY a case of there is something else wrong. The daro DOESNT work for all, nor do 5AR’s, estrogens, growth stims etc. Personally those of use with these issues like myself, @itchymadscalp @whatevr etc probably need to actually take things right back to growth factors. For me, I think the corticotropin releasing hormone angle is HUGE. It’s what fucked me in the first place after all. I’m not going to sit here and believe that taking some natural E will save me. I’m not that naive, and I’m sick of hearing it.

 

[peewee]

So I heard back from Mr Luo, if we group together he will give a great price, and we don't have to ship it to any one member to split, he will ship individually. I feel this is great news as I'm going to buy more and up my dose and see what happens.
He is very accommodating and easy to work with so I'm hoping other people want to jump in and take advantage. He said he has product from the batch he made and will discount, great price he said.
Anyone interested can respond here with how many grams they will buy. I'm in for 5 grams.

 

[Georgie]

So I heard back from Mr Luo, if we group together he will give a great price, and we don't have to ship it to any one member to split, he will ship individually. I feel this is great news as I'm going to buy more and up my dose and see what happens.
He is very accommodating and easy to work with so I'm hoping other people want to jump in and take advantage. He said he has product from the batch he made and will discount, great price he said.
Anyone interested can respond here with how many grams they will buy. I'm in for 5 grams.

How much though?

 

[peewee]

I guess it depends on how much we commit to. But he did say great.

 

[Georgie]

I guess it depends on how much we commit to. But he did say great.

Throw a ballpark amount at him. Say 10g. I want to know what his idea of “great is”. I also want assurance that it’s been tested for purity.

 

[peewee]

So do you mean 10 grams total for a mini buy, or you want in for 10g? I'm sure the more we go in with, the better the price. Maybe let's see how many grams in a couple of days and I can tell him, for example if we are at 25 grams, I'll ask and see what price.

 

[IdealForehead]

You are focusing entirely too much on ONE issue here. Yes, I have hormonal issues, but every single piece of written data I find regarding my condition states that a combined ocp is an adequate treatment. I’m not saying that is is FOR ME, but it should in the very least be helpful. Secondly, most of use use a host of different treatments ie growth stims, AA’s, 5AR’s, estrogens, growth factors etc because ONE treatment alone tends to do nothing, whereas the combination works in synergy to provide best results. So even if my estrogen was a large part of the problem, I would STILL need
to address dht and androgens, and therefore using AA’s and 5AR’s might at least help in some small way. It would be totally stupid of me to think “if I just take some natural estrogen all my Issues will be fixed. No. The issue here is far more complex than I’m just a female with sh*t female hormone production. There is a point at which you must stop dismissing the fact that I HAVE TRIED ESTROGEN which includes topical 17B, and that perhaps this is ACTUALLY a case of there is something else wrong. The daro DOESNT work for all, nor do 5AR’s, estrogens, growth stims etc. Personally those of use with these issues like myself, @itchymadscalp @whatevr etc probably need to actually take things right back to growth factors. For me, I think the corticotropin releasing hormone angle is HUGE. It’s what fucked me in the first place after all. I’m not going to sit here and believe that taking some natural E will save me. I’m not that naive, and I’m sick of hearing it.

Okay Georgie. I'm sorry. I'm not trying to upset or annoy you.

For the record, I never said to stop the antiandrogens. I have just said that if treatment with spironolactone, daro, duta, and cypro have not worked and even the combo of daro, duta, and cypro is not working then you have already now tried the most aggressive anti-androgenic treatment you reasonably can, and if that's not doing it, this is not primarily an androgenic issue. Can androgens still be important to block? Absolutely. So I would personally still continue some or all of those therapies.

Androgens are very simple. You just need to block them. As much as possible. So that is easy to address and you have now done it.

Unfortunately as we have discussed on this forum many times, estrogen, however, is not so simple.

We have reviewed how many doctors report that estrogen is all about balance.

Too little estrogen causes hair loss. And too much can as well.

Here is what one doctor has to say about it:

Excess Estrogen.
Estrogen, the power player in women’s bodies, is your friend when it’s appropriately balanced. It makes you feel energized, helps stabilize your moods and contributes to a healthy sex drive. Yet too much estrogen, which can be caused by weight gain, perimenopause or toxicity from exposure to endocrine disruptors (which are rampant in our food, water and plastic products), can lead to thinning hair. During and after pregnancy, for example, estrogen levels peakand then dip, causing sudden hair loss for many women.

http://www.saragottfriedmd.com/about-dr-sara/
​

I have tried to research possible causes and solutions for you because I'd like to see you succeed and I can see you are trying many things.

But if you are suffering from imbalanced estrogen, where you have an excess of estrogen receptor stimulation by the large amount of ethinyl estradiol, adding more topical estradiol won't fix that.

The complexity of estrogen is exactly why I have been so hesitant to add it to my regime up until now.

Every estrogen product I have seen including estrace which is just plain estradiol lists hair loss as a potential side effect.

For example:
https://www.rxlist.com/estrace-side-effects-drug-center.htm

"loss of scalp hair"

This again supports the notion that more is not always better with estrogen and that proper hair growth relies on having a good balance of estrogen. Not just more or stronger.

Looking at growth factors is an okay thing to do for stimulating new regrowth. But you'd first have to come up with a good explanation for why you are losing your hair on an ongoing basis first.

Hair loss in young people is generally in everything I've read some categorization of:

- hormonal (testosterone, estrogen)
- nutritional (eg. iron deficiency)
- autoimmune (alopecia arreata)

Your primary unique characteristics physically are above all else your hormonal imbalances. Given that your biopsies didn't show autoimmune damage, and your nutritional factors are good, but you have a dramatically abnormal resting hormonal profile, it still seems to suggest to me your problem is hormonal.

And based on the fact that estrogen excess and estrogen deficiency are both known possible causes of hair loss, I think it's a pretty important subject for you to adequately address.

Of course it's your body and your life, but I would try to consider and think about the question:

Why does every estrogen product for menopausal women list hair loss as a common potential risk?

I think it's a very important question in your case and I think it may answer a lot of what you're going through.

Estrogen is definitely a tricky subject when it comes to hair. Good luck.

 

[Georgie]

Okay Georgie. I'm sorry. I'm not trying to upset or annoy you.

For the record, I never said to stop the antiandrogens. I have just said that if treatment with spironolactone, daro, duta, and cypro have not worked and even the combo of daro, duta, and cypro is not working then you have already now tried the most aggressive anti-androgenic treatment you reasonably can, and if that's not doing it, this is not primarily an androgenic issue. Can androgens still be important to block? Absolutely. So I would personally still continue some or all of those therapies.

Androgens are very simple. You just need to block them. As much as possible. So that is easy to address and you have now done it.

Unfortunately as we have discussed on this forum many times, estrogen, however, is not so simple.

We have reviewed how many doctors report that estrogen is all about balance.

Too little estrogen causes hair loss. And too much can as well.

Here is what one doctor has to say about it:

Excess Estrogen.
Estrogen, the power player in women’s bodies, is your friend when it’s appropriately balanced. It makes you feel energized, helps stabilize your moods and contributes to a healthy sex drive. Yet too much estrogen, which can be caused by weight gain, perimenopause or toxicity from exposure to endocrine disruptors (which are rampant in our food, water and plastic products), can lead to thinning hair. During and after pregnancy, for example, estrogen levels peakand then dip, causing sudden hair loss for many women.

http://www.saragottfriedmd.com/about-dr-sara/
​

I have tried to research possible causes and solutions for you because I'd like to see you succeed and I can see you are trying many things.

But if you are suffering from imbalanced estrogen, where you have an excess of estrogen receptor stimulation by the large amount of ethinyl estradiol, adding more topical estradiol won't fix that.

The complexity of estrogen is exactly why I have been so hesitant to add it to my regime up until now.

Every estrogen product I have seen including estrace which is just plain estradiol lists hair loss as a potential side effect.

For example:
https://www.rxlist.com/estrace-side-effects-drug-center.htm

"loss of scalp hair"

This again supports the notion that more is not always better with estrogen and that proper hair growth relies on having a good balance of estrogen. Not just more or stronger.

Looking at growth factors is an okay thing to do for stimulating new regrowth. But you'd first have to come up with a good explanation for why you are losing your hair on an ongoing basis first.

Hair loss in young people is generally in everything I've read some categorization of:

- hormonal (testosterone, estrogen)
- nutritional (eg. iron deficiency)
- autoimmune (alopecia arreata)

Your primary unique characteristics physically are above all else your hormonal imbalances. Given that your biopsies didn't show autoimmune damage, and your nutritional factors are good, but you have a dramatically abnormal resting hormonal profile, it still seems to suggest to me your problem is hormonal.

And based on the fact that estrogen excess and estrogen deficiency are both known possible causes of hair loss, I think it's a pretty important subject for you to adequately address.

Of course it's your body and your life, but I would try to consider and think about the question:

Why does every estrogen product for menopausal women list hair loss as a common potential risk?

I think it's a very important question in your case and I think it may answer a lot of what you're going through.

Estrogen is definitely a tricky subject when it comes to hair. Good luck.

I’ve not meant to come across as aggressive, because I appreciate the help. I’m just exasperated and feel stuck between a million different opinions.
Yes, I’m aware that estrogen dominance can cause hairloss because it is likely that the excess will become testosterone and thereby have similar effects to adrenal hyperandrogenism. However, Diane is designed to be anti androgenic to counter this. It is literally the “hair” pill. Both of my sisters have been on it without issues with their hair. I simply can’t fathom how it could be harmful whilst taking it. Definitely coming off it is like an A bomb on your hair, but I’ve heard nothing of hairloss whilst taking it. It was actually the very first pill I wasn prescribed years ago as a teen when I had no estrogen. In fact, I’d been on and off it twice prior to 2014 without incident. I have looked into all the relevant studies which suggest that estrogens have an inhibitory effect upon FEMALE hair, but then have read studies which are totally congruent with my own hairloss, that is, estrogen in females is essential for not only hair growth but body and facial hair growth. So I am left wondering how I could have grown thick, luscious hair for years and years with no estrogen, no periods, no ovulation, and now WITH estrogen, i do not grow hair unless I use minoxidil. I’ll also add that I have tried lower dose pills (microgynon), and more recently gave Qlaira a shot. Both resulted in unbearable abdominal pain and bleeding and rapid onset shedding. I lasted a week on both, and in those weeks needed time off work because I could not even function. I’ve been trialing a 0.1% 17b topical in dmso and water. I may as well be rubbing saline onto my head.

I’ve begun to look deeper. I have this condition because I have been in a chronic state of hypercortisolism for years. I have read more about the reflex inflammatory processes involved in chronically elevated levels of glucocorticoids, and how Corticotropin releasing hormone particularly effects growth of tissues and is involved in inhibition of wound healing and hair growth, and is also a key player in the inflammatory processes of RA and gastrointestinal disorders. We know that I don’t respond to treatments like most would. My hair growth cycle is 50 shades of fucked up. I have thrown every obvious treatment at it that I can. I don’t believe it’s as easy as Aa’s, minoxidil and estrogen.

 

[Georgie]

So do you mean 10 grams total for a mini buy, or you want in for 10g? I'm sure the more we go in with, the better the price. Maybe let's see how many grams in a couple of days and I can tell him, for example if we are at 25 grams, I'll ask and see what price.

I mean in total, because I don’t think you’ll get that amount of interest to buy 25g.

 

[infinitepain]

So anyone has picture evidence that this works? it's been 52 pages now.

Something like this:

https://www.hairlosstalk.com/intera...-with-finasteride-after-6-months-pics.107836/

https://www.hairlosstalk.com/intera...ide-results-7-mo-treatment-pics.44087/page-15

I need to regrow my thined small follicles on my hairline inmediately to avoid dementia. My scalp itchiness also sucks. Should I start dermastamping if my scalp tingles? im afraid of making it worse. A scalp must be in good condition to heal.

What shocks me is the second thread, the guy says he dermarolls almost DAILY with a 0.5mm one and aplies the minoxidil after the wounding which sounds insane, yet I can't deny these f*****g pictures. He says he got the most regrowth when he started doing that. What are we missing here? shouldnt that be doing more wrong than good?

 

[Georgie]

So anyone has picture evidence that this works? it's been 52 pages now.

Something like this:

https://www.hairlosstalk.com/intera...-with-finasteride-after-6-months-pics.107836/

https://www.hairlosstalk.com/intera...ide-results-7-mo-treatment-pics.44087/page-15

I need to regrow my thined small follicles on my hairline inmediately to avoid dementia. My scalp itchiness also sucks. Should I start dermastamping if my scalp tingles? im afraid of making it worse. A scalp must be in good condition to heal.

What shocks me is the second thread, the guy says he dermarolls almost DAILY with a 0.5mm one and aplies the minoxidil after the wounding which sounds insane, yet I can't deny these f*****g pictures. He says he got the most regrowth when he started doing that. What are we missing here? shouldnt that be doing more wrong than good?

No we don’t have photos.

People respond differently to medications. Rolling with 0.5mm isn’t wounding. It might just increase absorption of topicals.

Do some research before you believe everything you see and read.

 

[furrydome]

Lastly, in the past 2 months, I gave into @bridgeburn 's logic and affection for estrogen at the frontotemporal regions and bought some over the counter estriol cream (this stuff). I've been using it to my temples and corners to stimulate regrowth and also all over my face for anti-wrinkle, anti-eye-bag, and anti-minoxidil-damage effect. There's maybe a very mild sexual side effect from the estriol in this high a dose, but I'm using quite a lot given the area I'm covering. If I just use it at the corners and hairline alone I don't notice any negative effects.

The estriol has been clearly very helpful and encouraging further terminalization of the vellus hairs that have been coming back. I wish I would have started it 6 months ago. Good adjunct for sure. Just realized my bottle is empty so gotta order more. It has definitely helped for the eye bags too from what I can see.

@IdealForehead Would you be able to write a short post about your efforts to deal with the minoxidil damage? I suspect it's more of an issue for those in their 30s+ who are already losing collagen due to age.

The past year has been brutal on my skin... gradually getting old guy face with young guy hair (yeah the opposite of most people here). Lesson learned, watch how much minoxidil you're spreading outside of the scalp.

 

[furrydome]

Rolling with 0.5mm isn’t wounding. It might just increase absorption of topicals.

I thought we established that even 0.5mm would stimulate some growth factors, though not nearly as much as 1.5mm+. Do I have that wrong?

 

[IdealForehead]

I’ve not meant to come across as aggressive, because I appreciate the help. I’m just exasperated and feel stuck between a million different opinions.
Yes, I’m aware that estrogen dominance can cause hairloss because it is likely that the excess will become testosterone and thereby have similar effects to adrenal hyperandrogenism. However, Diane is designed to be anti androgenic to counter this. It is literally the “hair” pill. Both of my sisters have been on it without issues with their hair. I simply can’t fathom how it could be harmful whilst taking it. Definitely coming off it is like an A bomb on your hair, but I’ve heard nothing of hairloss whilst taking it. It was actually the very first pill I wasn prescribed years ago as a teen when I had no estrogen. In fact, I’d been on and off it twice prior to 2014 without incident. I have looked into all the relevant studies which suggest that estrogens have an inhibitory effect upon FEMALE hair, but then have read studies which are totally congruent with my own hairloss, that is, estrogen in females is essential for not only hair growth but body and facial hair growth. So I am left wondering how I could have grown thick, luscious hair for years and years with no estrogen, no periods, no ovulation, and now WITH estrogen, i do not grow hair unless I use minoxidil. I’ll also add that I have tried lower dose pills (microgynon), and more recently gave Qlaira a shot. Both resulted in unbearable abdominal pain and bleeding and rapid onset shedding. I lasted a week on both, and in those weeks needed time off work because I could not even function. I’ve been trialing a 0.1% 17b topical in dmso and water. I may as well be rubbing saline onto my head.

I’ve begun to look deeper. I have this condition because I have been in a chronic state of hypercortisolism for years. I have read more about the reflex inflammatory processes involved in chronically elevated levels of glucocorticoids, and how Corticotropin releasing hormone particularly effects growth of tissues and is involved in inhibition of wound healing and hair growth, and is also a key player in the inflammatory processes of RA and gastrointestinal disorders. We know that I don’t respond to treatments like most would. My hair growth cycle is 50 shades of fucked up. I have thrown every obvious treatment at it that I can. I don’t believe it’s as easy as Aa’s, minoxidil and estrogen.

You raise some valid points, but I am a big fan of both Occam's Razor and the process of elimination as problem solving tools.

What I mean is, when faced with an unknown question and inadequate evidence or knowledge to make a clear assessment, I find it useful to work through systematically by starting with the simplest or most common explanations, exhausting solutions for each one at a time, and then moving on to the most experimental and esoteric approaches only once all the basics have been exhausted.

In actual fact, I think you have done this very well up to this point. In brief:

- Biopsies have ruled out an auto-immune cause with fair certainty.
- Iron infusions and extensive bloodwork has ruled out a nutritional cause or other general medical condition.
- Most recently, the use of daro+duta+cypro has ruled out with fair certainty (in my opinion) that this is a primarily androgenic issue, or that antiandrogens can likely solve your problem.

In my opinion, that workflow logically leads next into a deeper evaluation of your female hormones and how well the balance of them could be affecting your hair.

It is certainly possible that there is a far more esoteric cause such as the cortisol issues you describe. However, I do not think you have remotely enough data or trials to first rule out the contribution of estrogens to the problem. I also don't think you have run nearly sufficient trials to be able to say you've evaluated the female hormone issues with the same thoroughness you have evaluated the other preceding possibilities listed above.

The fact that you have experienced dramatic sheds of hair when switching estrogens/progesterones actually provides some strong evidence that this is where your problems are coming from. If the female hormones were not a major factor, they wouldn't have such a powerful effect on your hair.

I don't think it's correct that excessive estrogen causes hair loss by converting to testosterone. "Although testosterone can be converted to estradiol, the reverse does not happen."

https://www.americanscientist.org/article/testosterone-in-women

Estrogen is very complicated when it comes to hair and the research we have is very poor. But in essence, from the information we do have, estrogen can be fairly considered to have a Goldilocks effect on hair - too much is bad and too little is bad as well. (Laser therapy for hair has been shown to exhibit a similar Goldilocks effect.)

Estrogen must also be considered with finesse in that each type of estrogen works differently from the others and these differences extend to how they also work in different parts of the body.

Estrogenic activity within a tissue is influenced by the type of estrogen and the subtype of estrogen receptor found within that tissue,[20]as well as by the distribution of cofactors and corepressors of the estrogen-receptor complex within the tissue.[21] With estradiol as the standard, binding affinity for both estrogen receptor (ER)-α and -ß is equal at 100.[20] Estrone has a binding affinity for ER-α of 60 and for ER-ß of 37. Estriol binds to ER-α with an affinity of 14 and to ERß with an affinity of 21. Therefore, estradiol has the strongest binding affinity for both ER-α and -ß.

https://www.medscape.com/viewarticle/571299_6​

This is where the greatest argument for bioidentical hormones comes from.

Ethinyl estradiol does not work the same as natural estrogens. Ethinyl estradiol is a primary ER-alpha agonist, and it triggers very different tissue responses from the natural estrogens which have a much more balanced function:

Differential effect of estrogen receptor alpha and beta agonists on the receptor

In the current investigation, we examined the effect of three estrogens with different potency for specific estrogen receptors (ER) on RAGE expression in human microvascular endothelial cells (HMEC-1). Of the three estrogens tested, ethinyl estradiol (EE), an estrogen receptor alpha (ERα) agonist, was the strongest inducer of RAGE expression in HMEC-1. By comparison, 17-epiestriol, an estrogen receptor beta (ERβ) agonist and 17-β-E2, an ER agonist that is almost equally potent for ERα and ERβ were less effective in stimulating RAGE expression

https://www.sciencedirect.com/science/article/pii/S0167488905000467
​

There is a simple study which proves incontrovertibly that ethinyl estradiol does not work the same on body tissues as natural estrogens do. Also we can note that estriol, which is the most famous estrogen for hairg growth in pregnancy has a predominantly ER-beta affinity, while ethinyl estradiol has the exact opposite (high ER-alpha affinity)

If your primary estrogen (ethinyl estradiol) is so dramatically unbalanced and unnatural in its binding and tissue stimulation, how can you expect a natural response?

It is absolute fact that ethinyl estradiol is very different in the body compared to natural estradiol/estriol/estrone.

This provides a very clear and easy explanation for a lot of the problems you are having with good basic scientific principles behind it.

If you wish to test this hypothesis (which I think should be the next most logical step in your workflow), and you wish to avoid cycling hormones, then again an approach of Triest (estradiol/estriol/estrone) with a low dose progesterone IUD plus some topical and/or oral antiandrogens for insurance would objectively make the most sense.

Until you have tried a solution that involves a more balanced and natural stimulation of your estrogen receptors, it is not possible to say to what extent this is the issue. If the problem is the disproportionately high ER-alpha stimulation by ethinyl estradiol, then you will not adequately resolve that problem until you remove ethinyl estradiol from your body and replace it with something that provides a better balance of ER-alpha and ER-beta stimulation (eg. Triest).

That may be a difficult thing to conceive of doing, given the uterine pain and bleeding as well as shock losses you've suffered from prior shifts in estrogen in the past. But I think it's an absolutely necessary step to take at some point in this process, and I think it is the step with the highest probability of success given the facts discussed above.

In the big scheme of things (overlooking temporary pains and discomforts if we can), one of two things may happen if you do this: (1) the problem will be solved, or (2) you will have added imbalanced estrogen as yet another cause of your problem to have been ruled out.

In my opinion, only then would it make sense to start experimenting with your adrenal axis which is a much funnier system to manipulate and less likely to be the culprit in the context of the above.

Again this is all your choice. Whatever you do, don't stand still. Keep working logically through the system, as you are making progress whether you feel it or not sometimes. The process of elimination is a powerful problem solving tool of used correctlu. I recommend this approach next because I think there is the greatest evidence and highest probability that if you pursue it, it may be the last experiment you will need to run.