Exploring The Hormonal Route. Hair=life.

JaneyElizabeth

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Hi Junely, I was wondering what your HRT and hair loss cocktail was, I tried looking through the forums but it’s hard for new users to navigate.

I wanted to know if you were able to regrow your frontal hairline without using minoxidil, because I want to regrow my hairline as much as possible without using Min, because I was thinking the gains would be more permanent.
I don't think that HRT hair restoration works that way. There's no finasteride hair or min hair. It's all just hair with dormant follicles partially or fully re-invigorated. If you use min to regrow your hairline while on HRT, my prediction is that you won't need min to maintain as long as you stay on HRT but you might not be able to have full success on HRT without using finasteride and min and some other meds perhaps. All of these notions about finasteride hair and min hair overlook the fact that both together might effectuate improvements and perhaps synergistic ones.
 

Almas

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I estimate at least 24 months to go from a situation of being bald/balding say NW4 or worse, to hair of normal cis-female length, meaning at least having achieved a hair length below the ears and generally, in the best of cases, incredible regrowth and restoration along with much improved manageability and quality if everything comes together.
There are enough such examples on the forum. But I will be the first to use HRT as a Norwood 1 with severe hairline thinning. It would seem that the situation is simple. However, the hairline and temples are terribly amenable to therapy, and Ikarus has never been able to repair the area. There is a point of no return when the hair can no longer be restored. I hope I haven't overcome it.
 

JaneyElizabeth

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There are enough such examples on the forum. But I will be the first to use HRT as a Norwood 1 with severe hairline thinning. It would seem that the situation is simple. However, the hairline and temples are terribly amenable to therapy, and Ikarus has never been able to repair the area. There is a point of no return when the hair can no longer be restored. I hope I haven't overcome it.
I disagree about the hair line being more difficult to restore for MtF's necessarily as opposed to cis-males, for whom it does present either great or impossible challenges. I have seen no data indicative of a hard fall off from which recovery is impossible but it probably becomes more difficult with age. Microneedling and oral min might make a difference in these hairs. I have had strong regrowth at the hairline and I see hundreds of new hairs growing in the temple areas although most are still too small to be cosmetically significant but it further illustrates the time needed for complete improvement. I said 12 to 24 months but it might be that 36 months is more apt in terms of recovery time to a decent length.

For the truly bald, HRT is likely to be less of a sprint and more of a marathon and most cis-guys can't do this at the hormonal levels needed for up to two to three years to see cosmetically significant results. This might be the reason for the seemingly far better results encountered by MtF's since they have nothing else to do and nowhere to go except pretty much to continue with HRT for its other benefits.
 

Almas

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I disagree about the hair line being more difficult to restore for MtF's necessarily as opposed to cis-males, for whom it does present either great or impossible challenges. I have seen no data indicative of a hard fall off from which recovery is impossible but it probably becomes more difficult with age. Microneedling and oral min might make a difference in these hairs. I have had strong regrowth at the hairline and I see hundreds of new hairs growing in the temple areas although most are still too small to be cosmetically significant but it further illustrates the time needed for complete improvement. I said 12 to 24 months but it might be that 36 months is more apt in terms of recovery time to a decent length.

For the truly bald, HRT is likely to be less of a sprint and more of a marathon and most cis-guys can't do this at the hormonal levels needed for up to two to three years to see cosmetically significant results. This might be the reason for the seemingly far better results encountered by MtF's since they have nothing else to do and nowhere to go except pretty much to continue with HRT for its other benefits.
The frontal lobe has an aromatase deficiency and is therefore more difficult to repair. Have you ever thought that recovery never starts from the forehead, but comes from the top of the head? The longer your hair has been damaged, the longer you will need to use HRT.
If I went back in time, I would tell myself to start HRT last year when my hair was almost perfect. I think I would have easily achieved the ideal in 3 months
 

JaneyElizabeth

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The frontal lobe has an aromatase deficiency and is therefore more difficult to repair. Have you ever thought that recovery never starts from the forehead, but comes from the top of the head? The longer your hair has been damaged, the longer you will need to use HRT.
If I went back in time, I would tell myself to start HRT last year when my hair was almost perfect. I think I would have easily achieved the ideal in 3 months
Yes but the theory should include some reason why that hair is maintainable under HRT but not restorable by HRT and I don't think that we have any evidence except statistical evidence based upon normal curve distributions, meaning that we all know that hair loss tends to begin in the crown and temples. We further know that Rogaine and finasteride tend to be much more effective in the crown for males than at the hair line. But this usually pertains to people with diffuse thinning, even extreme diffuse thinning, meaning something to work with. Slick bald crowns are difficult to restore as well. I never had a slick bald crown and that area has filled in easily for me and that was where I first had baldness. The temples didn't go for many years and are now the last to fill in but again, we can think of these areas as being slick bald so that presents more of a challenge.
 

Almas

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Yes but the theory should include some reason why that hair is maintainable under HRT but not restorable by HRT and I don't think that we have any evidence except statistical evidence based upon normal curve distributions, meaning that we all know that hair loss tends to begin in the crown and temples. We further know that Rogaine and finasteride tend to be much more effective in the crown for males than at the hair line. But this usually pertains to people with diffuse thinning, even extreme diffuse thinning, meaning something to work with. Slick bald crowns are difficult to restore as well. I never had a slick bald crown and that area has filled in easily for me and that was where I first had baldness. The temples didn't go for many years and are now the last to fill in but again, we can think of these areas as being slick bald so that presents more of a challenge.
Temples and the growth line can also be restored on HRT like Noah, but the chances of restoring the temples are always lower than the chances of restoring the crown. I will hope that I will answer to HRT somehow, I do not even hope to get growth like Noah's - he is lucky. I will increase my chances by using the CPA, but it is more dangerous, I will try to do without it.
 

JaneyElizabeth

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Temples and the growth line can also be restored on HRT like Noah, but the chances of restoring the temples are always lower than the chances of restoring the crown. I will hope that I will answer to HRT somehow, I do not even hope to get growth like Noah's - he is lucky. I will increase my chances by using the CPA, but it is more dangerous, I will try to do without it.
From the pics that I have seen, your chances of failure are pretty close to zero. Look at transition timelines pics of young people who are non-balding and you will get an idea. There are clear and evident changes/improvements not only in count but also in volume/diameter which is also extremely important to have in order to have a full head of hair.

But I could be wrong. There might be genetic factors that promote restoration in some XY's and not in others. Originally my notion was that HRT could grow/regrow hair for any adult XY but the truth might be closer to HRT providing amazing maintenance but little actual increase in hair counts for many individuals. The pattern of baldness might matter with diffuse thinners presumably being put in a better starting position than those with traditional Norwood patterns. Time of dormancy is also likely to be a factor but it hasn't seemed to hinder me but it could be why my hair all of a sudden got much better after six or seven years of using estrogen and after about two to three years under a formal HRT program. I never gave up and just kept using estradiol especially topical. Oral min is also likely a game changer.

Find comfort in statistics even though I know that it is easy for others to proclaim, "don't worry; you will be fine" when you have to live out the results.
 

Almas

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From the pics that I have seen, your chances of failure are pretty close to zero. Look at transition timelines pics of young people who are non-balding and you will get an idea. There are clear and evident changes/improvements not only in count but also in volume/diameter which is also extremely important to have in order to have a full head of hair.

But I could be wrong. There might be genetic factors that promote restoration in some XY's and not in others. Originally my notion was that HRT could grow/regrow hair for any adult XY but the truth might be closer to HRT providing amazing maintenance but little actual increase in hair counts for many individuals. The pattern of baldness might matter with diffuse thinners presumably being put in a better starting position than those with traditional Norwood patterns. Time of dormancy is also likely to be a factor but it hasn't seemed to hinder me but it could be why my hair all of a sudden got much better after six or seven years of using estrogen and after about two to three years under a formal HRT program. I never gave up and just kept using estradiol especially topical. Oral min is also likely a game changer.

Find comfort in statistics even though I know that it is easy for others to proclaim, "don't worry; you will be fine" when you have to live out the results.
There is no point in finding solace in statistics, I have already experienced this with finasteride, Duta and Bica
Yes, the chances are really high, but in this thread you can also find people who have not been helped by HRT. I need to respond well to estradiol so that I can maintain a cycle of 3-4 months per year. If I have to, I will use HRT all the time, but this is a huge sacrifice for the sake of hair. I will not be able to live normally with this, and one problem will simply replace the other. If HRT reduces my height, I can really end up with suicide
The wait is excruciating. At the moment, I cannot start HRT because I do not have enough money. Now I am spending money on blepharoplasty - I have problems with the eyelids. After the operation, you will have to borrow money for injections, it will be August
If anyone is interested in plastic surgery, I can show you the results

I need to meet a 6 month cycle. Moreover, I have no money for breast removal. When I have the opportunity, I will remove the gland and do breast liposuction like FTM. There will be scars, but I have no choice. Hair> body
 
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JaneyElizabeth

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There is no point in finding solace in statistics, I have already experienced this with finasteride, Duta and Bica
Yes, the chances are really high, but in this thread you can also find people who have not been helped by HRT. I need to respond well to estradiol so that I can maintain a cycle of 3-4 months per year. If I have to, I will use HRT all the time, but this is a huge sacrifice for the sake of hair. I will not be able to live normally with this, and one problem will simply replace the other. If HRT reduces my height, I can really end up with suicide
The wait is excruciating. At the moment, I cannot start HRT because I do not have enough money. Now I am spending money on blepharoplasty - I have problems with the eyelids. After the operation, you will have to borrow money for injections, it will be August
If anyone is interested in plastic surgery, I can show you the results

I need to meet a 6 month cycle. Moreover, I have no money for breast removal. When I have the opportunity, I will remove the gland and do breast liposuction like FTM. There will be scars, but I have no choice. Hair> body
Yes, well, you are obsessed but don't let your intelligence divert you and if it doesn't work, then it doesn't work and the value of what Bridge achieved is partially diminished when we can't predict results reasonably. Maybe people understand this implicitly but it matters a great deal in terms of providing advice with confidence. That's why I recommend that people pick a protocol used by someone formerly successful with it and then stick to it if at all possible. Regrowth might take years and simply increase in intensity as time goes by or it might be highly linked to specific target levels achieved consistently over time. I used to believe the latter was more important but now I am unsure. The one thing that appears to be clear is that topical estradiol does not appear to be sufficient for substantive hair regrowth in any time period likely of interest to XY's. HRT in general might be similar.

Regrowth might also be linked to different skin effects which most people on HRT experience but not all. The difference in skin quality and appearance is night and day better for me now and the skin is smoother, lighter and softer.
 

Almas

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Yes, well, you are obsessed but don't let your intelligence divert you and if it doesn't work, then it doesn't work and the value of what Bridge achieved is partially diminished when we can't predict results reasonably. Maybe people understand this implicitly but it matters a great deal in terms of providing advice with confidence. That's why I recommend that people pick a protocol used by someone formerly successful with it and then stick to it if at all possible. Regrowth might take years and simply increase in intensity as time goes by or it might be highly linked to specific target levels achieved consistently over time. I used to believe the latter was more important but now I am unsure. The one thing that appears to be clear is that topical estradiol does not appear to be sufficient for substantive hair regrowth in any time period likely of interest to XY's. HRT in general might be similar.

Regrowth might also be linked to different skin effects which most people on HRT experience but not all. The difference in skin quality and appearance is night and day better for me now and the skin is smoother, lighter and softer.
CPA seems to be more effective than Bica, but it is not as secure. I would not want to take a drug that can cause meningioma for 1/3 of my life. I'm obsessed but try not to hurt myself
I will also try to be in the middle between T and E someday. Perhaps this will prevent baldness from progressing. Bicalutamide alone appears to be useless at all
 

JaneyElizabeth

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CPA seems to be more effective than Bica, but it is not as secure. I would not want to take a drug that can cause meningioma for 1/3 of my life. I'm obsessed but try not to hurt myself
I will also try to be in the middle between T and E someday. Perhaps this will prevent baldness from progressing. Bicalutamide alone appears to be useless at all
That's a shift in your thoughts and my main shift often as well in terms of what can be statistically substantiated. It might be that lower levels of estradiol do work for hair but that they simply take enormous amounts of time for the effects to become cosmetically significant and that is what we are really talking about on the MtF side of things. I have seen tiny bits of finasteride or say RU or CB growth and it is apparent when another looks closely but the person isn't one iota more attractive and such haphazard growth might actually make them less attractive.

I have started plucking deformed hairs of various lengths and I never, ever would have done that in a male context since "counts is counts and coverage is coverage" but eh, this isn't really true. Many of the hairs coming out in my brush are unpigmented or abnormal in terms of shape, often with tiny circular kinks on one end which I assume that my body is now rejecting so that it can start over with a more-linked anagen cycle. I used to see sort of a second plateau of what I call garbage hair protruding above my well-behaved hair but there were too many to pluck back then plus plucking can have variable effects on individual follicle restoration.
 

Almas

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[UPDATE] I received my hormone blood-work results.

Testosterone: 4.7 nmol/L (with the normal male range being 8.6 to 29.0 nmol/L)
Estradiol: 719 pmol/L (with the normal male range being 41 to 159 pmol/L)

After receiving this information, I can gather that my testosterone levels are significantly lower than the normal male range; although they are slightly higher than normal female ranges. Furthermore, my estradiol levels are significantly higher than the normal male range; they are within normal female ranges.

Within transgender women, the goal is to have estradiol levels within the range of 300 to 600 pmol/L. In that sense, my estradiol levels are slightly higher than the ranges which are aimed at transgender women. I can suspect this is due to the bicalutamide having a synergetic effect with estrogen.

I do have to wait slightly longer for my other hormone blood-work results, since I am not really allowed to know the results until my endocrinologist inspects them.

View attachment 122249
Why did Ikarus claim that its levels are higher than those of trans women when the level is 719pmol/l = 195 pg/ml in the range of 300-900 pg/ml?
 

KNemo

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Why did Ikarus claim that its levels are higher than those of trans women when the level is 719pmol/l = 195 pg/ml in the range of 300-900 pg/ml?
Because the target range for MTF transsexuals are normally 100-200pg/ml sometimes up to 300pg/ml?
Edit: a stable level of about 100pg/ml is higher than the average estradiol level of some healthy cis women.
 
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Almas

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Because the target range for MTF transsexuals are normally 100-200pg/ml sometimes up to 300pg/ml?
Edit: a stable level of about 100pg/ml is higher than the average estradiol level of some healthy cis women.
Strange, Lena and the Russian-speaking MTFs say we need levels of 300-900 pg / ml. On the last day before the next injection
 

KNemo

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Strange, Lena and the Russian-speaking MTFs say we need levels of 300-900 pg / ml. On the last day before the next injection
They're simply wrong. A level of 100pg/ml is sufficient for some MTFs to fully feminize, there are many such cases.
Another often repeated error is that high levels of estradiol is needed to reduce testosterone but 100pg/ml can be enough to give castrate range testosterone at least for some people.

Here's a graph showing estradiol levels for cis women. Note that the average level is under 100pg/ml and the absolute peak is 650pg/ml. Going for 300-900pg/ml as a lowest level is far higher than healthy cis women!

Just be careful and test your levels.
 

JaneyElizabeth

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They're simply wrong. A level of 100pg/ml is sufficient for some MTFs to fully feminize, there are many such cases.
Another often repeated error is that high levels of estradiol is needed to reduce testosterone but 100pg/ml can be enough to give castrate range testosterone at least for some people.

Here's a graph showing estradiol levels for cis women. Note that the average level is under 100pg/ml and the absolute peak is 650pg/ml. Going for 300-900pg/ml as a lowest level is far higher than healthy cis women!

Just be careful and test your levels.
You have to remember that for MtF's, estrogen is basically a mood and psychiatric drug and many MtF's struggle at levels below 300 pg/ml to "feel good" and to have libido. One of Lena's clients recently revealed that she had several blood clots and that she had been running at 2,500 pg/ml for over five years with only one break.

I also think that due to bombardment by T, that higher E2 levels might be necessary for hair restoration for XY's "just in it for the hair".
 

Almas

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You have to remember that for MtF's, estrogen is basically a mood and psychiatric drug and many MtF's struggle at levels below 300 pg/ml to "feel good" and to have libido. One of Lena's clients recently revealed that she had several blood clots and that she had been running at 2,500 pg/ml for over five years with only one break.

I also think that due to bombardment by T, that higher E2 levels might be necessary for hair restoration for XY's "just in it for the hair".
Since Bridgeburn and Noah used high doses of E, I will also keep E high. In this case, there is less chance of error. Moreover, it will help lower my T, and I want to lower it as much as possible. Because I don't want to use the CPA
 

KNemo

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You have to remember that for MtF's, estrogen is basically a mood and psychiatric drug and many MtF's struggle at levels below 300 pg/ml to "feel good" and to have libido. One of Lena's clients recently revealed that she had several blood clots and that she had been running at 2,500 pg/ml for over five years with only one break.

I also think that due to bombardment by T, that higher E2 levels might be necessary for hair restoration for XY's "just in it for the hair".
Placebo effects are strong however there might be some advantage for some MTF to have elevated E2 at least for some time, it's not well studied.

In any case Almas isn't an MTF and shouldn't try to go for experimental feminizing protocols at least initially. If removing DHT while lowering T and increasing E2 to a maximum of 100pg/ml doesn't give significant improvements after a year anything else isn't likely to help.
 

JaneyElizabeth

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Since Bridgeburn and Noah used high doses of E, I will also keep E high. In this case, there is less chance of error. Moreover, it will help lower my T, and I want to lower it as much as possible
I would re-read the thread and then try to do exactly what Bridge did. Just turn off your mind and be accepting. One thing common to him and me, is that we simply refused to try to avoid breast growth and that's pretty much what a person has to do to be successful as a "just in it for the hair" HRT guy.

His beard stopped growing and I had mine removed both of which differs from most guys who see no diminution in beard growth but no hair growth either.
 

JaneyElizabeth

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Placebo effects are strong however there might be some advantage for some MTF to have elevated E2 at least for some time, it's not well studied.

In any case Almas isn't an MTF and shouldn't try to go for experimental feminizing protocols at least initially. If removing DHT while lowering T and increasing E2 to a maximum of 100pg/ml doesn't give significant improvements after a year anything else isn't likely to help.
The problem comes down to risk vs. reward and what each one of us finds to be acceptable as a risk in exchange for hair. Admittedly, the better the hair, the more willing I am to take on some level of extra risk but I also believe that HRT maintenance is effective maybe down to 100 pg/ml as you mention.

If no breast growth is a prerequisite, then those guys should not even bother to try HRT. You cannot sweat breast growth in my opinion if you want to be successful. Maybe we will have better protocols going forward with Serms but they are expensive and far from foolproof and they might not be good for hair. Perhaps having developed breasts is good for hair and perhaps having little to no beard growth is good for hair so the beard guys shouldn't attempt this either.

It is difficult still to pinpoint the mechanism by which HRT commences regrowth. Is having zero T enough to regrow hair? Probably not so we still need some therapeutic level of estradiol ingestion for hair regrowth and for feminization in general, if that is the goal. But once someone starts saying that they can't have breasts or any increase in body fat or any lessening of beard growth and so on, more and more is being changed from the standard XX hair growth vehicle.

It appeared to me that not a single person on this thread except for Bridge or maybe only a few, have the knowledge and the experience to know what they are doing to the extent that they can micro-manage bodily adjustments. Trying to avoid breast growth might just induce more breast growth. So the only real option is to quit immediately upon seeing breast growth. Titrating downward is not likely to even remotely work until we get down to non-therapeutic doses.
 
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