Sheds, Proven Medications and Topical Estrogel:
Marginal, Incremental Improvements vs. Hair Restoration
Sheds are one of the main issues that I want to help folks with and which I wanted to get feedback about. Given that folks complain about sheds related to all of the top-tier treatments, what does that mean? Does it mean that such treatments don't work or does it mean that they work, temporarily, too well? I think that it is the latter. This is why I virtually always recommend lower starting dosages. Do not start off using what
@bridgeburn or I use if avoiding sheds is a major issue.
First of all, virtually no one has alleged sheds while using estradiol only but that is pretty rare for anyone to use single-shot. Most sheds alleged come from things that work either singly or in conjunction with another: minoxidil, finasteride, dutasteride, RU and all of the AA's but estradiol might too. Second, consider going into the hormonal approach wanting a shed and make a backup plan to get yourself through one. The easiest is probably shaving your head when starting or as soon as a shed begins but wigs and hair systems used temporarily might be better for say, presentation in a corporate setting. Then ride out the shed until hair is long enough that you feel comfortable again. This idea that sheds indicate that a med is not working seems to have no data associated with it. This certainly doesn't seem to be an issue of a person not responding to a med hair-wise; it seems to be an issue of responding too well. That's why I disbelieved in sheds for a long time or thought that they were exaggerated.
Now, I am starting to believe that sheds are a token of the med working very well and starting an initiation of better/female hair. If we want to do this by avoiding sheds, then I recommend titrating, starting slow and low and then gradually titrating upwards. AA's seem to be jarring to the system and it could be that AA's are liable to cause massive sheds by working too well, too fast. Nobody seeking success should stop during a shed or you are back to square one. There's a reason there are so few of us with success out there. This is hard to achieve without sustained commitment. I have shown to myself and maybe to others that just using some Estrogel on top does not seem a pathway out of this except for maintenance and some subtle improvements.
Another thing about AA's compared to MPA or progesterone is that they might hi-jack, if you will male receptors much more quickly and forcefully than estradiol by itself; that's what they do, occupy male receptors and this could be what causes the "benevolent sheds", the term that I have created to try to explain the phenomenon of sheds propelling us in the right direction. In this scenario, AA's quickly occupy all male receptors in the scalp and the body senses this signal and puts all of the hair affected by these receptors into quick catagen/telogen towards a quick, permanent recovery, provided that the AA's with estrogen continue in use.
Estrogen can likewise occupy or turn-off such receptors but it takes much longer and is therefore less of a bumpy ride towards hair improvement until hair growth is "turned back on" upon reaching ~200pg/ml.
Finally, what is the plan for the future if it turns out that maintaining hormonal levels as a female is necessary for both success and maintenance? Noah is trying to "go back" using only dutasteride. Now here, using moderate amounts of Estrogel might work great. Oral minoxidil might help preserve gains. We all proceed at out our risk and towards our own benefit but by providing feedback, maybe we can make this more foolproof and establish a protocol that is safer related to avoiding sheds while at the same time acknowledging that sheds are good when using proven hair meds, not bad.
Micro-needling has really had an effect on my thoughts about hair loss because of its effects on scar tissue. Scar tissue is something that the body can heal for both males and females; however, it rarely does so after the scar tissue reaches a point of stasis. Micro-needling appears to "trick" the body into expending resources to fix the scar tissue, and it might do similar things to balding scalp tissue. The difference is that scars don't return but balding scalp will, if micro-needling is desisted from. So the main difference seems to be that balding is an on-going hormonal process while scar tissue is a one-shot process but the principle of inducing the body to fix things that "it thinks are good enough" seems to make sense. Nobody dies from baldness
per se so why expend the system's resources to fix it once it is prevalent. I also think that beard growth and hair growth are delicately counter-balanced in whites and so again, that is why hair restoration is hard. Some MtF's (in a hormonal sense) like
@bridgeburn lose most beard development but older MtF's like me usually have to endure beard removal. Regardless, not having currently active beard follicles might be associated with better hair outcomes and it was Marky with his boy band predilections that led me to this supposition.
One thing that I have learned about writing in a legal context and also related to hormonal treatments is to avoid categorical judgments or assertions. I try to always put in "maybe", "perhaps" "possibly" etc. If the hair loss researchers don't know the answers than we are unlikely to find them except anecdotally so that's why an enduring community like this is needed. We aren't like people taking zinc or using caffeine; we know that our approach can work; instead we are trying to tailor it more so to individual needs. Sometimes, on other threads, people take umbrage and say things like "of course, trannies alway grow their hair back"; well, no they don't. We just wear wigs a lot and the one's who eschew wigs in such a scenario are the ones who get bullied. When new data points indicate that I am wrong in certain suppositions, I try not to cling to previously stated hypotheses. I had hoped that Estrogel used on the scalp could be a solution for cis-men in terms of hair restoration and it appears to me now, that it can only do so marginally unless and until someone hits adult female targets of say ~200pg/ml. It could be ~100pg/ml but it is substantially higher in terms of serum estradiol than any male is likely to have on his own.
Goddess bless.
