Let The Journey Begin (long Term Documentation)

[Yar]

@Yar I have a question. Would you say 1 mg estradiol + 25-50mg (low dose) spironolactone (+dutasteride) would be better than spironolactone 100-200 mg + duta? For maintenance, I dont need regrowth.

It is better to take 1 mg of estradiol without any 5-alpha-reductase inhibitors.

 

[baba_yaga]

You're just taking now estradiol? Are you maintaining?

I dont know why you are so against 5ARIs. They increase T which would then increase E as well, helping you increase the E levels in your system. And at the same time inhibit DHT.

 

[Yar]

You're just taking now estradiol? Are you maintaining?

I dont know why you are so against 5ARIs. They increase T which would then increase E as well, helping you increase the E levels in your system. And at the same time inhibit DHT.

Yes, I am taking only estradiol. The side effects were caused by taking finasteride.

 

[baba_yaga]

Yes, I am taking only estradiol. The side effects were caused by taking finasteride.

how long have you been on 1 mg oral estradiol? You are also taking estradiol gel as well?

No feminizing symptoms? What about concerns of permanent infertility on estrogen?

I am trying to figure out whether I take higher dose oral spironolactone and duta, or lower dose oral spironolactone and low dose estrogen and duta, trying to find the regimen with good chance of stabilization with the lower side effects profile

 

[Yar]

how long have you been on 1 mg oral estradiol? You are also taking estradiol gel as well?

No feminizing symptoms? What about concerns of permanent infertility on estrogen?

I am trying to figure out whether I take higher dose oral spironolactone and duta, or lower dose oral spironolactone and low dose estrogen and duta, trying to find the regimen with good chance of stabilization with the lower side effects profile

I previously took 3 mg of estradiol in gel form and 2 mg orally; at one point, the gel dosage even reached 4.5 mg. I also took 100 mg of spironolactone, splitting the dose between morning and evening. I don't recall if I took the spironolactone continuously or in alternating months. This was back in 2019–2020. I managed to reverse my Norwood 1.5 hair loss completely. I did develop some breast growth during the process, but it doesn't bother me at all—most men over 40 have that kind of chest. I am 41. Later, in 2020–2021, I continued taking estradiol but without the spironolactone. In 2022, I stopped taking estradiol and experienced a reversal; over time, my hair returned to the Norwood 1.5 stage. I don't remember exactly how long that reversal took. In 2026, I decided to experiment with much lower estradiol dosages. I concluded that it is the estradiol that promotes hair growth. I also became convinced that anti-androgens like spironolactone or cyproterone aren't necessary—nor are finasteride or dutasteride. All that's needed is 1 mg of estradiol gel, plus B vitamins and magnesium to support endogenous progesterone production for inhibiting 5-alpha-reductase.

 

[baba_yaga]

I previously took 3 mg of estradiol in gel form and 2 mg orally; at one point, the gel dosage even reached 4.5 mg. I also took 100 mg of spironolactone, splitting the dose between morning and evening. I don't recall if I took the spironolactone continuously or in alternating months. This was back in 2019–2020. I managed to reverse my Norwood 1.5 hair loss completely. I did develop some breast growth during the process, but it doesn't bother me at all—most men over 40 have that kind of chest. I am 41. Later, in 2020–2021, I continued taking estradiol but without the spironolactone. In 2022, I stopped taking estradiol and experienced a reversal; over time, my hair returned to the Norwood 1.5 stage. I don't remember exactly how long that reversal took. In 2026, I decided to experiment with much lower estradiol dosages. I concluded that it is the estradiol that promotes hair growth. I also became convinced that anti-androgens like spironolactone or cyproterone aren't necessary—nor are finasteride or dutasteride. All that's needed is 1 mg of estradiol gel, plus B vitamins and magnesium to support endogenous progesterone production for inhibiting 5-alpha-reductase.

I think you are right. Starting to believe it is better to take low dose anti-androgens alongside low dose estrogen instead of simply high dose anti-androgens. I have read many threads where people get significant results only when adding estrogen to their AAs.

Currently the plan is: give dutasteride 3-6 months to have an initial judgment. If any hair loss presents (i will not assume its a shed), i will start 25 mg spironolactone and estrogen gel at low dose.

 

[Yar]

I think you are right. Starting to believe it is better to take low dose anti-androgens alongside low dose estrogen instead of simply high dose anti-androgens. I have read many threads where people get significant results only when adding estrogen to their AAs.

Currently the plan is: give dutasteride 3-6 months to have an initial judgment. If any hair loss presents (i will not assume its a shed), i will start 25 mg spironolactone and estrogen gel at low dose.

Estradiol itself acts as an anti-androgen. When estradiol is absorbed in the intestine, it undergoes first-pass metabolism in the liver. The liver begins synthesizing the protein SHBG, which binds primarily to DHT and subsequently to testosterone. This neutralizes their effects, as the bound hormones are unable to attach to receptors. Anti-androgens are unnecessary; estradiol itself functions as an anti-androgen.

 

[coco_304]

I

Estradiol itself acts as an anti-androgen. When estradiol is absorbed in the intestine, it undergoes first-pass metabolism in the liver. The liver begins synthesizing the protein SHBG, which binds primarily to DHT and subsequently to testosterone. This neutralizes their effects, as the bound hormones are unable to attach to receptors. Anti-androgens are unnecessary; estradiol itself functions as an anti-androgen.

Its right about estrogel too?

 

[Yar]

I

Its right about estrogel too?

Once it enters the bloodstream, the estradiol gel is distributed to all organs and tissues; this blood reaches the liver via the systemic arteries.

 

[coco_304]

Once it enters the bloodstream, the estradiol gel is distributed to all organs and tissues; this blood reaches the liver via the systemic arteries.

Gemini said that estrogel dont raised shbg.

 

[Yar]

Gemini said that estrogel dont raised shbg.

Even I know that blood needs to be purified, and it’s purified by the liver—which means it passes through it.

 

[baba_yaga]

Estradiol itself acts as an anti-androgen. When estradiol is absorbed in the intestine, it undergoes first-pass metabolism in the liver. The liver begins synthesizing the protein SHBG, which binds primarily to DHT and subsequently to testosterone. This neutralizes their effects, as the bound hormones are unable to attach to receptors. Anti-androgens are unnecessary; estradiol itself functions as an anti-androgen.

I did not look it up in detail yet, but I read gel estradiol does not raise the risk of venous thromboembolism, unlike oral estradiol. It also does not raise SHBG, unlike oral.
Gel estradiol is lower in terms of potency, as it does not raise SHBG and therefore does not reduce free testosterone as effectively as oral. And with lower thromboembolism risk, I think one should start with gel instead of oral, at least initially.

 

[coco_304]

I did not look it up in detail yet, but I read gel estradiol does not raise the risk of venous thromboembolism, unlike oral estradiol. It also does not raise SHBG, unlike oral.
Gel estradiol is lower in terms of potency, as it does not raise SHBG and therefore does not reduce free testosterone as effectively as oral. And with lower thromboembolism risk, I think one should start with gel instead of oral, at least initially.

High shgb lead to risk of blood-cot.
If you take oral estradiol you get more e1 instead e2.
Anyway i think its right to take anti androgen with e2.
anti androgen reduce testosterone but the body need another hormone instead for cognitive function like e2.
The body need test or e or both

I think to stop hair loss we need,
1. reduce testosterone for less dht and testosterone or block T and DHT from scalp’s AR.
2. to raise estradiol, estradiol is the key signal for hair to growth.
3. health scalp. 1 and 2 dont work with sick scalp.

Sorry for my bad english.

 

[baba_yaga]

High shgb lead to risk of blood-cot.
If you take oral estradiol you get more e1 instead e2.
Anyway i think its right to take anti androgen with e2.
anti androgen reduce testosterone but the body need another hormone instead for cognitive function like e2.
The body need test or e or both

I think to stop hair loss we need,
1. reduce testosterone for less dht and testosterone or block T and DHT from scalp’s AR.
2. to raise estradiol, estradiol is the key signal for hair to growth.
3. health scalp. 1 and 2 dont work with sick scalp.

Sorry for my bad english.

Agree. We need both reduce androgens T and DHT, and increase estrogen to get any significant hair regrowth or at least permanent halting of hair loss.

I will have my spironolactone and estradiol gel on standby in case hair goes downhill on duta.

Is there a difference between E1 and E2 for hair loss/side effects?