Spironolactone/oral min not working. Now what?


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Reposting what I wrote on r/femalehairloss in hopes someone here might have some thoughts...

37/F with diagnosed Androgenetic Alopecia via observation and biopsy. Noticed thinning starting about 1 year after son was born. I've been on spironolactone for 2 years and moved up to 200 mg in September. I haven't noticed any slowing with shedding or miniaturization, however, doctor is adamant that it is doing something. Maybe something that I don't see. I would be happy with stabilization, but that is not happening.

Also been on oral min 1.25 mg. for 2 years (or longer?) and topical 5% min since 2019. I have not noticed any stabilization on the loss. Also, it's contributed to aging me . My dark circles were bad but they are now way worse. :(

I have also used ketoconazole shampoo, red light helmet, and microneedling without any noticeable changes so I discontinued use. Keto dried the f**k out of my thinning hair.

My hair is thinning since 2018. It started at the temples, but now I am experiencing over all thinning. The worst parts are my temples (left side worse), frontal hairline, and sides of head. Shedding is worse around my period. If I don't shower for even one day I feel the inflammation on my scalp. So I try to wash every day even though my hair looks frizzy. Interestingly enough my eyebrows are thinning.

I guess my question at this juncture is where I can go from here? I've tried all the usual routes, but they are not stopping my loss. Regrowth would be great, but I'm fine settling on stopping more loss and maintaining. I'm about to drop some cash on PRP, but am also feeling scared it's just going to cause shock loss and make things worse.

I also wonder if I have extreme dht sensitivity triggered by having a baby or if some other hormone is imbalanced. Most mornings I feel nauseous. I had weird cortisone levels once so the endocrinologist gave me further testing and I was told I was fine. I also have lots of GI issues and was diagnosed with IBS. My periods are also super light and dark brown. I've had hormone testing and have been told every time that everything is normal. So I'm just wondering if there is something I else I need to do. I know there are other meds men use, but I'm not sure which one I should try next and if I should start with a topical vs. oral medication. There's also stuff like bica. I'm always wary when I add a new medication into the mix if it's not going to treat the thing that needs to be treated. It also bugs me when I cannot address the root cause of what is going on because I don't even know what is going on.

If you've read to here thank you.