Hey Bridge! Good to see you!
I'm a trans woman, 42, I only realized it at 32 and started HRT at 34 and I went bald at age 21 (my dad went bald at 19, so I got his hair genes). I'm post bottom op since 2017 and switched to taking only estrogen. My body kept building resistance to Estrofem and Estrogel (applied to calves) and nowadays I am using Evorel patches, 1 on each calve.
I started minoxidil spray once a day last year for 6 months and from zero top of the scalp hair I started getting dilute growth. Then I had facial surgery and had to stop for a while. Two months ago I started minoxidil again, this time with 1 mg finasteride and I have been seeing even more growth, especially towards the back seeing lots of new short terminal hairs. I'm also doing my best to apply the minoxidil twice a day but it's really itchy and I hate it takes 2-3 hours to absorb and it drips to the back where I still have hair and makes it sticky.
I don't know if I can get oral minoxidil in my country, would you recommend that I do? I am afraid of regrowing facial hair, lowering blood pressure too much... then again, I already get swelling in my feet when I eat anything with added salt while under minoxidil regime, so I think it's going systemic anyway despite only applying it to the scalp.
Do you think it's important to apply estrogel directly on the scalp in addition to getting estrogen from my patches? Isn't there some health risk involved in doing that? I am also having issues getting my endocrinologist to prescribe to me both Estrogel and Evorel patches. I am currently taking 2 patches, maybe I could raise the dose but I'm afraid to build a resistance again.
Any tips on what I could do from your experience to improve my chances as post op, because lack of T (my blood results always show below test range) and having E by themselves haven't restored my hair but I have been seeing growth by adding minoxidil and now even more that I have also added finasteride but I am still way too dilute up there to go without a hat or a wig, which itch a lot... and even without them, just the minoxidil is itching horribly for me.
Right now my thinking is to ask my endo to increase my Evorel dosage and to try and get access to oral Minoxidil. Let me know if in your opinion I should take anything else like Estrogel on the scalp.
I also think I have fat malabsorption that might be impacting my hair, getting a GI panel for that. I have lack of subcutaneous fat in the skin around the eyes which is limiting my facial transition results which if I am right about the fat malabsorption could be explained by that, possibly. Gaining weight never reaches anywhere except my belly (was like that before transition too) and the rest of my body refuses to have fat on it.
My E levels are consistently low on blood tests which I believe could also have to do with possible fat malabsorption, but at least the patches worked to keep it measurable... before that estrogel and estrofem didn't work and E kept going down even as I raised dose until it went below test range. I'm vegan but I had these issues before I went vegan too. When I eat only whole plant foods it gets rid of feet swelling I otherwise get from minoxidil and reduces my belly bloating.