Guys, Janey, I'm new, and I need a whole new Androgenetic Alopecia regimen. Step one is to get on some kind of anti-androgen. I am a 40 something woman, Androgenetic Alopecia (secondary to PCOS) for over 20 years, lost over half my hair, and about half of that in a matter of months years and years ago. Have never psychologically recovered from that experience! Have been off Diane 35 for three years now and not wanting to go back on because of my age. Ended up (after a lot of experimenting and not sticking with anything else) only relying on Diane 35 as monotherapy for hair loss. Have not had a shed since coming off, but hair loss is progressing faster although scalp feels fine (the pill did not completely stop the loss, although it did slow it down. ) I am not under care of an endo (but have an upcoming appointment). I do not need contraception (I am gay and old) but to get anything prescribed I will need to go on hormonal contraception or a copper IUD (that's the way they do things here.) I don't want to faff about with that until I have worked out what I need to be on long term and I'm nervous about progestin-only contraception from a hair loss point of view. I don't want a progestin f*****g up my hair. Or if it does, I want to know that's the reason. Hence, starting the anti-androgens first.
So the plan is to DIY and experiment, and I may need to get blood tests done privately if needed. Obvs for bica it would be needed. Then I will see about getting what I want prescribed. I want to be able to chop and change until I'm happy. Bica is unlikely, duta is unlikely, finasteride, spironolactone and CPA all possible I think. Also, I don't know if I want to mess up my menstrual cycle too much (for health reasons, not hassle reasons, although obvs the hair is paramount. And the sexual sides are a minor consideration. Again, hair is paramount, but Diane has had some lasting effects there. Basically, most of the studies in women are done alongside estrogen-containing pills, which is fine, but I feel too old to risk being on one now. So I don't know how all this stuff is going to work without an OCP.
So the options are: spironolactone - I hate this stuff, I've tried it before, and there is no way I can do more than 100 mg, although I did read an interesting study about combining it with liquorice to offset some of the sides (well, not really the sides.) I have heart palpitations and a tendency to low blood pressure, so I would only really be interested in a low dose of spironolactone as support with finasteride I think, to block the increase in T, maybe just 50 mg. Also messes up periods, but the fatigue/dizziness etc is more of a concern for me.
CPA - I think I need to combine this with estrogen though? Plus the doses are insane, ten days out of the month a quarter of a pill is still a lot (Diane is only 2mg a day for 21 days out of 28). This needs more research.
finasteride - might try 2.5mg a day and see how it goes. Bit worried about raising the T too much. I have never had high T, but apparently it goes up about 40% in women. Conflicting studies on dosage in women, hence 2.5mg to start.
I could probably get any of these drugs prescribed with contraception.
These, however, seem less likely, although you never know:
dutasteride - think I'll try finasteride first, since if all goes badly, finasteride will be out of my system quicker.
Bica - very interested in this. Probably 12.5 mg or 25 mg a day. Ofc, potentially dangerous sides, liver must be monitored etc, so maybe a hassle to DIY? But some good recent studies. Both flut and bica seem to have the most impressive results for hair loss in women that I have seen. However, not sure how it's going to work with my PCOS. Also, on her alopecia, there have been two disasters; one lady ended up with serious lung disease within a few weeks, and one had reflex hyperandrogenicity. But then that could happen on finasteride too? Even the lady who had amazing results said the sexual side effects were severe, inability to orgasm etc. The worry is that those changes may not be fully reversible. I sound like a man complaining about this! But otoh, I've drooled over some of the studies and the progress pics! Seeing those partings tighten up! And aren't there always disasters on the internet?
I have a family history of breast cancer, which is a slight concern. spironolactone seems fine for that, obvs bica and finasteride/dutasteride are unknown.
Finance is a concern. I don't want to depend on an expensive regimen. I want something I can afford, come rain or shine. I already did the crazy spending money on random herbs and sh*t years ago. I wear a topper now outside the house, and I'm never going back unless I get considerable, OP levels of regrowth (which I'm not expecting.) So I have to pay for those. I also like taking as little of a drug as possible once it has built up in my tissues because I find with most anti-androgens that most of the benefit seems to be possible with a low dose.
Anyway, I'm posting here because this is a wonderful thread (I mean, seriously balding to hobbit hair in under 2 years!!) Very inspiring.