Nice thread, i read your post on tressless very instructive !
So my question is : What is the best treatment for baldness for a cis-male who don’t mind a slight gyno but who wants his dick to work fine ?
I will gladly go into that, and I assume you mean using HRT for its hair benefits, although there are many guys on here with knowledge related to Serms, which I consider an extremely high level technique and there just isn't even a whole lot of anecdotal info out there except to say that Serms do/can work but other MtF's and non-binary folks think that they are still risky in terms of avoiding breast growth. Weight lifters and body builders tend to have a lot of the knowledge related to Serms and masking their use and that of T, along with clomid.
In terms of maintaining sexual capacity, that seems well within reach for most XY's even those with adult female levels of estrogen. The key is to induce erections frequently and v**** is fine and still works for intact MtF's. The hitch is that you might not want to experience erections because your sex drive might be decreased and as I term it, it can become difficult to "groove" to your former pet fantasies. I think that this might primarily be an issue for people who use spironolactone, CPA and Bicalutamide but estrogen in general reduces fixation also. We know that CPA and MPA are both used to treat sexual offenders and to hopefully provide them with relief from fixative thought which is all but universal among males and all but unknown in females.
Note, I have used also and still use this med called MPA which for me has had only good sides and which might be a better and more straightforward hair med than the class commonly referred to as AA's. This gets confusing because technically finasteride, dutasteride, medroxyprogesterone acetate, CPA/Androcur and the 'mides are all anti-androgenic. Of the six, only MPA seems to work to actually decrease circulating levels of testosterone which makes it easier to monitor via testing. Reductase inhibitors are selective and only inhibit DHT while the other three are to me, just strange. They spoof higher estrogen and lower testosterone levels by occupying androgen receptors but they seem to be highly unpredictable in their effectiveness and sides. One reason why I wanted to get involved on here has been my nightmare of a year on spironolactone, which some people use and say works fine for them. These meds are also all synthetic, require a pass through the liver and are without a long history of human use.
It seems to me, based upon my own experiences with spironolactone that many DIY'ers get it backwards expecting estrogen to be more feminizing than AA's. Many of the stereotypical things about ideation related to males and females having different modes of getting into the mode can be true. On spironolactone plus estrogen, I found my strength vastly decreased; I was exhausted; I sweated profusely; had to pee constantly from the diuretic effects, lost virtually all of my hair and lost all of my sex drive, which for me was a feature not a bug, at least for a while. I literally could not get into the mind-set which was a relief from compulsion and the need to fixate, not just on sex but on other things while I tried to figure my life out.
There are several folks on here using AA's plus estrogen and getting good results but I tend to think that they are mostly necessary when someone can't reach target levels.
@bridgeburn who inspired many of us, stated that he never lost the ability to engage with his significant other although his erectile capacity might have been somewhat affected. He regrew long angelic curls like a rock star from not much more than a horse shoe pattern but his feminization was also all but complete, including breast development. He continued to use male pronouns which is similar to many non-binary folks, hence I use male pronouns in reference to him.
Although he did everyone a great service by pictorially proving over two years time that all but complete restoration with long periods of anagen could be achieved via HRT, he didn't follow through on really dealing with the idea as to whether his success was replicable without becoming recognizable as a female. Virtually all MtF's would drool over his results. Nevertheless, that only takes cis-guys so far. Now we know this is possible and believe or not, except for one off transition photos, there are essentially no pictorial essays or what have you that progress from complete baldness to a full head of hair. Many expected him to get a breast reduction to complete the experiment and there appeared to be disappointment from some when he declared that he was "keeping them".
Now the goal in my mind, is to see if his "journey" or that of the several others enjoying amazing success could be achieved without AA's because they are correlated with so many sides and problems but primarily without cis-guys having to use more E2 than necessary and obviously without their appearing feminized if possible. Thus, it's a goal to see if HRT has mostly incremental positive effects over time (it did for me) or whether this is a situation where hitting adult female targets is sort of a light switch turning hair growth back on (this also appears to be true for me). My current feeling is that both things occur but it might be necessary to maintain target levels in the female zone for a considerable amount of time, say from eight to 16 months to fully effectuate the anagen and hair growth properties from "turning on" "female" hair and to then move on to maintenance. There's a fellow name of Noah, who has gone off HRT and is at the one year mark using now only dutasteride and he posts frequently and we all hope for the best and so far, based upon the scores of pictures, there is only some corner recession, although the texture of the hair might have changed and his ability to grow it long is likely to be decreased but we shall see.
I have been very excited by oral minoxidil but I got a DM from someone today saying they used pills with dutasteride, finasteride and oral minoxidil and nothing doing even after two years and he sent me several pics. Nevertheless, I think that oral minoxidil is the best male hair treatment ever and combining it with dutasteride and derma-rolling and Keto/Nizoral is pretty much the gold standard for cis-males who don't fear reductase inhibitors. Please, if you want, post more details and people will chime in who might have similar goals and experiences to you. I look forward to hearing about your progress and every data point, anecdotal or not, is helpful to the next general of XY's.
Related to your choices, somewhat it depends upon your goals and hair loss history and your current meds. There are some cis-males who probably would be better served by either giving up or by putting an effort into learning how to harness derma-rolling. If you saw the poll at the beginning, almost thirty percent who take the time to answer, won't use dutasteride or finasteride which puts a person into a hole to begin with. So, I would start with dutasteride since it has better specs than finasteride and I would start at between 2.5 mg and 10 mg of oral minoxidil, which can be Kirkland's topical so this option is dirt cheap. You just have to convert mg into the ml equivalent which is a tiny amount made more difficult by the lack of metric droppers with extended ml markings.
Any treatment needs to be continued from six months to 12 months without switching meds in the HRT context unless the sides are too bad but then there is the option of tapering downward. Tapering upwards and downwards often referred to titration is something that many folks forget about when deciding they can't tolerate certain meds. Lots of guys have pinpointed different ways of using finasteride that benefit them without sides. I have only ever gotten unexpected/intolerable sides from spironolactone and not from dustasteride, estrogen or MPA.
If you have already committed at least possibly to the idea of using AA's or estrogen, then you can add estrogen plus an AA but not an AA alone as bone loss and other issues might present. How much estradiol? We don't know but I don't think anyone with significant cosmetic improvement has used less than 2 mg swallowed daily.
@bridgeburn for comparison was on two different aggressive protocols, even for MtF's. He took his estradiol tabs buccally or sublingually which tends to promote high levels of estrogen in the blood, up to three times as much.
Too much estrogen is pretty much impossible for MtF's and innocuous to human health so we can more or less just blast away with estrogen and AA's and that was his approach, the full-on kitchen sink where he didn't test and just went by the mirror, which is actually a pretty good method for MtF's but not for cis-males except HRT requires constant monitoring and things can sneak up on a person and once a person reaches the point of significant breast growth, he has to back off. I didn't though and neither did he. For me, I knew somehow that estrogen was the key even 36 years ago and I couldn't end the experiment until it had played out.
A lot of this is or can be thrilling. There's very little that can compete with hair restoration in terms of rolling back the clock and improving looks and youth. More and more, I am spending many minutes a day brushing mine because it doesn't "hurt" to brush vigorously and I no longer fear an AA shed. The psychological state is fascinating as well but people need to be wary; some might like the psychological effects so much that they don't want to "go back". I am seriously very close to being just as happy with my entire physical and psychological aspect as I have been since I was 17. I wasn't done with my hair and you probably aren't either.
