Gender Outlaw

FTM Transition Journal

1. Jacky V. 5.4.09 / 4am

   Good luck with the results you’re looking for. I’m actually on Procar now to try to fight against the conversation of T to DHT because my hair has been thinning so much. I REALLY don’t want to go bald.

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   1. Claire 7.28.09 / 2pm

      I am a trans woman, and I’m using Avodart (dutasteride 0.5 mg) to frustrate T -> DHT formation, because I wasn’t happy with the thinning of my body hair on T-blockers (spironolactone) alone. It’s supposed to be much more effective at reducing DHT levels in skin (which would prevent it from killing follicles on your scalp), because it inhibits alpha-5-reductase type I and II (rather than just type I for finasteride.) If Proscar isn’t saving your hair, you could ask your doctor about Avodart.

      Reply
2. genderoutlaw 5.4.09 / 7am

   From what I understand, Procar is the same thing as Propencia and Finisteride. It will be interesting to watch your estriadol levels as blocking DHT systemically can raise E.

   You could also try topical Minoxidil (Rogaine). This was originally a blood pressure medication and works by dilating blood vessels to the scalp, keeping nutrient delivery to follicles running. Regular scalp massage is also recommended for similar reasons. Minoxidil doesn’t block DHT.

   Other options are the HairGenesis line, and other oral, natural DHT blocking supplements (which you can find at health food stores.)

   I really don’t want to go bald either! Do you know if there is a genetic disposition to pattern baldness in your family? My dad’s side all had full heads of hair, but I don’t know enough about my mom’s side to have an answer for this.

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3. Jacky V. 5.5.09 / 2pm

   Hmmm. Well, my endo didn’t seem too concerned about that. Considering he hasn’t even had to raise my dose of T because with my 50mg per week, I’m in range and have all the desired effects, I guess he figures this won’t hurt me. And there is some leeway in raising my T levels if needed.

   From what I’ve read, minoxidil doesn’t have as much back-up and also is mostly recommended for crown baldness. My endo says it’s better to catch it now with the finesteride because it will help prevent further hair loss.

   My brother is almost completely bald but my mother’s 6 brothers all have full heads of hair even in old age. I suspect my mother carried the gene from her dad so her brother’s didn’t get it, since they only got their X’s from their mom. Therefore, she transmitted to my brother and, possibly, to me.

   On my dad’s side, hard to tell. He was not bald at all although his hair thinned dramatically in the years leading to his death at 51. But he had a bunch of illnesses that accounted for that. I don’t know any of his female blood relatives or their offspring since he was adopted.

   Anyway, the beard hasn’t stopped darkening at all since I started the proscar so . . . time will tell, I guess.

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4. genderoutlaw 5.5.09 / 5pm

   I battled with high E until my hysto, and it took a long time for my T to get within range, so it was just my personal experience that inspired the comment about DHT and E levels.

   I haven’t read too much about hair loss products, but I also read that minoxidil is only effective on the crown. However, I passed this on to a friend of mine who’s in the same boat (using DHT and wanting to prevent hair loss) and he said he found studies from 2005 that indicate that it also works on the temples. Who knows? As Homer Simpson says, “People can come up with statistics to prove anything. Forty percent of all people know that.”

   Good to know that Procar will prevent further loss, thanks for passing that on. But it’s oral and also blocks DHT systemically? That wouldn’t help the DHT Dude.

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5. genderoutlaw 5.6.09 / 9am

   Jacky, I heard from a guy who’s on Finisteride (and T but not DHT) and he feels blocking DHT systemically with it could be the cause of what he perceives as a recent stunting of virilization (specifically, less facial hair growth all of the sudden.) Every body reacts differently to all this, but I would certainly be interested in hearing from you if you start to experience anything similar.

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6. Jacky V. 5.6.09 / 2pm

   Interesting. I’ve been on finesteride for about a month now. I haven’t seen any decrease in virilization. In fact, my beard is darker and coarser than it was a month ago AND I have new body hair, still. Like I said, my endo was SO not worried about it.

   He said that bio men are hesistant to go on it because it lowers their levels but that in my case, because I inject weekly, it will offset any potential losses. Maybe that’s the thing . .. maybe there is a connection with frequency and mode of injection . . .

   I really trust my endo. He has lots of experience with both MTFs and FTMs. I hear things from other trans guys from other areas outside of Montreal who are surprised, for instance, that I do sub-cutaneous injections. But my endo insists that it’s as effective. He was right, in my case! Also, he explained to me that weekly injections were good because they prevented the emotional roller coaster that some guys experience since I reinject before the previous dose is completely absorbed.

   So . . .time will tell. If I start to see reversals in my process, I’ll consult him but if the trend of the past month continues, it seems I have nothing to worry about.

   About minoxidil . . . another thing I forgot to mention is that I actually did order some online. Kirkland brand specifically. I used it for about a week before it drove me nuts. Spreading this icky stuff twice a day? No thanks! Especially when I want to go out in the world and NOT have a sticky looking forehead LOL

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   1. genderoutlaw 7.25.09 / 6pm

      I mention this only because I just came across it, not to be argumentative. (Also to include more information for anyone who stumbles across this conversation in the future.)

      From Nick Gorton’s Medical Therapy and Health Maintenance for Transgender Men (http://nickgorton.org), p. 48:

      Propecia (finasteride) is a Type-II 5a-Reductase inhibitor… Inhibiting the enzyme in transmen would therefor be expected to decrease hair loss in the scalp and slow or stop facial hair growth… finasteride also decreases serum DHT levels by as much as 65%.

      Reply
7. genderoutlaw 5.6.09 / 2pm

   Hmm, interesting thought about frequency of injection offsetting a drop in DHT levels. I’ll pass that on to my friend. His cycle is a little longer than 7 days and maybe changing this would make a difference.

   I don’t know enough about T… surely DHT is not the sole metabolite that’s responsible for facial hair growth, voice changes, muscle development and genital tissue growth? Perhaps one of others, just a particularly powerful one?

   I think you’re the only person I know who does sub-Q. Right on the T leaflet that comes with my injection it says it’s supposed to be a deep IM injection. I’ve never seen a bodybuilder talk about sub-Q either. But you’re walking evidence that sub-Q works!! Jeez, judging by your beard, maybe it works better! So, obviously it’s just as effective. Are there any specific benefits or reasons why your endo recommends sub-Q administration?

   I consider myself lucky because I haven’t experienced any of the emotional roller coaster that’s attributed to biweekly injections. I wondered if that would change post-hysto, but so far so good. I don’t want to inject more frequently than I do, so I’m happy about this.

   Oh no, twice a day hair gunk doesn’t sound pleasurable at all!!

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8. Jacky V. 5.7.09 / 6am

   I’m just speculating, by the way, about the point on injection frequency and reading between the lines of what my endo told me. I’ll ask more about it next time . .. there usually isn’t a lot of time and I always have to pick and choose what I’m going to ask about that day.

   But all the trans guys that I know who go to him do sub-Q, except for the one that had to switch to gel on account of allergic reactions or something.

   What he told me when he gave me my first prescription is that it is AS effective as intra-muscular and that it is easier to learn and to self-administer, so that’s why he goes that way. He didn’t mention any benefits pertaining to effects, etc. Whenever I talk about effects, he always says: time. No matter what method, time is the biggest factor in terms of seeing effects. Increasing my dose, he claims, would not speed things up. Not that I need them to be speedier . . .I’m pretty content with how things are going.

   Glad you haven’t had the emotional roller coaster thing! I know a couple of guys who do . .. no fun at all!

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9. genderoutlaw 5.7.09 / 7am

   Easier to self-administer… that’s what I suspected. I was also wondering about if it results in less scar tissue. I haven’t even tried a rump injection because of the flexibility involved. I try to pick different spots on my thighs, and I alternate legs, but I wonder if over time there will be a build up of scar tissue that might make it tougher to get the needle in. My doctor said this could happen, and at that point I’d have no choice to switch to rump. I wonder if sub-Q avoids this?

   Yeah, T is cumulative and takes time. I still have to tap into patience, especially regarding my scant facial hair. I had my dose continuously titrated (standard practice) because it was not suppressing my high E.

   Reply
   1. kelleyroo2 5.9.09 / 9am

      I rump inject, well my wife does it for me, but I believe i could also do it with the bathroom mirror being big enough to see what I am doing. If you do start doing rump injections strohecker’s pharmacy has a tutorial online on how do it properly.

      Reply
      1. genderoutlaw 5.9.09 / 9am

         Thanks for that! Here are the links to those tutorials, which include video as well:

         How to give an intramuscular injection
         How to give a subcutaneous injection
10. Jacky V. 5.7.09 / 9am

    I’m not sure if sub Q avoids scar tissue. I do know that there is a grid (the same one diabetic use) of the abdomen and thighs and I’m supposed to keep track, making sure that I wait a couple of months before re-injecting in the same spot to make sure that area has time to adjust to the foreign material.

    Reply
11. genderoutlaw 5.7.09 / 10am

    For anyone else looking for info about rotating injection sites, this is clear and useful: What is a Good Pattern for Insulin Injection Rotation?

    Regarding sub-cutaneous injection of testosterone, this study of sub-Q administration of T in biomales concluded that,

    Therapy with weekly subcutaneous testosterone produced serum levels that were within the normal range in 100% of patients for both peak and trough levels. This is the first report, which demonstrated the efficacy of delivering weekly testosterone using this cheap, safe, and less painful subcutaneous route.

    There is a huge forum thread about this available here (8 pages long.) It’s suggested that the IM requirement is something perpetuated by pharm companies who want to make T injection seem less of a hassle by recommending less frequent administration. (Lower volume and more frequent injections are recommended with sub-Q, to minimize potential for development of abscesses, and because lower absorption is claimed.) There’s much discussion about the potential for more aromatisation of T to E with sub-Q (which I think we’ve talked about here before) but it doesn’t sound like there are any hard facts backing this up.

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12. Daniel 5.7.09 / 6pm

    I have been injecting sub-q for a few months now. I haven’t had any issues with it (or my levels) at all, and am happy I made the switch as I was finding it VERY hard to do the IM injections anymore. Feel free to ask me any specific questions if you’d like as well.

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13. genderoutlaw 5.7.09 / 6pm

    Cool, thanks for chiming in Daniel! I was thinking people who don’t like needles might be well suited to sub-Q: perhaps they could inject using a diabetic injection aid like this one.

    Reply
14. 15 months on T « Gender Outlaw 7.3.09 / 9am

    [...] currently injecting 200mg every two weeks. Beginning April 29 (after my hysterectomy and when I started DHT cream) I reduced my dose to 150mg and maintained this for 2 months. My T level at 6 weeks post-hysto was [...]

    Reply

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