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[QUOTE=chickenbutt]you know, i have no idea!!...both of them have heard about it but they say, "you think you've got it bad...i've seen women with far worse..." no kidding...as though that helps....i just don't understand how they can be so unsympathetic AND women....i feel like doctor shopping just to get the rx and be checked for potassium levels....anyone know any docs in north jersey?[/QUOTE]


Hmm...you can tell them to kiss your assets and just go to an Endocrionologist or another doctor instead. Hirsutism can be Idiopathic or Hormonal...although both are hormonal ;-)

[U]Idiopathic Hirsutism[/U] = when you have normal hormone levels but increases Follicular Sensitivity and usually increased DHT production in the hair follicles.

[U]Androgenic Hirsutism [/U] = which is due to having HIGHER than normal amounts of androgens (Testosterone, DHT, etc) in the blood stream and also increased DHT in the follicles.


A good indicator of Androgenic Hirsutism would be if you have other hormonal problems. We know that you have acne (but this could also be due to sensitivity), but what else? Irregular Cycles, Hair loss (on scalp), Dandruff, Wieght Issues, etc?

Of course, none of that truly matters because if it's not Hypertrichosis (usually it isn't), than it's caused by some form of androgenic activity. It actually took a woman doctor (I was 17) before anyone seriously looked into giving me medications for my crazy hormones. She put me on BC, did nothing for the hirsutism, but did help reduce the acne. So later I saw an Endocrinologist (2nd one) and he said tha some people can just be extra sensitive to normal hormones and if I wanted I could go on Spironolactone. Well 6 months later (new male regular doctor), I had him put me on 200mg of Sprionolactone =)

That was my medication for 3 years. I just read something the other day that Spironolactone only reduces androgen levels by 30%. I must admit that's how much it added to the effects of my BC. So instead of 50% clear skin...I would have a 60% - 80% clear skin (80% was only during the summer). This did help reduce some of the body hair, but not as much as changing my diet and spiro did (past 18 months).

Anyway, this is currently my own conundrum. I've been on Spironolactone for nearly 6 years, although I recently stopped 2 months ago. I still have hirsutism and it looks as if some hairs are growing back. This is the thing I want to get across to any of you women with hirsutism and androgenic alopecia (scalp hair loss to DHT). [B]ONCE the hair follicles have been sensitized, even when your testosterone levels naturally decline (in your 20s and so on)...those follicles will STILL be sensitive & stimulated by DHT. [/B] Meaning, you will ALWAYS need a Follicular Anti-androgen (external or internal) otherwise, the hair will come back (unless it dies). Therefore, the sooner you can get control of your Acne, Hirsutism, and other Hormonal disturbances, the less "drama" you'll have to deal with when you get older.

Now back to what I was saying, Spironolactone (Aldactone) has been around quite awhile and has been used for the treatment of hormonal disorders in women for over 20 years. So yes, you really [B]need [/B] to get a 2nd or 3rd opinion because those doctors no nothing about this! What makes this more effective than Birth Control is because it actually binds to the Androgen Recptor (it's an analogue) and becomes antagonistic. It prevents the Androgen from binding, which means it also prevents the need for 5 alpha reductase enzyme, meaning less DHT that's converted. I was on 200mg for 3 years (Sprio-BC combo), then 150mg for 1 year ([B]Avandia[/B] - Spiro) and then 150mg of Spiro and a [I]Customized[/I] Gluten-Free Diet.

Of ALL those combinations.... the GF Diet-Spiro combo was [B]the[/B] Most effective thing for my Hirsutism, Menstrual Cramps, and Acne!!! Discovering what a huge impact changing my diet had on my skin, I'm hoping to do the same with replacing the Spiro with some sort of Supplement or Herb. Mainly the only problems I have left to deal with are my Dandruff, slight androgenic alopecia, and mild hirustism (spiro only took care of some of the hirsutism) which are all symptoms of [I]some[/I] DHT exposure or sensitivity. =(

For those interested in anti-androgens, if you live outside of the U.S. [B]Cyproterone Acetate[/B] (CPA is also in Diane 35) is supposed to be supperior to Spiro. In [B]1987[/B] there was a clinical trial run where they used dosages of 50mg on women and after 6 - 8 months they noticed improvements in their hirsutism. There's also another article I found that mentioned that women can start with 100mg - 200mg of spiro for 6 - 12 months and then reduce to a maintence dose of 25mg - 50mg. I suppose that sounds about accurate because there are women on here that claimed that 25mg - 50mg of Spiro CLEARED them. Wish it did that for my acne, but it didn't. Yet I'm wondering if I might be able to handle my mild hirsutism with 50mg....hmm.

Also another combination is to combine [B]Progesterone[/B] and [B]Birth Control[/B]. This is actually what Joeh follows...sorta. He's a male and uses 100mg of Spiro and Estrogen to clear his skin. This is actually the basis of not just [B]Diane 35[/B], but [B]Yasmin[/B] and [B]Allesse[/B], but of course it really does depend on where your hormonal imbalance is coming from because they use different anti-androgens.

Alternative Treatments thus far include: NAC (w/ 2-3x Vitamic C dose), Saw Palmetto, [B]Nettle[/B], [B]Beta Sitosterol[/B], [B]Vitex[/B] (encourages production of Progesterone),[B] NPC [/B] (natural Progesterone Cream), and a form of [B]Low Carb/Hormonal Balancing Diet[/B]. Anyway, it always seemed to me that I might have good luck if I just went out and bought a man's Prostate Formula because whatever is used to treat acne, hirsutism is usually going to also be used to treat Male Patterned baldness and Prostate Hyperplasia. Then again...sometimes it can backfire (cause increase growth) or do nothing at all.

There are people on here that RAVE about Saw Palmetto (men and women) at dosages ranging from 100mg - 350mg (or more) improving or clearing their acne. LOL, but when I was taking 1800mg for several months (3 seperate times) it did nothing. Maybe it was because I was already taking BC-Spiro (competing?) so that's something I may have to revisit. I've mainly read that [B]Saw Palmetto (at 85% - 95% sterols) [/B] decreases hair and acne, but also improves prostate function similar to Finasteride (Proscar, Propecia)! It does so by the same mechanisms as Sprionolactone, by acting as an analogue and binding to the androgen receptors, etc. It also goes under the name of Permixxon (I guess for the clinical trials) or it's natural name [I]Serona Repens [/I] and [U]reduces DHT by 50%[/U].


Now, if you want a really effect DHT blocker you want to hit it at [B]5 alpha-Reducatase Type I and Type II enzymes[/B] (why the thrill over Avodart, but it's only for men). DHT is responsible for the body hair growth and scalp hair loss due to stimulation of androgen receptors in the hair follicles. It also stimulates the oil glands (sebacious glands) and induces inflammation, etc that creates a symptom we like to call Acne. Below are the types of 5-alpha reducase enzymes:

[U]Type I[/U] (33% of DHT) - skin, sebacious glands, sweat glands, & scalp follicles Ex: Spironolactone, Flutamide

[U]Type II[/U] (66% of DHT)- sebacious glands, hair follicles & prostate Ex: Finasteride


Hmm...just like Spiro is actually a duretic but acts like an anti-androgen too, there's a drug used for control of stomach acids and ulcers that also acts as an anti-androgen...[B]Tagamet[/B] (Cimetidine). Apparently it has worked to treat hirsutism (facial hair) and the results are promissing for the treatment of alopecia. However, like I was mentioned earlier anything you find that works for you will usually be a Long Term Treatment, so you want something with the least to no side effects. Drugs have their own side effects, but to help jump start your progress you could try one of the above. Now, for those wanting to go the natural route, probably finding supplements that bind to the androgen receptor and [B]blocks [/B] androgen interaction is probably a best bet in terms of this whole mess.

HTH and Good luck (finding a better doctor) =)





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