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High Progesterone: A Clue to Post-Op Hair Loss?

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I hope some here can provide a more in-depth explanation than my endo did for why my progesterone level tested so high. I don’t smoke, drink or do drugs; I’m in very good health. But this month was the first time that I had asked to have progesterone tested.

The testes produce most of the progesterone in cis men. But I’m 10 years post-op and have been on estradiol valerate injections twice monthly long before and ever since. So I was shocked when the blood levels showed it at 13 ng. My endo said that the adrenals are evidently producing enough progesterone to balance my exogenous estrogen levels. “Balance”? Then why did the Lab Corp statement say ‘high” 13 ng? Too bad I have no record of any pre-op progesterone level test. Would the level likely be this high?

This month T serum <3 ng. Bound T is <.2. E is 909 ng. B12 level is “high” at 1474 pg. HDL and LDL have long been high at 252 and 137. Iron is 339 bind/serum 339/125 ug. Creatinine serum LOW 0.62 mg;  BUN/Creatinine ratio 13

But regardless of progesterone levels, might I still be at risk for “estrogen dominance”?

Even if not, could my progesterone levels put me at risk for other deleterious effects?

My main concerns are scalp hair and libido, in that order. But to take the latter first, as strange it may sound to some here, I wouldn't at all miss libido if it went away. I will never forget the very first two years after I began therapy (estradiol valerate, spiro and a little Premarin), long ago. I grew back so much hair that I looked like a different person!! I was truly stunning. And almost as heavenly was the totally unexpected loss of libido. Poof! It just vaporized; or as if some big weight had fallen off my shoulders.

Without 10% minoxidil + 0.1% progesterone and Dutasteride that my derm and endo had prescribed my hair would surely be worse than it is. But why did the hair loss AND libido slowly come back at all? Especially after orchiectomy??

And if the adrenals were trying to “normalize” my estrogen levels then why are they secreting high levels

of progesterone, rather than just normal levels? Surely, the 0.1% progesterone in the topical that I press into my scalp twice daily is way too small to even penetrate the skin into the bloodstream, much less effect systemic levels.


Besides, by being a competitive inhibitor of 5-alpha reductase, progesterone is a natural antagonist of hair killing DHT. https://en.wikipedia.org/wiki/Progesterone_(medication)#Pharmacodynamics


Might it be that I’ve been using too much E for a typical post-op person, and/or because the vials

of estradiol valerate are almost certainly synthetic rather than bioidentical?


I can get natural estradiol valerate made by a local compounding pharmacy. But what signs should a post-op person look for to determine the right estrogen dosing?


Bottom line: How likely is my high progesterone contributing to libido and hair loss years after surgery? If yes, would it likely decrease if my endo lowers the dose of the 40mg/mL estradiol valerate I take every 14 days?



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D&T, this is something for you to have a discussion with your endo about it. They would have a better understanding than any of us of the particulars of your case. The topical cream could enter the blood stream too I think, but I am not a doctor.

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Hi D&T, 

Your E value seems high, if I am reading it correctly but as Marcie suggests I would have a talk with your Endo about this situation.  I am post op and use weekly Bio-identical transdermal patches which I like since the delivery is even with no spikes that can be problematic with other deliver systems.  


My doctor does follow my hormone levels but is most interested in how my body is accepting the meds and how I feel rather than the number since we tend to be somewhat of a science project (my opinion, not my doctor's).  At my recent appointment my doctor was not really concerned with Progesterone.  I'm sure you have researched estrogen dominance, have you experienced any of the symptoms?   We are all different and one size does not fit all.  





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First off -- a "skin pop" is a VERY effective way of delivery to your blood stream even with small amounts of the medication.  The second point I see here, is Information Overload for someone with less than 16 years as the head of a major endocrinology research facility.  Without having that high an interest or experience, this kind of information makes you prone to such unusual conditions as Psychosis of the Liver experienced by a few people who have scared themselves with IO  If you are taking your prescribed medication under the supervision of a Doctor or Medical Team (as I am) and are getting results that are within the ranges of what is described in the World Professional Assoc. for Transgender Health's Standards of Care v.7 get out and run a few laps or play a couple of rounds of golf and enjoy life.  Life is to be experienced not measured to death.  Take it one day at a time and love it.


PS, Psychosis of the Liver is not a real medical problem, although some claim it.

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