Pharmacology of Different Progestogens: The Special Case of Drospirenone

The conversation discusses using estradiol mesotherapy to replicate hormone replacement therapy results while minimizing systemic exposure. It also covers the use of Spironolactone cream, which reportedly has no systemic side effects, and the potential risks of using bicalutamide and Spironolactone in men.

A 37-year-old woman with androgenetic alopecia is using spironolactone, oral and topical minoxidil, and considering PRP therapy due to lack of progress. She is unable to obtain finasteride, dutasteride, or bicalutamide and is exploring other options like Clascoterone and RU58841.

Finasteride has no effect on the user's estradiol levels, and body fat may influence aromatization. The user is on testosterone replacement therapy and uses everyday injections to manage high RBC count, with plans to measure DHT, DHEA-S, and pregnenolone levels.

RU58841, an anti-androgenic compound, showed early promise for treating alopecia but faced challenges after its patent in 1997. Despite advancing to Phase II trials, safety concerns and financial struggles led Aventis to abandon its development. Proskelia, which later merged into ProStrakan, couldn't prioritize the drug, leading to its eventual stagnation and failure to reach the market.

Some users have experienced good hair regrowth with estradiol, cyproterone acetate, spironolactone, and bicalutamide, but these treatments may cause feminization and other side effects. It's advised to consult a doctor before using these treatments, as they can lower testosterone and have significant risks.

Spironolactone and estrogen may be more effective for hair regrowth in transgender women than finasteride alone. Estrogen and spironolactone suppress testosterone, potentially reducing DHT more effectively than finasteride.