Urinary 5-Ene-Steroid Excretion in Non-Classical Congenital Adrenal Hyperplasia Due to 3β-Hydroxysteroid Dehydrogenase Deficiency

The conversation discusses the hypothesis that a lack of the enzyme 3-alpha hydroxysteroid dehydrogenase (3α-HSD) on the scalp may contribute to hair loss by allowing DHT to accumulate. Despite interest in this theory, no recent research has been conducted, and current treatments like finasteride and minoxidil remain the most supported options.

A 30-year-old female with PCOS and male pattern baldness is frustrated with her endocrinologist's recommendation of only Spironolactone and minoxidil, feeling that dutasteride, finasteride, and progesterone would be more effective. Other users suggest various online sources for treatments, warn against self-medicating due to potential risks, and recommend seeking a specialized endocrinologist or considering additional treatments like Inositol, Berberine, and dermaneedling.

The conversation discusses alternative and unorthodox hair loss treatments, including RU58841, nandrolone, and dianabol, as well as theoretical approaches involving high doses of estrogen and selective estrogen receptor modulators. These methods are considered extreme and potentially harmful but are explored for those unable to tolerate traditional 5-alpha reductase inhibitors.

The user has been using oral minoxidil and dutasteride for hair loss without success and is considering adding topical 17α-estradiol, Pyrilutamide, Clascoterone, or cetirizine. They have confirmed low serum DHT levels and are exploring additional treatments due to genetic sensitivity to DHT and prostaglandin D2.

The user is experiencing diffuse thinning and receded hairline, using dutasteride, minoxidil, and ketoconazole without regrowth, and was prescribed clobetasol propionate 0.05% with salicylic acid for possible inflammation. Other users caution against using the strong steroid without a serious condition, sharing experiences of adverse effects and alternative treatments for scalp issues.

Elevated bile acids can inhibit the enzyme AKR1C2, leading to increased DHT levels, which may accelerate hair loss in those predisposed to androgenetic alopecia. Treatments mentioned include topical minoxidil and finasteride.