Women Hair Loss Forums - Finasteride/Spiro/Yaz combo no longer working. Thoughts?

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peridot

30.08.2008, 15:48

Finasteride/Spiro/Yaz combo no longer working. Thoughts? (Androgenetic Alopcia (AGA) Female Pattern)
Post reply

I haven't been on the boards in a long time b/c I was really trying to give my regimen its due before panicking. It was this:

2.5 MG Fin
100 MG Spiro
Yaz

Last time I posted, back in late spring, the report was positive: shed count was way down throughout April and May. Then, in June, it started back up again. I switched to Yasmin to see if that would help, since I hadn't had any problems with Yaz. It didn't, so after a month I went back to Yaz, which I've been back on for about 2 wks.

Undoubtedly going up and down w/ estrogen levels by switching BCPs isn't helping, and I'll probably do it again, back to Yasmin, since I think I need all the E I can get. The other switch I made was to raise the Spiro up to 150, which I was originally prescribed anyway, but was trying to build gradually.

The past 3 showers have been the worst I've had in this 2 year nightmare—150-200 hairs lost each time, easily.

My body has also been changing for the worse—weight gain; all told, my guess is that I'm in early perimenopause.

SO, here's the question: what would you do at this point? I know some of you are on dosages of Fin and Spiro as high as 5 MG/400 MG, respectively. Would you raise your dosage? Or would you switch and try Avodart or Flutamide or something?

Thanks so much. Sorry I don't have better news to report.

peridot is located in [NA] and he is available to meet: NO

Chris

30.08.2008, 16:27

@ peridot
Finasteride/Spiro/Yaz combo no longer working. Thoughts?
Post reply

Peridot,
It's been along time since you've posted! I was thinking that you must have recovered and didn't need to be here anymore.
I finally started Yaz in June and after that one month pack changed to Yasmin thinking that the higher level of E would be better. I mean, if I'm going to go on birth control at the age of 46 why not get as much E as possible??? I've only been on Yasmin for about 2 months and I've noticed a slight decrease in shedding. However, I don't think I've been on it long enough for it to make a difference yet. Why didn't you just stay on Yasmin? I can't tell you anything about spiro. I'm not on that. Only Rogaine and Yasmin. However, my shed picked up in Spring and has been full steam ahead all Summer at 150-200 after washing so you can imagine how little hair I have left.

Chris is located in [NA] and he is available to meet: NO

mauri

30.08.2008, 19:44

@ peridot
Finasteride/Spiro/Yaz combo no longer working. Thoughts?
Post reply

peridot,

Ive been on the 200 spiro and 5mg finasteride since Feb. 1 of this year. My hair is definitely better although I pretty much attribute that to the higher estrogen with the vivelle dot. I think the reason I had any T issues is that my E got down to 80 at the beginning of peri and what T I had took over. I feel the finasteride has helped to keep hair in my head longer. My shed had dropped from 200+ down to 20-30 daily for several months. It was up to 100 again for about 5 days and now back to 30-60. I think that is because my E level dropped in the summer due to uneven patch application. My hair will never be what it was before peri but at this point it is very much acceptible to me and Im glad to have what I do.
If I were in your situation I would probably not go higher than 250 spiro and definitely no higher finasteride than 5mg. If that doesnt work then I would probably go try a different medicine. If your issue is estrogen then we know what you need. I would get the E tested to see what level you are at. If you are on BCP then you cant get a true level without stopping for some time and I'd be afraid of doing that.
Mauri

mauri is located in [NA] and he is available to meet: NO

HairSite Admin

31.08.2008, 02:41

@ peridot
Finasteride/Spiro/Yaz combo no longer working. Thoughts?
Post reply

There are no studies which address the effect of very high dose of spironolactone on FPHL.
But one should be aware of the complications like high potassium levels that can occur while on spiro.
High potassium can affect the heart.

» I haven't been on the boards in a long time b/c I was really trying to give
» my regimen its due before panicking. It was this:
»
» 2.5 MG Fin
» 100 MG Spiro
» Yaz
»
» Last time I posted, back in late spring, the report was positive: shed
» count was way down throughout April and May. Then, in June, it started back
» up again. I switched to Yasmin to see if that would help, since I hadn't
» had any problems with Yaz. It didn't, so after a month I went back to Yaz,
» which I've been back on for about 2 wks.
»
» Undoubtedly going up and down w/ estrogen levels by switching BCPs isn't
» helping, and I'll probably do it again, back to Yasmin, since I think I
» need all the E I can get. The other switch I made was to raise the Spiro up
» to 150, which I was originally prescribed anyway, but was trying to build
» gradually.
»
» The past 3 showers have been the worst I've had in this 2 year
» nightmare—150-200 hairs lost each time, easily.
»
» My body has also been changing for the worse—weight gain; all told, my
» guess is that I'm in early perimenopause.
»
» SO, here's the question: what would you do at this point? I know some of
» you are on dosages of Fin and Spiro as high as 5 MG/400 MG, respectively.
» Would you raise your dosage? Or would you switch and try Avodart or
» Flutamide or something?
»
» Thanks so much. Sorry I don't have better news to report.

HairSite Admin is located in [NA] and he is available to meet: NO
---
I offer research assistance for HairSite.
email: hairsite@aol.com for free consultations
=====================================
reminder:
1. FREE Hair Replacement System Worldwide

peridot

31.08.2008, 09:38

@ Chris
Finasteride/Spiro/Yaz combo no longer working. Thoughts?
Post reply

Hey Chris—I hear you and feel for you!
I don't know why I went back to Yaz...I guess because I was trying to recreate the success of spring, and the words of Yasmin naysayers were still echoing in my head. But it was a panicked mistake, so at the end of thie month I'll go back to Yasmin. All that back-and-forthing can't be good, but it's too late now.
What's your next plan of attack? Have you decided?

peridot is located in [NA] and he is available to meet: NO

peridot

31.08.2008, 09:43

@ mauri
Finasteride/Spiro/Yaz combo no longer working. Thoughts?
Post reply

Mauri—
That's great to hear. Congrats on the success.

Last I had my E tested—3 days into my cycle, which my gyno said even if I'm on the pill would be close enough for a fairly if not perfect accurate reading—it was definitely low. That was early spring.

Of course they said even if it is low, and even if you are in peri at age 38, you're already on the regimen we'd be starting for you, namely Yaz and Spiro.

Anyway, I think I'll check with my doctors about raising both dosages. Who prescribed those dosages for you—gyno, endo, derm?

Thanks!

» Ive been on the 200 spiro and 5mg finasteride since Feb. 1 of this
» year. My hair is definitely better although I pretty much attribute that to
» the higher estrogen with the vivelle dot. I think the reason I had any T
» issues is that my E got down to 80 at the beginning of peri and what T I
» had took over. I feel the finasteride has helped to keep hair in my head
» longer. My shed had dropped from 200+ down to 20-30 daily for several
» months. It was up to 100 again for about 5 days and now back to 30-60. I
» think that is because my E level dropped in the summer due to uneven patch
» application. My hair will never be what it was before peri but at this
» point it is very much acceptible to me and Im glad to have what I do.
» If I were in your situation I would probably not go higher than 250
» spiro and definitely no higher finasteride than 5mg. If that doesnt work
» then I would probably go try a different medicine. If your issue is
» estrogen then we know what you need. I would get the E tested to see what
» level you are at. If you are on BCP then you cant get a true level without
» stopping for some time and I'd be afraid of doing that.
» Mauri

peridot is located in [NA] and he is available to meet: NO

Chris

31.08.2008, 10:54

@ peridot
Finasteride/Spiro/Yaz combo no longer working. Thoughts?
Post reply

Hey peridot,
Well, I don't have another plan of attack. I'm still waiting for the Yasmin to kick in (hopefully) as I've read it could take 3-4 months or longer to see an improvement. Actually, Yasmin is my last resort so if it doesn't work I'm screwed. I guess I could try going on spiro or something but I don't think I'll ever do that because I know I'll be one of those unlucky few that has a dread shed. After shedding so much all Summer and having a dread shed on top of that I will look like Smeagel from Lord of the Rings ("cry" out loud!). No thanks. I guess if the Yasmin ends up not helping, I'll just give up the battle and wear a wig the rest of my life. :-(

Chris is located in [NA] and he is available to meet: NO

mauri

31.08.2008, 11:27

@ peridot
Finasteride/Spiro/Yaz combo no longer working. Thoughts?
Post reply

It was prescribed by Dr. Redmond in NY. I was not on spiro but only finasteride and HRT. Then when my hair became oily all of a sudden, he put me on 100mg. My hair was still oily and then I went up to 200mg. Immediately my scalp and forhead stopped showing any oil and my hair began to feel more normal for me. I have not had the potassium levels checked but have the appointment in late September which will be 9 months of spiro. If the levels show too high I will probably drop to 150mg and down from there. We still arent sure what really caused the shed since my T levels were not high. If I dont need all the spiro now then I certainly would drop down in mg's
Im 50 so I know my E dropping had a great deal to do with hair loss.
Mauri

mauri is located in [NA] and he is available to meet: NO

peridot

02.09.2008, 10:21

@ Chris
Finasteride/Spiro/Yaz combo no longer working. Thoughts?
Post reply

I might try switching from Fin to Avodart, but I'm with you—this battle is only worth fighting so hard for so long for so little. I've mentioned a few times some of the women I've met on another forum who finally gave up and wear bonded pieces. They are quite happy with them and say they feel as though they've gotten their lives back. Of course that's not ideal, but none of this is.

And in 5-10 years, we can have HM. Maybe.

peridot is located in [NA] and he is available to meet: NO

julie1977

02.09.2008, 15:51

@ HairSite Admin
Finasteride/Spiro/Yaz combo no longer working. Thoughts?
Post reply

There is a very important study:

Background It has not been conclusively established that female pattern hair loss (FPHL) is either due to androgens or responsive to oral antiandrogen therapy.

Objectives To evaluate the efficacy of oral antiandrogen therapy in the management of women with FPHL using standardized photographic techniques (Canfield Scientific), and to identify clinical and histological parameters predictive of clinical response.

Methods For this single-centre, before–after, open intervention study, 80 women aged between 12 and 79 years, with FPHL and biopsy-confirmed hair follicle miniaturization [terminal/vellus (T/V) hair ratio ≤ 4 : 1] were photographed at baseline and again after receiving a minimum of 12 months of oral antiandrogen therapy. Forty women received spironolactone 200 mg daily and 40 women received cyproterone acetate, either 50 mg daily or 100 mg for 10 days per month if premenopausal. Women using topical minoxidil were excluded. Standardized photographs of the midfrontal and vertex scalp were taken with the head positioned in a stereotactic device. Images were evaluated by a panel of three clinicians experienced in the assessment of FPHL, blinded to patient details and treatment and using a three-point scale.

Results As there was no significant difference in the results or the trend between spironolactone and cyproterone acetate the results were combined. Thirty-five (44%) women had hair regrowth, 35 (44%) had no clear change in hair density before and after treatment, and 10 (12%) experienced continuing hair loss during the treatment period. Ordinal logistic regression analysis to identify predictors of response revealed no influence of patient age, menopause status, serum ferritin, serum hormone levels, clinical stage (Ludwig) or histological parameters such as T/V ratio or fibrosis. The only significant predictor was midscalp clinical grade, with higher-scale values associated with a greater response (P = 0·013).

Conclusion Eighty-eight percent of women receiving oral antiandrogens could expect to see no progression of their FPHL or improvement. High midscalp clinical grade was the only predictor of response identified. A placebo-controlled study is required to compare this outcome to the natural history of FPHL.

Accepted for publication 25 February 2004

julie1977 is located in [NA] and he is available to meet: NO

peridot

03.09.2008, 15:18

@ julie1977
Finasteride/Spiro/Yaz combo no longer working. Thoughts?
Post reply

Yes, but...*something* was working, and then stopped. Do you think it was strictly the Yaz/Yasmin, the estrogen bump? If so, why did it stop?

peridot is located in [NA] and he is available to meet: NO

peridot

03.09.2008, 15:26

@ peridot
Finasteride/Spiro/Yaz combo no longer working. Thoughts?
Post reply

» Yes, but...*something* was working, and then stopped. Do you think it was
» strictly the Yaz/Yasmin, the estrogen bump? If so, why did it stop?

I forgot to add I use Rogaine 5% too. None of it's been of much use, but it's scary to stop once you've started just in case it's helping it from getting even worse even quicker.

peridot is located in [NA] and he is available to meet: NO

eb

15.09.2008, 00:08

@ peridot
Finasteride/Spiro/Yaz combo no longer working. Thoughts?
Post reply

Peridot, hi! I haven't been on any of the hair boards in a long while, but I thougbt of you the other day. I would not jump ship just yet. Lots of women who have overall success ALSO have periodic sheds. First, stop going on and off BCP. Just because Yaz and Yasmin are very similar doesn't mean your hair doesn't know you're switching from one to the other. If this shed lasts longer than 4 months, then I'd reevaulate, probably bump up the spiro to 200. I wouldn't take more than 200 as the law of diminishing returns applies. The other option is to bump up the fin to 5mg. But don't do both together (although at this point you may feel like you have no more hair to "experiment" with. But I bet you do)! I know one lady who has awesome results on 5mg fin, Yasmin and 100mg spiro plus Rogaine foam. She started at 200mg spiro originally but swore it made her worse so she cut down to 100 and raised the fin. The bulk of her success has been from the fin with Rogaine, not the spiro.

Avodart scared me enough and flutamide scares me even more. Flut is the only one I haven't tried. I took Avodart for a week and it made my skin WORSE, and my migraine unbearable.

Anyway, don't adjust things in a panic. Hope you can ride out this shed!

» I haven't been on the boards in a long time b/c I was really trying to give
» my regimen its due before panicking. It was this:
»
» 2.5 MG Fin
» 100 MG Spiro
» Yaz
»
» Last time I posted, back in late spring, the report was positive: shed
» count was way down throughout April and May. Then, in June, it started back
» up again. I switched to Yasmin to see if that would help, since I hadn't
» had any problems with Yaz. It didn't, so after a month I went back to Yaz,
» which I've been back on for about 2 wks.
»
» Undoubtedly going up and down w/ estrogen levels by switching BCPs isn't
» helping, and I'll probably do it again, back to Yasmin, since I think I
» need all the E I can get. The other switch I made was to raise the Spiro up
» to 150, which I was originally prescribed anyway, but was trying to build
» gradually.
»
» The past 3 showers have been the worst I've had in this 2 year
» nightmare—150-200 hairs lost each time, easily.
»
» My body has also been changing for the worse—weight gain; all told, my
» guess is that I'm in early perimenopause.
»
» SO, here's the question: what would you do at this point? I know some of
» you are on dosages of Fin and Spiro as high as 5 MG/400 MG, respectively.
» Would you raise your dosage? Or would you switch and try Avodart or
» Flutamide or something?
»
» Thanks so much. Sorry I don't have better news to report.

eb is located in [NA] and he is available to meet: NO

CCR

02.11.2008, 12:42

@ julie1977
Finasteride/Spiro/Yaz combo no longer working. Thoughts?
Post reply

» There is a very important study:
»
» Background It has not been conclusively established that female pattern
» hair loss (FPHL) is either due to androgens or responsive to oral
» antiandrogen therapy.
»
» Objectives To evaluate the efficacy of oral antiandrogen therapy in the
» management of women with FPHL using standardized photographic techniques
» (Canfield Scientific), and to identify clinical and histological parameters
» predictive of clinical response.
»
» Methods For this single-centre, before–after, open intervention study, 80
» women aged between 12 and 79 years, with FPHL and biopsy-confirmed hair
» follicle miniaturization [terminal/vellus (T/V) hair ratio ≤ 4 : 1]
» were photographed at baseline and again after receiving a minimum of 12
» months of oral antiandrogen therapy. Forty women received spironolactone
» 200 mg daily and 40 women received cyproterone acetate, either 50 mg daily
» or 100 mg for 10 days per month if premenopausal. Women using topical
» minoxidil were excluded. Standardized photographs of the midfrontal and
» vertex scalp were taken with the head positioned in a stereotactic device.
» Images were evaluated by a panel of three clinicians experienced in the
» assessment of FPHL, blinded to patient details and treatment and using a
» three-point scale.
»
» Results As there was no significant difference in the results or the trend
» between spironolactone and cyproterone acetate the results were combined.
» Thirty-five (44%) women had hair regrowth, 35 (44%) had no clear change in
» hair density before and after treatment, and 10 (12%) experienced
» continuing hair loss during the treatment period. Ordinal logistic
» regression analysis to identify predictors of response revealed no
» influence of patient age, menopause status, serum ferritin, serum hormone
» levels, clinical stage (Ludwig) or histological parameters such as T/V
» ratio or fibrosis. The only significant predictor was midscalp clinical
» grade, with higher-scale values associated with a greater response (P =
» 0·013).
»
» Conclusion Eighty-eight percent of women receiving oral antiandrogens
» could expect to see no progression of their FPHL or improvement. High
» midscalp clinical grade was the only predictor of response identified. A
» placebo-controlled study is required to compare this outcome to the natural
» history of FPHL.
»
» Accepted for publication 25 February 2004

WHERE IS THIS PUBLISHED? PLEASE CITE JOURNAL & TIME THANKS

CCR is located in [NA] and he is available to meet: YES

JL

02.11.2008, 15:06

@ CCR
Finasteride/Spiro/Yaz combo no longer working. Thoughts?
Post reply

Although I didn't post the study, I have seen it. Here is the citation:

Revue / Journal Title
British journal of dermatology ISSN 0007-0963 CODEN BJDEAZ
Source / Source
2005, vol. 152, no3, pp. 466-473 [8 page(s) (article)] (42 ref.)

My question is, what is "midscalp clinical grade"???

JL is located in [NA] and he is available to meet: NO

peridot 30.08.2008, 15:48	Finasteride/Spiro/Yaz combo no longer working. Thoughts? (Androgenetic Alopcia (AGA) Female Pattern) Post reply
	I haven't been on the boards in a long time b/c I was really trying to give my regimen its due before panicking. It was this: 2.5 MG Fin 100 MG Spiro Yaz Last time I posted, back in late spring, the report was positive: shed count was way down throughout April and May. Then, in June, it started back up again. I switched to Yasmin to see if that would help, since I hadn't had any problems with Yaz. It didn't, so after a month I went back to Yaz, which I've been back on for about 2 wks. Undoubtedly going up and down w/ estrogen levels by switching BCPs isn't helping, and I'll probably do it again, back to Yasmin, since I think I need all the E I can get. The other switch I made was to raise the Spiro up to 150, which I was originally prescribed anyway, but was trying to build gradually. The past 3 showers have been the worst I've had in this 2 year nightmare—150-200 hairs lost each time, easily. My body has also been changing for the worse—weight gain; all told, my guess is that I'm in early perimenopause. SO, here's the question: what would you do at this point? I know some of you are on dosages of Fin and Spiro as high as 5 MG/400 MG, respectively. Would you raise your dosage? Or would you switch and try Avodart or Flutamide or something? Thanks so much. Sorry I don't have better news to report. peridot is located in [NA] and he is available to meet: NO
Chris 30.08.2008, 16:27 @ peridot	Finasteride/Spiro/Yaz combo no longer working. Thoughts? Post reply
	Peridot, It's been along time since you've posted! I was thinking that you must have recovered and didn't need to be here anymore. I finally started Yaz in June and after that one month pack changed to Yasmin thinking that the higher level of E would be better. I mean, if I'm going to go on birth control at the age of 46 why not get as much E as possible??? I've only been on Yasmin for about 2 months and I've noticed a slight decrease in shedding. However, I don't think I've been on it long enough for it to make a difference yet. Why didn't you just stay on Yasmin? I can't tell you anything about spiro. I'm not on that. Only Rogaine and Yasmin. However, my shed picked up in Spring and has been full steam ahead all Summer at 150-200 after washing so you can imagine how little hair I have left. Chris is located in [NA] and he is available to meet: NO
mauri 30.08.2008, 19:44 @ peridot	Finasteride/Spiro/Yaz combo no longer working. Thoughts? Post reply
	peridot, Ive been on the 200 spiro and 5mg finasteride since Feb. 1 of this year. My hair is definitely better although I pretty much attribute that to the higher estrogen with the vivelle dot. I think the reason I had any T issues is that my E got down to 80 at the beginning of peri and what T I had took over. I feel the finasteride has helped to keep hair in my head longer. My shed had dropped from 200+ down to 20-30 daily for several months. It was up to 100 again for about 5 days and now back to 30-60. I think that is because my E level dropped in the summer due to uneven patch application. My hair will never be what it was before peri but at this point it is very much acceptible to me and Im glad to have what I do. If I were in your situation I would probably not go higher than 250 spiro and definitely no higher finasteride than 5mg. If that doesnt work then I would probably go try a different medicine. If your issue is estrogen then we know what you need. I would get the E tested to see what level you are at. If you are on BCP then you cant get a true level without stopping for some time and I'd be afraid of doing that. Mauri mauri is located in [NA] and he is available to meet: NO
HairSite Admin 31.08.2008, 02:41 @ peridot	Finasteride/Spiro/Yaz combo no longer working. Thoughts? Post reply
	There are no studies which address the effect of very high dose of spironolactone on FPHL. But one should be aware of the complications like high potassium levels that can occur while on spiro. High potassium can affect the heart. » I haven't been on the boards in a long time b/c I was really trying to give » my regimen its due before panicking. It was this: » » 2.5 MG Fin » 100 MG Spiro » Yaz » » Last time I posted, back in late spring, the report was positive: shed » count was way down throughout April and May. Then, in June, it started back » up again. I switched to Yasmin to see if that would help, since I hadn't » had any problems with Yaz. It didn't, so after a month I went back to Yaz, » which I've been back on for about 2 wks. » » Undoubtedly going up and down w/ estrogen levels by switching BCPs isn't » helping, and I'll probably do it again, back to Yasmin, since I think I » need all the E I can get. The other switch I made was to raise the Spiro up » to 150, which I was originally prescribed anyway, but was trying to build » gradually. » » The past 3 showers have been the worst I've had in this 2 year » nightmare—150-200 hairs lost each time, easily. » » My body has also been changing for the worse—weight gain; all told, my » guess is that I'm in early perimenopause. » » SO, here's the question: what would you do at this point? I know some of » you are on dosages of Fin and Spiro as high as 5 MG/400 MG, respectively. » Would you raise your dosage? Or would you switch and try Avodart or » Flutamide or something? » » Thanks so much. Sorry I don't have better news to report. HairSite Admin is located in [NA] and he is available to meet: NO --- I offer research assistance for HairSite. email: hairsite@aol.com for free consultations ===================================== reminder: 1. FREE Hair Replacement System Worldwide
peridot 31.08.2008, 09:38 @ Chris	Finasteride/Spiro/Yaz combo no longer working. Thoughts? Post reply
	Hey Chris—I hear you and feel for you! I don't know why I went back to Yaz...I guess because I was trying to recreate the success of spring, and the words of Yasmin naysayers were still echoing in my head. But it was a panicked mistake, so at the end of thie month I'll go back to Yasmin. All that back-and-forthing can't be good, but it's too late now. What's your next plan of attack? Have you decided? peridot is located in [NA] and he is available to meet: NO
peridot 31.08.2008, 09:43 @ mauri	Finasteride/Spiro/Yaz combo no longer working. Thoughts? Post reply
	Mauri— That's great to hear. Congrats on the success. Last I had my E tested—3 days into my cycle, which my gyno said even if I'm on the pill would be close enough for a fairly if not perfect accurate reading—it was definitely low. That was early spring. Of course they said even if it is low, and even if you are in peri at age 38, you're already on the regimen we'd be starting for you, namely Yaz and Spiro. Anyway, I think I'll check with my doctors about raising both dosages. Who prescribed those dosages for you—gyno, endo, derm? Thanks! » Ive been on the 200 spiro and 5mg finasteride since Feb. 1 of this » year. My hair is definitely better although I pretty much attribute that to » the higher estrogen with the vivelle dot. I think the reason I had any T » issues is that my E got down to 80 at the beginning of peri and what T I » had took over. I feel the finasteride has helped to keep hair in my head » longer. My shed had dropped from 200+ down to 20-30 daily for several » months. It was up to 100 again for about 5 days and now back to 30-60. I » think that is because my E level dropped in the summer due to uneven patch » application. My hair will never be what it was before peri but at this » point it is very much acceptible to me and Im glad to have what I do. » If I were in your situation I would probably not go higher than 250 » spiro and definitely no higher finasteride than 5mg. If that doesnt work » then I would probably go try a different medicine. If your issue is » estrogen then we know what you need. I would get the E tested to see what » level you are at. If you are on BCP then you cant get a true level without » stopping for some time and I'd be afraid of doing that. » Mauri peridot is located in [NA] and he is available to meet: NO
Chris 31.08.2008, 10:54 @ peridot	Finasteride/Spiro/Yaz combo no longer working. Thoughts? Post reply
	Hey peridot, Well, I don't have another plan of attack. I'm still waiting for the Yasmin to kick in (hopefully) as I've read it could take 3-4 months or longer to see an improvement. Actually, Yasmin is my last resort so if it doesn't work I'm screwed. I guess I could try going on spiro or something but I don't think I'll ever do that because I know I'll be one of those unlucky few that has a dread shed. After shedding so much all Summer and having a dread shed on top of that I will look like Smeagel from Lord of the Rings ("cry" out loud!). No thanks. I guess if the Yasmin ends up not helping, I'll just give up the battle and wear a wig the rest of my life. Chris is located in [NA] and he is available to meet: NO
mauri 31.08.2008, 11:27 @ peridot	Finasteride/Spiro/Yaz combo no longer working. Thoughts? Post reply
	It was prescribed by Dr. Redmond in NY. I was not on spiro but only finasteride and HRT. Then when my hair became oily all of a sudden, he put me on 100mg. My hair was still oily and then I went up to 200mg. Immediately my scalp and forhead stopped showing any oil and my hair began to feel more normal for me. I have not had the potassium levels checked but have the appointment in late September which will be 9 months of spiro. If the levels show too high I will probably drop to 150mg and down from there. We still arent sure what really caused the shed since my T levels were not high. If I dont need all the spiro now then I certainly would drop down in mg's Im 50 so I know my E dropping had a great deal to do with hair loss. Mauri mauri is located in [NA] and he is available to meet: NO
peridot 02.09.2008, 10:21 @ Chris	Finasteride/Spiro/Yaz combo no longer working. Thoughts? Post reply
	I might try switching from Fin to Avodart, but I'm with you—this battle is only worth fighting so hard for so long for so little. I've mentioned a few times some of the women I've met on another forum who finally gave up and wear bonded pieces. They are quite happy with them and say they feel as though they've gotten their lives back. Of course that's not ideal, but none of this is. And in 5-10 years, we can have HM. Maybe. peridot is located in [NA] and he is available to meet: NO
julie1977 02.09.2008, 15:51 @ HairSite Admin	Finasteride/Spiro/Yaz combo no longer working. Thoughts? Post reply
	There is a very important study: Background It has not been conclusively established that female pattern hair loss (FPHL) is either due to androgens or responsive to oral antiandrogen therapy. Objectives To evaluate the efficacy of oral antiandrogen therapy in the management of women with FPHL using standardized photographic techniques (Canfield Scientific), and to identify clinical and histological parameters predictive of clinical response. Methods For this single-centre, before–after, open intervention study, 80 women aged between 12 and 79 years, with FPHL and biopsy-confirmed hair follicle miniaturization [terminal/vellus (T/V) hair ratio ≤ 4 : 1] were photographed at baseline and again after receiving a minimum of 12 months of oral antiandrogen therapy. Forty women received spironolactone 200 mg daily and 40 women received cyproterone acetate, either 50 mg daily or 100 mg for 10 days per month if premenopausal. Women using topical minoxidil were excluded. Standardized photographs of the midfrontal and vertex scalp were taken with the head positioned in a stereotactic device. Images were evaluated by a panel of three clinicians experienced in the assessment of FPHL, blinded to patient details and treatment and using a three-point scale. Results As there was no significant difference in the results or the trend between spironolactone and cyproterone acetate the results were combined. Thirty-five (44%) women had hair regrowth, 35 (44%) had no clear change in hair density before and after treatment, and 10 (12%) experienced continuing hair loss during the treatment period. Ordinal logistic regression analysis to identify predictors of response revealed no influence of patient age, menopause status, serum ferritin, serum hormone levels, clinical stage (Ludwig) or histological parameters such as T/V ratio or fibrosis. The only significant predictor was midscalp clinical grade, with higher-scale values associated with a greater response (P = 0·013). Conclusion Eighty-eight percent of women receiving oral antiandrogens could expect to see no progression of their FPHL or improvement. High midscalp clinical grade was the only predictor of response identified. A placebo-controlled study is required to compare this outcome to the natural history of FPHL. Accepted for publication 25 February 2004 julie1977 is located in [NA] and he is available to meet: NO
peridot 03.09.2008, 15:18 @ julie1977	Finasteride/Spiro/Yaz combo no longer working. Thoughts? Post reply
	Yes, but...something was working, and then stopped. Do you think it was strictly the Yaz/Yasmin, the estrogen bump? If so, why did it stop? peridot is located in [NA] and he is available to meet: NO
peridot 03.09.2008, 15:26 @ peridot	Finasteride/Spiro/Yaz combo no longer working. Thoughts? Post reply
	» Yes, but...something was working, and then stopped. Do you think it was » strictly the Yaz/Yasmin, the estrogen bump? If so, why did it stop? I forgot to add I use Rogaine 5% too. None of it's been of much use, but it's scary to stop once you've started just in case it's helping it from getting even worse even quicker. peridot is located in [NA] and he is available to meet: NO
eb 15.09.2008, 00:08 @ peridot	Finasteride/Spiro/Yaz combo no longer working. Thoughts? Post reply
	Peridot, hi! I haven't been on any of the hair boards in a long while, but I thougbt of you the other day. I would not jump ship just yet. Lots of women who have overall success ALSO have periodic sheds. First, stop going on and off BCP. Just because Yaz and Yasmin are very similar doesn't mean your hair doesn't know you're switching from one to the other. If this shed lasts longer than 4 months, then I'd reevaulate, probably bump up the spiro to 200. I wouldn't take more than 200 as the law of diminishing returns applies. The other option is to bump up the fin to 5mg. But don't do both together (although at this point you may feel like you have no more hair to "experiment" with. But I bet you do)! I know one lady who has awesome results on 5mg fin, Yasmin and 100mg spiro plus Rogaine foam. She started at 200mg spiro originally but swore it made her worse so she cut down to 100 and raised the fin. The bulk of her success has been from the fin with Rogaine, not the spiro. Avodart scared me enough and flutamide scares me even more. Flut is the only one I haven't tried. I took Avodart for a week and it made my skin WORSE, and my migraine unbearable. Anyway, don't adjust things in a panic. Hope you can ride out this shed! » I haven't been on the boards in a long time b/c I was really trying to give » my regimen its due before panicking. It was this: » » 2.5 MG Fin » 100 MG Spiro » Yaz » » Last time I posted, back in late spring, the report was positive: shed » count was way down throughout April and May. Then, in June, it started back » up again. I switched to Yasmin to see if that would help, since I hadn't » had any problems with Yaz. It didn't, so after a month I went back to Yaz, » which I've been back on for about 2 wks. » » Undoubtedly going up and down w/ estrogen levels by switching BCPs isn't » helping, and I'll probably do it again, back to Yasmin, since I think I » need all the E I can get. The other switch I made was to raise the Spiro up » to 150, which I was originally prescribed anyway, but was trying to build » gradually. » » The past 3 showers have been the worst I've had in this 2 year » nightmare—150-200 hairs lost each time, easily. » » My body has also been changing for the worse—weight gain; all told, my » guess is that I'm in early perimenopause. » » SO, here's the question: what would you do at this point? I know some of » you are on dosages of Fin and Spiro as high as 5 MG/400 MG, respectively. » Would you raise your dosage? Or would you switch and try Avodart or » Flutamide or something? » » Thanks so much. Sorry I don't have better news to report. eb is located in [NA] and he is available to meet: NO
CCR 02.11.2008, 12:42 @ julie1977	Finasteride/Spiro/Yaz combo no longer working. Thoughts? Post reply
	» There is a very important study: » » Background It has not been conclusively established that female pattern » hair loss (FPHL) is either due to androgens or responsive to oral » antiandrogen therapy. » » Objectives To evaluate the efficacy of oral antiandrogen therapy in the » management of women with FPHL using standardized photographic techniques » (Canfield Scientific), and to identify clinical and histological parameters » predictive of clinical response. » » Methods For this single-centre, before–after, open intervention study, 80 » women aged between 12 and 79 years, with FPHL and biopsy-confirmed hair » follicle miniaturization [terminal/vellus (T/V) hair ratio ≤ 4 : 1] » were photographed at baseline and again after receiving a minimum of 12 » months of oral antiandrogen therapy. Forty women received spironolactone » 200 mg daily and 40 women received cyproterone acetate, either 50 mg daily » or 100 mg for 10 days per month if premenopausal. Women using topical » minoxidil were excluded. Standardized photographs of the midfrontal and » vertex scalp were taken with the head positioned in a stereotactic device. » Images were evaluated by a panel of three clinicians experienced in the » assessment of FPHL, blinded to patient details and treatment and using a » three-point scale. » » Results As there was no significant difference in the results or the trend » between spironolactone and cyproterone acetate the results were combined. » Thirty-five (44%) women had hair regrowth, 35 (44%) had no clear change in » hair density before and after treatment, and 10 (12%) experienced » continuing hair loss during the treatment period. Ordinal logistic » regression analysis to identify predictors of response revealed no » influence of patient age, menopause status, serum ferritin, serum hormone » levels, clinical stage (Ludwig) or histological parameters such as T/V » ratio or fibrosis. The only significant predictor was midscalp clinical » grade, with higher-scale values associated with a greater response (P = » 0·013). » » Conclusion Eighty-eight percent of women receiving oral antiandrogens » could expect to see no progression of their FPHL or improvement. High » midscalp clinical grade was the only predictor of response identified. A » placebo-controlled study is required to compare this outcome to the natural » history of FPHL. » » Accepted for publication 25 February 2004 WHERE IS THIS PUBLISHED? PLEASE CITE JOURNAL & TIME THANKS CCR is located in [NA] and he is available to meet: YES
JL 02.11.2008, 15:06 @ CCR	Finasteride/Spiro/Yaz combo no longer working. Thoughts? Post reply
	Although I didn't post the study, I have seen it. Here is the citation: Revue / Journal Title British journal of dermatology ISSN 0007-0963 CODEN BJDEAZ Source / Source 2005, vol. 152, no3, pp. 466-473 [8 page(s) (article)] (42 ref.) My question is, what is "midscalp clinical grade"??? JL is located in [NA] and he is available to meet: NO