Estrogen Therapy and Hair Growth

For the male readers of this blog, estrogen (also known as oestrogen) is not something that one would consider to be of interest. For one, estrogen is largely a female sex hormone. What male would want to start taking it and develop female secondary sexual characteristics such as breast enlargement?

Having said that, estrogen does have some properties that benefit overall health. Among these include heart protection (less atherosclerosis); strengthening of immunity; and reduction of inflammation. High levels of estrogen are though to be one of the reasons behind why females outlive males. The main negative of high estrogen is a greater chance of developing breast cancer.

Update: Recently, I discovered the below advice on Realself from Dr. Stephen Mulholland. He gives estrogen injections to his hair loss patients. I do not know of any other hair transplant surgeon who publicly advertises such a unique treatment strategy.

Estrogen Hair Loss
A doctor recommends estrogen injections as a hair loss treatment.

Update: December 24, 2021

Estrogen Monotherapy for Hair Growth

Since I originally wrote this post, I have become increasingly fascinated by estrogen’s hair growth properties. In my 2021 updated post on Male-to-Female (MTF) transgender persons, some of the before and after transformations are astounding.

Most transgender females take estrogen (typically in the form of estradiol, aka “E2”) as well as Finasteride or Dutasteride. Many also add anti-androgens such as spironolactone or cyproterone acetate into the mix. This is known as hormone replacement therapy (HRT).

What I am most curious about is non-transgender men who only use topical estrogen (cream, lotion, patch or spray) to regrow their hair. I would have never though that this would be a very effective solo hair loss treatment. Moreover, some amount of topical medication always gets absorbed into the bloodstream. So the feminizing side effects are likely to be significant, even if perhaps less so than with injected or oral estrogen supplementation.

Diane-35 and Alfatradiol

Some women take Diane-35 (which is a combination of ethinylestradiol estrogen and cyproterone acetate) to tackle androgen-dependent conditions. These include acne, seborrhea, hirsutism and scalp hair loss.

Yet others take alfatradiol, also known as 17α-estradiol. It is a weak estrogen and 5α-reductase inhibitor that is used topically in the treatment of pattern hair loss. One famous study found that  topical alfatradiol resulted in deceleration or stabilization of hair loss in women, but did not increase hair thickness and density like  topical minoxidil.

Reddit to the Rescue

What encouraged me to re-examine subject matter is Reddit. In recent months, I have seen a number of threads by people focused on using estrogen monotherapy to treat hair loss. In many cases, the “monotherapy” is ultimately supplemented with Minoxidil or Finasteride, but this is still okay by me.

I do not frequent Reddit more than twice a week, and rarely go to the transgender related subreddits. So I likely missed dozens of  other threads in 2021. Thankfully, I bookmarked the below ones. I hope to ultimately find more such testimonials from males who are definitely not transgender. In the comments, feel free to post links to any that you find interesting. And they need not just be limited to Reddit.

  • Yesterday, someone posted a question titled “Can estradiol mono-therapy help grow back your hairline”? Several of the responses are quite encouraging.
  • Three days ago, someone posted this amazing transformation from using just Finasteride and Oestrogel for two years. She claims that this is all her real hair.
  • One month ago, someone posted a very interestingly titled thread with six before and after photos (make sure to swipe right of each image). According to this person’s theory, an artificial selective estrogen receptor modulator (SERM) would be almost as good as a hair loss cure. Provided it is combined with an oral Minoxidil and an anti-androgen. Note that most people prefer an anti-androgen and DHT blocker combination. But oral Minoxidil is becoming a lot more popular too.
  • Earlier in 2021, someone posted phenomenal before and after results from using just estrogen plus Minoxidil as a hair loss treatment. I would guess that the vast majority of this transformation is due to the estrogen.

February 25, 2015

Estrogen Hormone Therapy and Hair Growth

The reason I decided to write a post on estrogen is because I recently read an extremely interesting 2012 interview with Dr. George Cotsarelis. While the main part of the interview is devoted to the oft discussed PGD2, there are several other interesting subjects discussed. The second page of the interview is what really surprised me in a good way.

In the first part of this interview, Dr. Cotsarelis discusses the old and well known Dr. James Hamilton study from the 1950s. In this research, it was found that men who were castrated before puberty (eunuchs) never went bald. However, upon being given testosterone, those with a family history of baldness still started to loose hair.

The second part of the interview is more interesting. It covers the fact that even after someone has lost much of his hair due to androgenic alopecia, he can regrow a lot of it when given estrogen (after castration)!

This point is supposedly verified by many studies on Male-to-Female (MTF) transitioning transgender persons. Such patients show hair regrowth after their being castrated and getting on estrogen hormone replacement therapy (HRT). Usually with the addition of an anti-androgen such as Spironolactone.

While I do not think any of us men want to get castrated or take estrogen (estradiol), this is still an incredible finding. One of the best examples is in the before and after image below from this study.

Estrogen Hair Growth
Estrogen (Estradiol) treatment for hair growth. Source: Journal of the American Academy of Dermatology.

Note that both estrogen and progesterone extend the anagen growth phase cycle of hair follicles. In contrast, testosterone and dihydrotestosterone (DHT) do the opposite and shorter the hair growth phase. Make sure to also read my post on how finasteride impacts testosterone and estrogen levels.

Hair Regrowth Difficulties

Over the years, I have read a number of articles in which doctors and professionals seem to suggest that once hair is gone (turns vellus), it can never return. This is also why Finasteride and Minoxidil virtually never bring back any significant amount of hair for someone who is mostly or entirely bald. However, it seems like hair can regrow in fully bald areas of the scalp in some instances.

There have been anecdotal reviews on Dutasteride actually regrowing long dormant hair. But these have been few and far between. Over a decade ago, Dr. Marty Sawaya caused an insane level of excitement on hair loss forums when she reported that one of her older patients gained back most of his lost hair when on Dutasteride. But that whole episode was controversial and not replicated.

More recent research suggests that a balding scalp still has all the follicle stem cells intact. But certain progenitor cells have become depleted. Basically, the cells are there, but the activity is not there. Dr. Cotsarelis has suggested that perhaps blocking PGD2 will allow the stem cells to make progenitor cells again. However, this is not a certainty, and neither is hair regrowth guaranteed once PGD2 is inhibited.

I suspect that this powerful impact of estrogen on hair regrowth is still not strong enough to grow back all of one’s lost hair. This is because many older balding MTF transsexuals seem to get hair transplants even after getting castrated and beginning estrogen therapy.

Finally, for men who take Finasteride (Propecia, Proscar), one potential side effect is increased estrogen levels. This sometimes results in the dreaded gynecomastia (male breast enlargement), along with fat gain in other parts of the body. Their are numerous complaints on hair loss forums about this side effect. Most studies indicate that the chances of developing gyno from taking 5-alpha-reductase inhibitors is extremely low.

55 thoughts on “Estrogen Therapy and Hair Growth”

  1. Skin Perturbation PLUS Ruxolitinib (lotion) is the 100% cure here now? And you mention EVERYTHING ELSE but what could be a REAL 100% Cure? Why do you not ask the medical researchers?

    Tired hearing about new discovered protein interactions in which a cure for hair loss could be only 5 years away. Is the cure here right now? And you ignore it?

  2. I too think skin perturbation/slight wounding + an anti -imflamatory would have some surprising results.. and it is quite weird no one has even tried this…

    Every disease in the human body is caused by some form of tiny cellular chronic immflamation which doesn’t let he body repair itself…. the fact that the medical industry refuses to test this out in mpb patients is very worrying… i think they realised that if they give the population antiimflamatories… we will all live to 100+ which is NOT GOOD!

    1. I’ve been doing slight wounding + rubbing an onion in daily for a year now and my results are beyond anything I gained from minoxidil

  3. Mpb follicles sensence prematurely a little like the aging process. Therefore it is hard if not impossible to get good regrowth. We need to find a way to clear the sensence cell out of the bulge to allow fresh cells to repopulate the stem cell niche

  4. Hola quisiera saber que opinan de la micropignentacion capilar???? Se utiliza en caso de querer llevar el pelo rapado y obtener mayor densidad. Parece una buena opción hasta que salga una cura. Y es menos agresivo que una cirugía. El administrador que opina???? Creo que es un tema que nunca se ha tocado.

  5. Lo que si me gusta de la micropigmentación es que es poco agresivo. Tengo algunas dudas: con el paso del tiempo y cuando tenes que hacer retoques no quedará una mancha homogenea??? realmente en persona no se nota???
    Yo todavía tengo pelo ose que se mezclaría con el mismo, por lo menos hasta que salga una solución. Y otra duda es si no afecta el pelo existente y si realmente desasaparece con el paso del tiempo, que no quede manchado en caso de volver a tener el pelo mas largo. Espero que me puedan dar sugerencias. En argentina hay alguno bueno?????

  6. Nose nada sobre el tema. miralo aver… yo pensaba que era un tatuaje ypor lo tanto se queda siempre… y si tienes pelo y a la vez te haces la micropigmentacion entonces eso si que se notara.

  7. Alguien que me pueda dar mas información sobre micropigmentación capilar??? en argentina conocen a alguien??? Quedará natural? Gracias.

    1. Diego….. no haces mas que preguntar y preguntar sobre absolutamente todo… no te lo tomes a mal pero creo que deberias coger las riendas e indagar un poco tu.. sino cualquiera te dice algo y te lo cres.. busca clinicas por argentina, valoraciones, videos en youtube… esta todo por internet… te digo esto por que me da cierta pena verte tan desesperado preguntando a todo el mundo.. suerte.

  8. A mi me parece que para eso están estos blog. Cada uno tiene derecho a preguntar lo que quiere. Es mas vos mismo le contestaste a Diego diciendole que la micropigmentación era una buena alternativa y cuando el te preguntó mas información vos le dijiste que no sabías nada del tema. Si no sabes nada del tema no recomiendes porque podes llevarlo a tomar una mala decisión. Justamente todos los que estamos aca es porque estamos desesperado por el tema pelo. Porque hace mas de 20 años que no sale nada. Nadie tiene derecho a agredir a nadie.
    Diego fijate en Argentina hay una empresa que se llama Pigmentalia, de Alejandro Chueco, parece que es buena.

  9. Gracias Gustavo! voy a ver esta clínica que me recomendaste. Respecto a lo que digan los otros, no me interesa, si quiero preguntar voy a seguir preguntando, siempre hago lo que siento y lo que quiero en la vida. Por eso me va bien. Tampoco estoy desesperado, solo me estoy informando para no equivocarme. Es un tema que me preocupa pero no es para tanto. Lo importante está dentro de mi casa, mi familia. Saluditos!!!!!

  10. Como que gente desubicada? te he dicho que no te lo tomaras mal pero esque no es normal que preguntes 10 preguntas al dia sobre 10 temas distintos… esta muy bien que hagas lo que quieras en la vida.. yo tambien lo hago y esta muiy bien pero no cres que te debes a ti mismo un poco de esfuerzo en encontrar tu soluciones? sino dependeras de los demas… yo no he agredido a nadie , le he dado mi opinion a diego sobre la micropigmentacion que me parece una solucion increible pero esque en vez de mirar el de que se trata la micropigmentacion, empieza a preguntar si crea manchas si noseque y nose que.. nose me parece muy raro que siendo lo afortunados que somos en tener internet haya gente que aun asi con estas herramientas a su disposicion tengan que preguntar como si no tuviesen informacion alguna… yo creo que el desubicado eres tu gustavo que yo le he contestado varias preguntas a diego, ya que soy hispanohablante y me estas agrediendo tu diciendo que estoy desubicado.. asique por favor no seamos hipcritas. yo solo quiero que diego pueda independizarse un poco en este tema y no sea presa de lo que ponga el admin en el blog ya que es un hombre como nosotros que se le cae el pelo y tampoco es un oraculo.. saludos.

  11. “respecto a lo que digan los otros, no me interesa” .. no te interesa lo que te digo pero si te interesa cuando soy el unico que responde a tus preguntas? esto es una broma no? sois asi todos los argentinos? si no sabes hablar ingles aun asi hay miles de fuentes de informacion para todo en internet.

  12. Y gustavo , precisamente le conteste mi opinion( lo que el buscaba) y luego le he dicho lo de las preguntas por que precisamente yo no soy nadie para recomendarle clinicas, por eso le recomende que se informara el mismo, por favor le mi mensaje antes de decir que hay gente desubicada que el unico desubicado eres tu.

  13. Ultima cosa Gustavo.. hace unos dias le dije al admin que deberia poner una nota en este blog diciendo que el no “responde a preguntas” ya que suficiente trabajo tiene con INDAGAR EL MISMO en internet para mantenernos informados… y que paso?? me dio las gracias puesto a que la gente le hacia tantas preguntas que le agobiaban…. mis mensajes son un poco agresivos ahora por que me ha molestado muhco tu comentario de desubicado cuando le estoy ayudando a tu “amigo”.

  14. It seems to me that everyone has a right to ask many times as desired and not feel like answering that do not. Besides not know the ages of the people who come on this blog, there are more people than there is no known internet search properly. Why resort to these blog, precisely because it is easier. The attack does not lead anywhere. I do not know but I understand Diego. All are about the same in this blog, so if someone bothers people asking a lot to go and ready. Thank You.

  15. Someone complained about the ads and I apologize. Lost all but one of my advertisers this year, so was forced to add Google ads using their automated AI insertion technology.

  16. I’ve read recently that the reason women live on average longer than men is because they are on average shorter than men – this explains most of the variance (based on the findings that short people live longer).

    1. Yes. Though testosterone induced homicide rate dominance by males does not help their life expectancy. Overdose, suicide and cirrhosis rates also higher in males in most countries. As are workplace deaths.

  17. Should look more into topical E3 use with finasteride. Seems to be completely overlooked by the community but the risk of feminizing sides is incredible low (largest risk is gyno that can be avoided by stopping at the warning signs) and results seem to be pretty significant over longer periods of time. I’ve now spoke to 5-6 people who have used 10-30mg daily of e3 with fin/dut/ru and gotten significant regrowth. Not anywhere near as significant as a full HRT regimen, but more significant then minoxidil or finasteride and can regrow on bald scalp after some time.

      1. No sorry admin, you can try pump bottles from over the counter or amazon but the stuff that will actually get results is medical grade. Can’t really ethically recommend sources for that.

  18. I was looking into Methyl Estradiolpropanoate (MEP) a while ago because it was sold over the counter. It only acts locally and is not an estrogen but has estrogen like effects. I only found one company (Biopelle) that sells it and it’s super expensive. There are a few papers on MEP concerning estrogen deficient skin which doesn’t mean it translates to hair growth.

    I’m just like everybody else when I started seeing that it is possible to regrow hair (previously thought dead) with hormone therapy. I started beating on the hood of google for male safe alternatives.

  19. Dear bald friends, after 30 years it’s hard to still believe that a cure to our problem will be found … Happy New Year everyone.

  20. Yeah, 2021 was a bust. Fingers crossed for 2022. If nothing comes in 2022, I may go see about a HT. I don’t have much donor hair (thin) but I’ll leave it to the experts to tell me what’s possible and what isn’t.

    1. Yeah you should go for it. 2021 we had some good major updates.
      That means 2022 wont be a lot of news from Riken and Stemson.

    1. …and possibly even a second scar below? (If you’re bored-‘pinch up’ the pic.) Also, the suit to his right looks like he’s about to be electrocuted by two yellow leads above his head.

  21. I have always been against hair transplant, I never wanted to accept the idea that a cure could not be found, but in recent years I have lost hope, many things have been said … but nothing has come out, we are still stuck with the fina and minox after 30 years :( at this point the transplant really becomes the only option, but even this is not a definitive cure … it SUCKS

    1. I don’t understand why so many are against them. If one has the money (they’re not cheap) and the donor hair, why not? 3k grafts each surgery – do two (a few years apart). Expensive but it would make a huge difference for some (like me). I’ve seen some amazing work done out there by some incredible docs. If I had thick sides I’d have done it already.

    1. Thanks for the link, although the paper was published almost a year ago.

      I read quite some papers from Pelage (and Carthronix, Lowry’s other venture) and the science really seems to be superior, or let’s say the idea of tackling hair loss, via stem cell activation. Which would theoretically be the „easiest“ way to a cure.

      Unfortunately Pelage is flying completely under the radar, so nobody knows where they are standing, but AbbVie is involved and they for sure know the potential.

      Same goes for Olix – imho superior to many other approaches.

      Both Pelage and Olix had presented astonishing results in mice.

  22. Do you guys believe in Kintor?

    I personally believe in HMI-115 but it seems like it will be *very* expensive according to HairLossTalk so…… *bye-bye*

      1. Winlevi is nice to see but the question is when will they start Phase 3 for AGA? And what are the results? And when will it come to market?

  23. Scientists are claiming they have a cure for baldness with that nano patches. When will we know if this is the real deal?

  24. Admin, this may be too much of a deep-dive into bodybuilding and the use of AAS, but did you ever cover the idea of running a nandrolone based-HRT for hairloss? Ive run cycles of nandrolone decanoate (only) or with a small amount of testosterone and my hair got better than it is with just my natural hormonal enviroment.

    Nandrolone (or better to say, its metabolite DHN) is far less androgenic than testosterone or DHT and having mostly nandrolone in your system creates a far less androgenic hormonal enviroment which will yield in better hair growth.

    There are some problems that come with nandrolone only-cycles or hrt, but it has been done before, even long-term in AIDS-patients. Maybe something you might wanna look into.

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