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Comment by adnauseum | Hacker News Reader

This, and solutions for male pattern baldness.

Male pattern baldness is a solved problem, if caught early enough; people just don't usually bother, because the cleanest solution (a 5α-RI) can interfere with sexual function, the "proper" fix for that (low-dose topical application) is time-consuming (so people normally just kludge it with Viagra), and the medicines involved can (indirectly) cause breast growth with prolonged use (unlikely to be a problem with low-dose topical application, and can also be mitigated, although overshooting that mitigation can cause osteoporosis) and are "don't even touch this if you're pregnant" class (they can interfere with fœtal development).

If I have to relinquish my sexual function and grow breasts to reduce baldness, then baldness is not a solved problem.

out of curiosity, what else would you expect the side effect profile of something mediating the effects of a potent androgen on the body to look like?

it's not estrogen where you would expect breast growth (and can't count on any particular changes to sexual function anyway), it's inhibiting conversion of testosterone to dihydrotestosterone which could have that effect, much like you could spontaneously develop gynecomastia without intentionally fiddling with your hormone balance. calling it unsolved sounds a lot like calling the very many conditions with medications that have more likely and worse side effects equally unsolved.

> it's not estrogen where you would expect breast growth

Actually, it is. Reducing DHT levels causes the body to elevate both testosterone and œstrogen levels, via homeostasis. But yeah, it's not a direct effect, and if it's a problem you can twiddle further to make it go away. (You could even do that pre-emptively, though you normally get days and days of warning before breast development actually starts, so I'd advocate the "wait and see" approach.)

  > what else would you expect the side effect profile of something mediating the effects of a potent androgen on the body to look like?

I'm a consumer, not a medical professional. I have no expectations based upon detailed familiarity with the underlying biology. Or is the target market for these products medical professionals?

That's what the patient information sheet is for, and why everyone's supposed to have access to a trained medical professional they can freely consult for things like this.

A condition is typically considered solved if there are drugs or procedures that cure it and either (a) have extremely rare side effects, or (b) have side-effects that are not as big a problem as the condition they are curing. If a pill existed that cured trh common cold but had a 1% chance of giving you cancer of the throat, people wouldn't proclaim "we've cured the common cold!".

Low-dose topical application doesn't have those problems. Heck, even "dose your entire body" doesn't always lead to sexual dysfunction. (And breast development is a rare side-effect that you'd notice before anything permanent happens, and is easily-addressed.) However, it is topical application of a medicine that can interfere with fœtal development.

Oh, almost forgot: any messing around with sex hormone levels puts you at risk of depression. That's big side effect #3 (though again, many people don't even notice it).

Started with topical Minoxidil at age 21. Have (almost) a full head of hair. Now I take it in pill form.

No breasts. And no other issues.

Minoxidil is a sledgehammer: it's got all sorts of other effects (e.g. reducing your blood pressure, beta something something). I wouldn't expect it to cause breast development, though, since it doesn't act on œstrogen receptors.

You seem knowledgeable. Where's a safe place to order the topical application from? I'm not in the US or Europe, our doctors aren't going to be bothered with (or knowledgeable about) something like treating baldness.

My Gmail username is the same as my HN username if you prefer to answer in private. Thanks

I don't have the savvy for stuff like actually acquiring medicines, unfortunately. You might be able to just buy it from your local pharmacy; but if not, you could check https://hrtcafe.net/ or – as a sibling commenter suggested – look into minoxidil (which works via a different mechanism). I wouldn't recommend minoxidil unless its other effects would be beneficial to you, since I'm leery of things that affect blood pressure and circulation – but I'm not actually trained in this stuff, so maybe it's considered safer.

Finasteride is less potent, but is normally recommended for cis men; not sure why. Theoretically, I'd expect dutasteride to be the better medication (and https://doi.org/10.2147/CIA.S192435 bears that out) if you can get hold of it.

I'd have thought finasteride and dutasteride weren't safe to take if there's a chance of you getting someone pregnant, but https://www.nhs.uk/medicines/finasteride/fertility-and-pregn... says it's fine, actually. https://doi.org/10.4103/0974-1208.86093 goes into more detail on that. (I'm not aware of any other impacts on fœtal development, only the intersex condition mentioned in that article – note that the backdoor pathway described in https://doi.org/10.1002/dvdy.23892 also requires the 5α-reductase enzyme –, but I'd still advise caution.)

Thank you. This is an extremely informative comment that gives me many avenues to pursue. Much appreciated.

By the 24th century, no one will care that you are bald.

I'm doubtful that President Camacho could've gained so much power without that fantastic coif

Unless you are Brian “Hairlacher” formerly of the Chicago Bears and shilling hair replacement on Chicago area billboards for years now.

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