Quote from chickenbutt:

you know, i have no idea!!...both of them have heard about it but they say, "you think you've got it bad...i've seen women with far worse..." no kidding...as though that helps....i just don't understand how they can be so unsympathetic AND women....i feel like doctor shopping just to get the rx and be checked for potassium levels....anyone know any docs in north jersey?

Hmm...you can tell them to kiss your assets and just go to an Endocrionologist or another doctor instead. Hirsutism can be Idiopathic or Hormonal...although both are hormonal ;-)

Idiopathic Hirsutism = when you have normal hormone levels but increases Follicular Sensitivity and usually increased DHT production in the hair follicles.

Androgenic Hirsutism = which is due to having HIGHER than normal amounts of androgens (Testosterone, DHT, etc) in the blood stream and also increased DHT in the follicles.


A good indicator of Androgenic Hirsutism would be if you have other hormonal problems. We know that you have acne (but this could also be due to sensitivity), but what else? Irregular Cycles, Hair loss (on scalp), Dandruff, Wieght Issues, etc?

Of course, none of that truly matters because if it's not Hypertrichosis (usually it isn't), than it's caused by some form of androgenic activity. It actually took a woman doctor (I was 17) before anyone seriously looked into giving me medications for my crazy hormones. She put me on BC, did nothing for the hirsutism, but did help reduce the acne. So later I saw an Endocrinologist (2nd one) and he said tha some people can just be extra sensitive to normal hormones and if I wanted I could go on Spironolactone. Well 6 months later (new male regular doctor), I had him put me on 200mg of Sprionolactone =)

That was my medication for 3 years. I just read something the other day that Spironolactone only reduces androgen levels by 30%. I must admit that's how much it added to the effects of my BC. So instead of 50% clear skin...I would have a 60% - 80% clear skin (80% was only during the summer). This did help reduce some of the body hair, but not as much as changing my diet and spiro did (past 18 months).

Anyway, this is currently my own conundrum. I've been on Spironolactone for nearly 6 years, although I recently stopped 2 months ago. I still have hirsutism and it looks as if some hairs are growing back. This is the thing I want to get across to any of you women with hirsutism and androgenic alopecia (scalp hair loss to DHT). ONCE the hair follicles have been sensitized, even when your testosterone levels naturally decline (in your 20s and so on)...those follicles will STILL be sensitive & stimulated by DHT. Meaning, you will ALWAYS need a Follicular Anti-androgen (external or internal) otherwise, the hair will come back (unless it dies). Therefore, the sooner you can get control of your Acne, Hirsutism, and other Hormonal disturbances, the less "drama" you'll have to deal with when you get older.

Now back to what I was saying, Spironolactone (Aldactone) has been around quite awhile and has been used for the treatment of hormonal disorders in women for over 20 years. So yes, you really need to get a 2nd or 3rd opinion because those doctors no nothing about this! What makes this more effective than Birth Control is because it actually binds to the Androgen Recptor (it's an analogue) and becomes antagonistic. It prevents the Androgen from binding, which means it also prevents the need for 5 alpha reductase enzyme, meaning less DHT that's converted. I was on 200mg for 3 years (Sprio-BC combo), then 150mg for 1 year (Avandia - Spiro) and then 150mg of Spiro and a Customized Gluten-Free Diet.

Of ALL those combinations.... the GF Diet-Spiro combo was the Most effective thing for my Hirsutism, Menstrual Cramps, and Acne!!! Discovering what a huge impact changing my diet had on my skin, I'm hoping to do the same with replacing the Spiro with some sort of Supplement or Herb. Mainly the only problems I have left to deal with are my Dandruff, slight androgenic alopecia, and mild hirustism (spiro only took care of some of the hirsutism) which are all symptoms of some DHT exposure or sensitivity. =(

For those interested in anti-androgens, if you live outside of the U.S. Cyproterone Acetate (CPA is also in Diane 35) is supposed to be supperior to Spiro. In 1987 there was a clinical trial run where they used dosages of 50mg on women and after 6 - 8 months they noticed improvements in their hirsutism. There's also another article I found that mentioned that women can start with 100mg - 200mg of spiro for 6 - 12 months and then reduce to a maintence dose of 25mg - 50mg. I suppose that sounds about accurate because there are women on here that claimed that 25mg - 50mg of Spiro CLEARED them. Wish it did that for my acne, but it didn't. Yet I'm wondering if I might be able to handle my mild hirsutism with 50mg....hmm.

Also another combination is to combine Progesterone and Birth Control. This is actually what Joeh follows...sorta. He's a male and uses 100mg of Spiro and Estrogen to clear his skin. This is actually the basis of not just Diane 35, but Yasmin and Allesse, but of course it really does depend on where your hormonal imbalance is coming from because they use different anti-androgens.

Alternative Treatments thus far include: NAC (w/ 2-3x Vitamic C dose), Saw Palmetto, Nettle, Beta Sitosterol, Vitex (encourages production of Progesterone), NPC (natural Progesterone Cream), and a form of Low Carb/Hormonal Balancing Diet. Anyway, it always seemed to me that I might have good luck if I just went out and bought a man's Prostate Formula because whatever is used to treat acne, hirsutism is usually going to also be used to treat Male Patterned baldness and Prostate Hyperplasia. Then again...sometimes it can backfire (cause increase growth) or do nothing at all.

There are people on here that RAVE about Saw Palmetto (men and women) at dosages ranging from 100mg - 350mg (or more) improving or clearing their acne. LOL, but when I was taking 1800mg for several months (3 seperate times) it did nothing. Maybe it was because I was already taking BC-Spiro (competing?) so that's something I may have to revisit. I've mainly read that Saw Palmetto (at 85% - 95% sterols) decreases hair and acne, but also improves prostate function similar to Finasteride (Proscar, Propecia)! It does so by the same mechanisms as Sprionolactone, by acting as an analogue and binding to the androgen receptors, etc. It also goes under the name of Permixxon (I guess for the clinical trials) or it's natural name Serona Repens and reduces DHT by 50%.


Now, if you want a really effect DHT blocker you want to hit it at 5 alpha-Reducatase Type I and Type II enzymes (why the thrill over Avodart, but it's only for men). DHT is responsible for the body hair growth and scalp hair loss due to stimulation of androgen receptors in the hair follicles. It also stimulates the oil glands (sebacious glands) and induces inflammation, etc that creates a symptom we like to call Acne. Below are the types of 5-alpha reducase enzymes:

Type I (33% of DHT) - skin, sebacious glands, sweat glands, & scalp follicles Ex: Spironolactone, Flutamide

Type II (66% of DHT)- sebacious glands, hair follicles & prostate Ex: Finasteride


Hmm...just like Spiro is actually a duretic but acts like an anti-androgen too, there's a drug used for control of stomach acids and ulcers that also acts as an anti-androgen...Tagamet (Cimetidine). Apparently it has worked to treat hirsutism (facial hair) and the results are promissing for the treatment of alopecia. However, like I was mentioned earlier anything you find that works for you will usually be a Long Term Treatment, so you want something with the least to no side effects. Drugs have their own side effects, but to help jump start your progress you could try one of the above. Now, for those wanting to go the natural route, probably finding supplements that bind to the androgen receptor and blocks androgen interaction is probably a best bet in terms of this whole mess.

HTH and Good luck (finding a better doctor) =)

Hey =)

Let me tell you, doctors and endocrinologists were not receptive to me. I don't know if it was because they didn't really care, or because they were clueless or because they didn't want to interrupt my hormones during puberty (wish they had sooner though), but it took awhile.

I had a derm for a few years that said it was due to a Hormonal Imbalance and then when I was 14 I saw an Endocrinologist (Internal Medicine doc). He wasn't from my hospital so they ran all tests (for free), except one because it required another lab. That one test was the one I needed =( I didn't get anywhere until I went in for something else actually...lol. That's when I was 17 and first saw this new doctor...a woman!!! She looked at me and my body acne and my body hair and said "no, this isn't right. you're not supposed to have this." =) She put me on the BC, but that wasn't enough. So she made an appt with an 2nd Endo that was visiting my hospital and that's when he mentioned spiro to me. BC still wasn't working so in Aug. of 1998, i saw another doctor (had turned 18 so got an "Adult" doctor). He put me on Spiro. Started at 50mg and worked up to 200mg over a month I think.

What got me here today was a result of wanting my body acne and hirsutism to be GONE. BC-Spiro helped, but they couldn't break my Breakout Cycle (Fall-Winter acne) and I noticed that I was still growing more body hair (even though it was reducing some). So I went to a derm at my hospital and they gave me RetinA (again) and Minocycline. Well the Minocycline pretty much did the job for me and I was only on it for 3 months. I realized that I didn't want to be on it forever and so I stoppped. Within in less than a month I was broken out worse than ever!!! BC-Spiro were powerless...that's when things started to get depressing...

It was almost 7 or 8 months later, that I was at my Gyno for my checkup and asked her if I could go off of the BC because I'm feeling a bit depressed and more sensitive. She asked why I was taking it and I told her it because of my hormonal imbalance. She said that she "would have to make an appt with an Endocrinologist to make sure I do it properly." =)

I remember I first saw HIM, in April 2001. He was the BEST thing that ever happened to me. He tested me that day, but then took me off of both BC and Spiro because he needed a baseline for my hormones. So...if you want this, you will have to go off of ALL your hormones (no BC). I waited 2 months (takes about 2 - 3 months for meds to make changes in system) and went back. He took 17 tubes of Blood and 2 urine contains (gallon size) to run 32 tests! LOL, everybody at the blood lab knows his work ;-)

After those first tests, he was concered about my Cortisol levels so he had me do another 24 hour urine collection (the gallong jug). Everything turned out normal there, so he said I was probably PCOS or Insulin Resistant. He ran a few tests to confirm that I didn't have Diabetes, but in the end he said the Medication would still be the same (somewhere on here I think that's posted...look up PCOS). It's a good thing I got back on Meds because by mid-july I was starting to breakout ;-) After some tweeking my final combo was Avandia (2mg) and Spiro (150mg). Like clockwork every 2 - 3 months I got my hormones checked along the way I would tell him info I learned from these boards and websites. He would either question the basis of treatment (like B5 & Vitamin D3) or would say "OK, I'll test you for that too" Overall the past 2 years with him, were great and I hope I find an endo that just as knowledgable and caring (I'm no longer get free healthcare since I'm 23). He was really good, he listened to me, worked with me, tested me for things that I suspected (if it seemed slightly plausible), caught the labs mistake (for NCCAH testing) and rested me for that, and gave me copies of my test results, LOL, and even he says I should be a doctor.

My bottom line for ALL that, LOL, was that when I tried to get things done, it didn't work. Usually I got the most help, when I was asking for help in another direction (mind boggling). Also, if you noticed it took 3 Endocrinolgists (the first may have worked) over 6 years before I knew what was wrong! Honestly it should have been taken care of sooner, so if your regular doctor and Gyno, both of which are women (shocking), don't care enough, find yourself another doctor or go to an endocrinologist. I don't know if you have to go to the very best, but if you can afford to, he/she may be even more beneficial (lol, some info i found for you came from Redomond's). They may be able to offer you a combo that really kicks this hirsutism in the butt ;-) Of course there's always laser (I dont want to be dependent on drugs or supplements for this). So just go see another doctor and hopefully that doctor will give you a referral. My school practioner she handed me the referral but I've yet to go see a new Endocrinologist yet (been 7 months). It feels great to not need them for my acne anymore, but I still need to see what they have to say about the rest, if I can't figure it out.

Now go get that 2nd opinon! ;-)


P.S. Yes, your job is to be humble, yet still more informed about this then they are. If you KNOW what you're talking about, they will take you more seriously (or get offended..lol). I don't know what you should take... I remember doing a search on google and all the result pages mentioned Spiro for acne treatment...lol. Take a page like that. Otherwise, you shouldn't have to work that hard with them, please find someone wiser.