so the androgens piece is really what nobody prepares you for. you go to ur endocrinologist and they talk about insulin resistance and irregular cycles, but then you’re also just watching your hair thin. for me it became noticeable pretty quickly after the diagnosis. my hairdresser asked if i was stressed (which, fair, but no) - it was genuinely just the androgens.
the real answer is yes, it does reverse, but it takes actual time. like months and months of your androgens actually being down before you see regrowth. i’m three mos into spironolactone and metformin, and i’m still in the losing-more-than-growing-back phase. but my endo was reassuring that it’s not permanent - it’s responsive to treatment.
the frustrating part is just the waiting. acne cleared up the same way. once the androgens started responding, everything shifted. what i really want to know though is whether anyone else has tracked the actual timeline?
like how many mos before the hair actually started coming back thicker?
The waiting part is definitely the most frustrating piece of this. Where I’d gently push back is on the “it does reverse” framing from your endo. For some, yes. But it’s not a guarantee, and it depends on how long the follicles have been exposed to high androgen levels.
Over time they can miniaturize to a point where they won’t reactivate, even if your androgens come down. So the timeline isn’t just about waiting for regrowth, it’s about arresting the miniaturization process first. fwiw, I’d also suggest tracking fasting insulin as your primary metric here, not just time. The androgens are a downstream effect of hyperinsulinemia signaling your ovaries…
Spironolactone is great for blocking the androgen receptors, but if your fasting insulin is still high, the root signal is still active. The real timeline for hair regrowth is pegged to how fast and how low you can get that insulin number, which is a much more direct measure of whether the underlying metabolic driver is being addressed.
three mos into treatment is a decent benchmark, “the waiting” part is what gets me, as you said, acne cleared up quickly for you but hair regrowth seems to take longer, did you notice any correlation with cycle regularity or was it just androgen levels