The high was short lived.
Even with an increased dose of estrogen, my hair continued to fall. I dreaded showering and hated the hairbrush. Standing up from the chair where I’d been reading became traumatic; all I’d want was to run to the kitchen to grab a square of dark chocolate, but initiating that quest meant catching a glimpse of the hundreds of long hairs coating the back of the blue chair where I’d been nesting. Hoods became hair catchers; vacuum rollers were coated in skeins of strawberry blonde; on sunny days, area rugs glinted gold.
My brain hyperfixated on a very specific story problem: If the internet said losing 150 hairs a day was “normal,” and I was seeing 400+ hairs a day come out of my head, how long before I’d be considering a massive wildflower tattoo to cover my shiny pate?
The psychological weight of Loss is invisible but heavy. During every movement of every minute of every day, my brain, soul, and heart were stress mourning – a state compounded by the fact that hair loss isn’t the end of the world or of a life. “It’s just hair,” I’d tell myself, the “just” meant to remind me that the superficialities of bodies don’t matter.
However. When it comes to cultural messaging, it often seems our bodies are all that matter. Lips? Should be plumper. Wrinkles? Need to be ironed away. Big stomach, hips, thighs? Have a surgery. Find hundreds of dollars per month to pay for GLP-1 shots. No muscles? There’s a supplement for that. Stop being a pussy and grab some weights so you can progress to failure. Poor posture? For a fee, there’s a course you can take. Eczema? It’s your diet. Hair not thick enough? Try extensions, wigs, serums, shampoos, red lights, cold caps, pills.
And so I did. Cycling from despair to sadness, I tried rosemary oil and cried at the handfuls of hair in the shower drain when I washed it out. Sherlock Holmesing, I messaged my OB-GYN and told her I had deduced my hair had fallen out more aggressively, when I was cycling with progesterone, during the weeks I was taking the pills versus the week I took off. Could I try a different type of progesterone?
Within a few hours, she’d replied:
We can definitely change up the progesterone. There is a patch that has estradiol/progesterone combination which is handy so you don’t have to take a pill. It is a different progesterone so could help.
Also we could add a medication called spironolactone. Spironolactone is an aldosterone antagonist that competitively blocks androgen receptors and weakly inhibits androgen synthesis. This is to help block the testosterone from attaching to the hair follicles.
Another medication option is finasteride; which is a type 2 5-alpha-reductase inhibitor that is frequently used in the treatment of male pattern hair loss. Finasteride inhibits the conversion of testosterone to dihydrotestosterone, thereby reducing the effects of dihydrotestosterone on hair follicles. Typical dosing is 2.5 to 5 mg per day. Clinical signs of response are expected within six months.
A final option is topical minoxidil. This can take upwards of 6 months for results as well. I like topical because it is not an oral agent that can compete with other medications and have side effects.
Thoughts about all of this?
My first thought was “Wow. Look at all this information! Look at these options! I don’t have to live under the curse of defective follicles anymore!!”
Taking a blowtorch to my browser’s search bar, I researched the options. It seemed like I could use topical minoxidil in conjunction with any of the oral medications. Eventually, I tossed a dart at the patient portal. It landed on Spironolactone.
I’d set my alarm for 7:45 a.m. If I was going to hit the Dance Cardio class with friends at 9 a.m. on a Sunday, an alarm or ten were in order.
The second I sat up, though, the world began to spin. Whoaaaaaaaaaaaaaaaaa. Down was up; up was everywhere; there was no center.
Lying down for a reset, I tried again, this time putting my feet on the floor and standing up. Immediately, everything went kitty-wampus as I clutched for the wall, trying to find purchase. Slowly, feeling like I was being spun inside a snow globe, I reached for the edge of the bookshelf and leveraged my body upright. But walking seemed impossible, given the spinning horizon. I dropped to all fours, then rolled to my back. Who knew a room could move in six directions at once?
As I lay on the rug, ruing my aversion to vacuuming, I recalled that people suffering from vertigo sometimes right their worlds through a series of tipping maneuvers. It was all about the ear crystals and getting them back into place. However, the idea of reading instructions off a screen felt impossible. What if I just did some Downward Dogs and a variety of inversions and head tips and prayed to the goddess of True North?
Three or four Downward Dogs and full-body collapses later, I decided I could walk to the bathroom if I held onto the walls. Once I settled onto the toilet, though, the room spun wildly. I wiped. I fell to the floor on all fours and hit another Downward Dog.
With each inversion, the spinning subsided a bit more. Eventually, having humped down the stairs on my rear end, I ended up in the kitchen, where a few more Downward Dogs—so many crumbs on my palms—finally brought me back to myself.
Could I trust the feeling? Was I okay?
Always one to plunge ahead, I moved tentatively toward the Dance Cardio class. Before heading into the small, packed studio, I filled in my friends, including the instructor, telling them about my wild morning and asking them to throw their bodies toward the trajectory of my fall, should I appear to be gyroscoping toward the floor.
Listening with mouth agape, the instructor cautioned me to take the class easy and bow out if needed. When I got to the point of saying, “And, you know, I have a suspicion about what might have caused this weird dizziness. I mean, it could straight up just be vertigo, but I’m actually suspecting this new prescription drug I’m on, Spironolactone. It’s been a little over a week since I started taking it, so I wonder if all this world spinning means it’s hitting my system?”
“Ohhh, yeah,” the instructor exhaled. “I bet you’re right. I was on Spironolactone in my teens for acne, and what you’re saying makes total sense. That stuff is strong shit. It helped my acne, but it really messes with you.”
We moved into the studio. It was time to dance. The only open square footage was in front of the front row. I shrugged. If “Murder on the Dance Floor” took me out, there were four rows of strong women behind me. It would be light work for them to drag my corpse to the car.
(Final installment tomorrow!)
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