@HisHobbyIsSex
Here's more info. I'm 51, for reference.
I researched private endocrinologists and picked one that specialised in PCOS, amongst other things, and seemed very well regarded. He turned out to be a really nice man, too, and I was so relieved by the time I walked out of the consulting room. I wasn't imagining the hair loss, I wasn't imagining the acne (both of these were a resurgence of PCOS symptoms, which had been really well controlled most of my life due to Dianette and other anti-androgen therapy, such as spironolactone and finasteride. )
My periods had come back, though, in my late 40s, despite stopping Dianette and my skin and hair were ok, so I'd thought PCOS was over and I'd really taken my eye/mind completely off it. Photos of me in 2018/19 have lovely hair! A few years later I attributed hair thinning to menopause, generally, (not connecting it at all with the fact that a menopause specialist in 2020-ish had recommended stopping my remaining anti-androgen, which was spironolactone. I started oestrogen patches but wasted, gosh, two years, really, with higher and higher doses being recommended by the menopause specialist. I kept thinking, maybe things will improve if I just get more oestrogen!
My recent diagnosis with the Consultant Endocrinologist was androgenetic alopecia. He prescribed spironolactone 100mg twice daily and said I'd know within six weeks if it was helping, if my acne (cystic spots on chin) improved. My skin did improve, massively, and really quickly. So that's good.
The hair on my head, though, is another story. The doctor explained that my current hair had grown under really poor conditions, with an androgen dominance, and couldn't be "fixed" - I just need to hope that later hair cycles in a year or so improve. It's a bastarding thing. I guess the changes happened so slowly and gradually I just didn't cotton on that it was happening. And it will take an equally long time to potentially improve.
I also discussed HRT with the Consultant.
I'm now on Oestrogel 2 pumps a day (turns out I wasn't absorbing the bloody patches!) and for the progesterone element, I take cyproterone acetate.
Cyproterone acetate is a further anti-androgen which is also a progesterone.
Usually used in men with prostate cancer but also in treatment of women suffering from disorders associated with androgenization, eg, acne or hirsutism.
GPs won't be comfortable prescribing it and it's left my GP in a kerfuffle, despite not being able or bothered to give me one iota of help when I first went to them.
I've asked to be referred to NHS Endocrinology but there's a nine month wait for that.
Good luck to all of you who are working through any of this type of thing.