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Theory: on TRT, topical estrogen on the scalp topical DHT on the nipples could be adjunctive treatments that cancel out each other’s downsides — estrogen fighting scalp miniaturization, DHT countering estrogen’s effect on breast tissue. Important nuance: serum DHT isn’t actually what causes balding — it’s local 5-alpha-reductase activity in the scalp converting testosterone to DHT right there. That needs to be addressed separately (topical 5AR inhibitors, not just systemic hormone tweaks). This
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