Hope it’s ok for me to post this here, this community is probably the only one with useful advice.

I am a 29 cis female. I’ve been losing my hair for 12 years and on spiro for 10. I’ve asked for fin/dut many times to a variety of different doctors with no luck.

When I first went to an endo 10 years ago they diagnosed me with NCAH. My DHEAS was very high but my T was normal. However, I don’t have any other symptoms besides hair loss, which appears to be mostly genetic anyway. No acne, maybe a little hairier than average but not to the point of clinical hirsutism. There are definitely clues that I received a little extra androgen dose while developing, but nothing reversible.

I was on 100mg spiro for a couple years, tested again and my DHEAS was still high, so my doctor doubled it to 200. However, that test was 10 years ago and obviously androgens decline during your 20s. I am worried my T might become low, given that it was never high in the first place, especially because I don’t notice other NCAH symptoms, although ny PCP seems very concerned about my DHEAS levels. He says it could have effects on “brain and body” but never specified what those effects are. Every time I go in he’s like “how’s the acne” and I have to remind him I have no acne (not sure how he can’t tell just by looking at my face and seeing no acne there lol), no hirsutism, nothing.

My priorities are in this order:

1) address hair loss

2) preserve T levels

3) a distant 3rd, keep DHEAS normal

Anyway I’m still losing my hair so I want to introduce fin/dut but have to DIY because nobody will give it to me due to the teratogenic effects. But of course that means I’d be going full nuclear with AAs unless I ALSO reduce my spiro dosage. And ideally I would have a doc continuing to monitor androgen levels.

I’m not sure if I should gradually reduce spiro and on what schedule, do I introduce fin at the same time or have an overlap where I’m taking both at full dose? Or should I go to a doctor and inform them I’m DIYing and see if they’ll give me any help from a harm reduction standpoint? I think they are mostly worried about getting sued so if they aren’t prescribing the fin they should feel in the clear, right?