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Women Can Lose Their Hair and Struggle With Baldness Too

Written by Adrian Blackwell, MD

Can women lose their hair and go bald like men do? Why am I losing my hair?

Why do some women lose their hair?

Great question! This is a large topic with lots of possible answers. If you are losing your hair or have concerns about the health of your hair, it is important to see your doctor or a skin specialist (i.e., dermatologist).

Hair loss in women can be attributed to many different causes, such as problems with the skin on the top of your head, skin infections (like ringworm), skin diseases (like psoriasis), mental health problems, gland and hormone problems (such as thyroid diseases), and certain medications. There certainly isn’t one easy explanation for every case.

To figure out what’s going on with your hair, a doctor needs to see you and ask questions. You might need to do some special tests (like blood tests, hair samples, or skin samples) to figure out why you are losing your hair and how to treat you.

In this article, we are going to focus on only just one cause of hair loss in women, Female Pattern Hair Loss (FPHL).

Female Pattern Hair Loss (FPHL)

FPHL is a broad term to describe balding in women. Women lose hair along the front of their scalp and on the very top of their head, such as in the picture at the beginning of this article. Since this hair loss typically occurs in the same way in different women- according to a pattern - the condition is called Female Pattern Hair Loss.

In men, hair loss is caused by a problem with testosterone breakdown, which creates something called DHT (dihydrotestosterone). DHT is an androgen-type hormone that can hurt the growth of new hair. Instead of thick, deeply colored, long hair, what grows in a pattern along the top of the head are thin, short, and colorless hairs.

But it’s not quite the same story for women. Like men, some women have higher levels of androgens. But, most of the time, this is not the case for women with FPHL. Doctors have studied this problem in women. In this study, only 39% of the women with FPHL had elevated levels of androgens in their blood.

So some women with FPHL have elevated levels of androgens in their blood, but most do not. It is not yet known why women who have normal androgen levels suffer from hair loss in this way.

illustration-of-female-pattern-baldness

Why do some women have increased levels of androgens in their blood? Do I need to get my androgen levels tested?

If you are losing hair, you definitely need to speak with your doctor about it. Certain medical problems can cause increased levels of androgens in a woman’s body, which hurts hair growth. The most common cause of increased androgen levels in women is polycystic ovarian syndrome (PCOS), which you can read more about here. There are other causes of increased androgen levels, like adrenal or ovarian tumors. Make sure to talk to your doctor about your hair loss and whether or not special tests like androgen blood levels are right for you.

So who gets FPHL?

This can be a pretty common problem for women. In some studies, FPHL happens in almost 20% of white women. It appears to be less common in Asian women. There is not a lot of information about the exact numbers of this problem in African American or Hispanic women.

When does FPHL start and will it ever stop?

FPHL can start at any time in a woman’s life. It may start when a woman is in her teenage years, but it typically does not start until a woman is almost 30 years old. No matter when it starts, FPHL will slowly get worse every year and usually peak sometime after the age of 50. In most cases, the problem will not go away, and most women should not expect that their hair will recover or improve without treatment.

How can you treat FPHL?

There are a lot of options to treat FPHL. The most common medicine is minoxidil (Rogaine). This comes in a foam or spray that you put in your hair every day, in the same way you would use shampoo. If this medicine does not work, there are other ways to treat hair loss in women. The most commonly used medicines in the United States are spironolactone and finasteride — both of these are made into pills. There is no clear-cut evidence here to tell us which treatment is the best for women who do not improve with minoxidil. Some women even consider hair transplant surgery. The bottom line here is that you should ask your doctor about all the available options to treat your hair loss.

Is finasteride safe for women? Is finasteride good to take for FPHL?

Finasteride is probably safe for women who are NOT pregnant. The problem with finasteride is that it has been shown to harm unborn babies. This is why the FDA has not officially approved finasteride as a safe medicine for women in the treatment of FPHL. But what if you are not pregnant or cannot have children? Finasteride might be an option for you. However, this is something you need to talk about with your doctor. The studies are not clear: some show finasteride helping women with hair loss, but others show the drug having no effect at all.

The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of HeyDoctor, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.

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