Hair Loss in Women
Female Pattern Hair Loss (FPHL), or androgenetic alopecia, is the most common type of hair loss in women. It starts at the middle of the scalp and moves outward. Oftentimes, it looks like your part line is widening, but your frontal hairline remains intact. With FPHL, women rarely lose all of their hair.
While the exact biological cause is unknown, FPHL is more common in women with obesity, high blood pressure and insulin resistance (pre-diabetes). Medications and stress can also be a big factor. Noticing that your part is widening or your ponytail is thinning may be a good reason to see your doctor. Help! What works?
Common myths about hair loss in women
Before we dive into treatments, it’s important that we set the record straight on common misconceptions surrounding female pattern baldness. These myths often make women unnecessarily worried and lead women down the wrong path in terms therapy.
1) Female pattern baldness is inherited.
Genetics seem to play a role in female pattern baldness, but the connection to inherited genes is less clear than in male pattern baldness. No definitive familial inheritance has been identified in women, unlike in men with androgenic alopecia (male pattern baldness) where genetics play an important role from both mom and dad’s side.
2) Women with high levels of male hormones are at a higher risk for female pattern baldness.
This is false. While higher levels of male hormones, also known as androgens, might be related to female pattern baldness, the majority of female hair loss is NOT tied to high levels of androgens. It’s not like male pattern balding, which is directly related to levels of androgens in the body. Only 39% of women with FPHL have high androgen levels.
3) Hormone replacement therapy increases the risk for female pattern baldness.
Also false. Hormone replacement therapy (HRT) like oral estrogen has no clear effect on hair growth, and in some studies, HRT was found to actually prevent balding.
Medical causes for hair loss in women
The direct cause of female pattern baldness is unknown, but general hair loss in women can be due to many other medical reasons. Before you point to FPHL as your diagnosis, look for these:
- An underactive or overactive thyroid. Hypothyroidism or hyperthyroidism may cause hair loss, and is easy to rule out with a blood test that measures levels of TSH (thyroid stimulating hormone).
- Iron deficiency anemia. Women with low iron levels often suffer from hair loss. An easy lab test to detect iron levels looks for ferritin in the blood. Women with ferritin levels lower than 100 ng/dl tend to report hair loss more frequently.
- Psychological and emotional stress. A major illness, severe psychological trauma, significant weight loss and childbirth may trigger an episode of hair loss that begins a few months after the episode. This is called telogen effluvium, and hair loss occurs in all areas of the scalp.
- Polycystic ovarian syndrome (PCOS). Sometimes, this condition causes your body to produce too many androgens, which can decrease the growth of hair on your scalp.
- Medications. Some common culprits of medication-related hair loss include beta-blockers, antidepressants, anticoagulants and chemotherapy drugs.