Women’s Hair Loss: A Difficult Issue

Male hair loss is a big deal! The airwaves are filled with ads selling treatments and it’s the subject of jokes; a sure sign that it is not only a sensitive area but one that has high visibility. On the other hand, hair loss in women is rarely mentioned, even though most women begin to experience it by the time they are forty years of age. For some women, it’s devastating and is accompanied by loss of self-esteem. When we try to discuss it with our doctors, they often pass it off as of no consequence since it is not life-threatening.

Causes

Actually, the loss of hair that comes with aging has the same root cause in women as in men. While the hormone testosterone is the culprit, it’s not as simple as that. Dihydrotestosterone (DHT) actually gets the blame, but it comes about because of a combination of testosterone and the enzyme 5-alpha reductase. DHT binds to receptors in scalp follicles and kills them. The difference between hereditary hair loss in women and in men is one of volume. Because men have more testosterone, they are more likely to lose more of their hair.

Hair loss can also be caused by hyperthyroidism, hypothyroidism, pregnancy, disease, and certain medications.

Oral Contraceptives and Hair Loss

Millions of women have been prescribed oral contraception since its approval by the FDA in 1960. However, not many are aware that the Pill often leads to hair loss, which may occur while on the pill or following the stopping of the use of the medication.

If you are concerned about the hair loss that might accompany the use of oral contraceptives, you should ask your doctor about those with the least androgenic activity. Talk to your doctor about your concerns about hair loss.

Treatments for Women

The matter of androgen levels is a matter of concern in women, and your doctor will hesitate to prescribe any of the standard treatments that men are using to stave off hair loss. Unfortunately, drug companies have not been inclined to address the matter of drugs for women for this purpose. Your doctor should call for a battery of tests before prescribing anything.

Once the actual cause of your hair loss has been determined as a result of the tests, following are some of the medications that may be prescribed:

• Minoxidil, applied topically: The dosage is smaller than for men; if the standard male dose is prescribed, you should be carefully supervised.
• Androgen Receptor Inhibitors: Spironolactone, Cimetidine, and Cyproterone Acetate.
• Oral Contraceptives: Low-androgen-index birth control pills under a doctor’s strict supervision.
• Ketoconazole: Used topically, it limits the production of testosterone and other androgens.
• Finasteride: Taken orally, it inhibits the enzyme 5-alpha reductase in the hair follicle.
• Cyproterone Acetate with Ethinyloestradiol: Contraceptive tablets prescribed in Europe for hair loss in women.

Learn more about Women's Hair Loss Treatment.