Female Pattern Hair Loss - Learn What to Look For and How to Treat It.

Hair loss at any age can be devastating, wreaking havoc on your self esteem.  Your hairstyle decision to camouflage the loss may even become the subject of an awkward joke at the Oscars delivered on the world wide screen. Hair loss can result from many causes, not just the autoimmune kind Jada Pinkett Smith famously suffers. Hormonal imbalances, autoimmune diseases, nutritional deficiencies, stress, illness and traction (ponytails!) all contribute to hair loss in women.

The most common type of hair loss in women is female pattern hair loss (androgenic alopecia), according to the American Academy of Dermatology.  It can occur at any age but typically begins during your menopause transition, in your 40s and 50s, as your estrogen and progesterone levels begin to decline.  Unfortunately, female pattern hair loss is progressive, meaning you will continue to lose your hair overtime.  Look around the next time you are in a room full of senior women.  I bet you see a lot of scalps visible through the sea of hair.  Thankfully, unlike men, women rarely go bald.

Since hormonal hair loss is usually gradual, you may not notice right away but there are signs. The slow widening of your part, thinning of your ponytail or overall thinning of your hair on the top of your head are common complaints.  A great resource for your hair health is your stylist. If your hair is thinning, they notice, so don’t be afraid to ask.  

Beginning treatment as soon as you or your stylist notice is very important! Hair loss treatments take time, so stick with whatever treatment you choose for at least 12 months before deciding it failed. Treatment for female pattern hair loss is meant to minimize additional loss while encouraging hair regrowth.  

Prior to treatment, lab testing is usually recommended to rule out a metabolic disorder such as hypothyroidism (under active thyroid) or anemia (low blood count).  Nutritional deficiencies can also cause hair loss, so checking your zinc and B vitamin levels can be helpful. Although there are no definitive blood tests to diagnose female pattern hair loss, most providers recommend monitoring your hormone levels of testosterone and dehydroepiandrosterone sulfate (DHEAS) to rule out an imbalance. More often than not, lab testing is found to be normal, so don’t be surprised.  Female pattern hair loss is also genetic. Thanks mom and dad!

Many women ask if hormone replacement therapy will prevent or slow female pattern hair loss. The truth is, we aren’t sure. The medical literature is conflicting. If you are suffering from menopause symptoms and want to feel well, sleep well and live well,  then absolutely try hormone therapy.  But if you are looking to use hormone therapy solely to maintain your mane, the jury is still out. The menopause specialists at MyMenopauseRx can help you decide if hormone replacement therapy is right for you.

If you are tempted instead to reach for one of the many supplements marketed to regrow and thicken your hair, buyer beware.   According to the American Academy of Dermatology, most medical studies showed neither biotin or folic acid had a positive effect on hair growth or thickness.  However, medical research into adding omega-3 fatty acids, omega-6 fatty acids, and antioxidants into your diet has shown they may help after 6 months of use.

Instead of adding supplements, many providers will typically recommend you begin over the counter topical minoxidil.  MyMenopauseRx providers usually guide you to use the man’s preparation, a 5% concentration, since it can be applied once daily.  Another simple treatment option that is frequently recommended is the combination of topical minoxidil and an oral prescription medication such as spironolactone. Spironolactone has the extra benefit of treating hormonal acne and pesky hair growth on your face - both common menopause complaints.

When it comes to hair loss treatments, patience is key!  Hair regrowth is slow and it takes about 12 months to see results of any treatment.  If after about 12 months you do not experience the improvement you hoped for, alternative therapies like platelet rich plasma injections or low laser light therapy can be helpful.  Both are considered experimental but each have multiple medical studies to support their use.

Whether you choose to treat your hair loss or not, you are beautiful!  Hair is just an accessory. Don’t let hair loss steal your self esteem.

Barbra Hanna, DO, NCMP

Barbra Hanna, DO, NCMP