Can hormones cause female pattern hair loss (FPHL) and is it permanent?

Can hormones cause female pattern hair loss

Author: Stephanie Moore, AIT

FPHL affects around 40% of women by the time they are 70 years old and is currently thought only to occur in those who have inherited the genetic predisposition for it. In this article, trichologist, Stephanie Moore, AIT answers the question: Can hormones cause female pattern hair loss (FPHL) and is it permanent?

The hair loss only affects the follicles to the top of the scalp, where there are more androgen receptors and is similar to male pattern hair loss (MPHL), but in women it follows a different pattern with a diffuse thinning rather than areas of complete loss, also meaning that it is very rare for women to go completely bald on top as men can.

Due to the nature of the hair growth cycle taking years, rather than months, the condition is slowly progressive – over each subsequent growth cycle of hair, each hair grows back smaller in diameter, called ‘miniaturisation’, and has a shorter lifespan before subsequent periods of follicles lying dormant, contributing to a more visible scalp.

There is currently no cure so if left untreated this hair loss is permanent and can progress. Some women find that although it will not regrow on its own, the loss can stabilise over time and it does respond well to treatments, many of which are more the sooner that they are used.

Minoxidil is a first line licensed treatment for FPHL; it is available as a topical spray or foam that works by slowing down the progression of the hair loss and can increase the hair shaft diameter and stimulate and lengthen the anagen growth phase of the hair follicle. Minoxidil will take between 3-6 months to see any beneficial effects due to the growth cycle/rate of hair growth and a Trichologist can help you monitor any new hair growth to see if the treatment is working. It is only effective for the amount of time that it is used for, with the hair loss progressing at the same rate as before if you stop using it.

There are a range of other emerging treatments offering promising results so far: low level light laser therapy (LLLT) for home use in the form a cap or band, micro-needling and platelet rich plasma (PRP) injections that are thought to stimulate the follicle and enhance collagen production in the surrounding tissues.

The only permanent treatment for FPHL is hair transplant surgery, where the unaffected hair follicles from the back of the head are surgically removed and placed within the areas of loss to the top of the scalp.

What is the impact of hormones?

There is a suspected predetermined hereditary sensitivity within this condition, which is the reason not all women suffer with it. The currently accepted explanation is that in those predisposed, the reduction of oestrogen allows the normal level of androgen hormones, such as testosterone to become more prevalent in the body; testosterone is then converted into a more potent androgen called dihydrotestosterone (DHT), which targets the receptors in the hair follicles at the top of the head.

Although they both refer to the same pattern of hair loss, FPHL is seen as a separate clinical entity with other possible complex hormonal pathways still to be researched and is the preferred term over androgenetic alopecia, which is usually used to refer to hyperandrogenism from conditions like polycystic ovarian syndrome and also male pattern hair loss, where androgens alone are clearly the cause.

Stephanie Moore, AIT is a qualified Trichologist and be contacted for a consultation via her website at: www.surreytrichologyclinic.co.uk

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