Causes

Hormonal hair loss 

Organizing medicine in pharmacy

Hormone imbalances can cause a number of different health issues, from rapid swings in your mood and mental state to weight gain, adult acne, fatigue etc. Hormone imbalances are also a very common cause of hair loss in women, and we will take you through the main types of hormone imbalances associated with hair loss in this article.

Before we dive in, it's important to remember that with hormone related hair loss, you should work with your doctor to test and identify what type of hormone imbalance you are experiencing, and how you can work to correct this. You should not self-diagnose a hormone imbalance based on this article. However, you can use this as an introduction to learning more about this topic. 

DHT  and hair loss

Dihydrotestosterone (DHT) is a hormone which derives from the male-sex hormone, testosterone. It is responsible for hair loss in both men and women. You might be interested to know that DHT is required for hair growth across the body, but can have a negative impact for hair growth on the head. Testosterone is converted into DHT with the help of the enzyme 5-alpha reductase. For genetically-susceptible hair follicles, DHT results in a shortening of the hair’s growth phase (anagen phase), causing hair miniaturisation and permanent hair loss over time. 

Women have very low levels of testosterone in their body, but the female body still requires some testosterone to function properly. If the levels of testosterone in your body rises (which could be due to a number of different reasons), this could have a significant impact on your hair. However, it also depends on how sensitive your hair follicles are to DHT. For some women, even a very minute increase in DHT can result in significant hair loss because they are very sensitive to DHT. 

Hair loss caused by DHT is focused around the crown of the head, and it is very rare for a woman’s hairline to recede (this is only common with men), and women do not become fully bald. The pattern of hair loss with DHT is the same as that of female pattern baldness, and although the mechanism might be the same, it is important to remember that some women might experience high levels of DHT due to non-genetic or genetic factors.  

Hair loss on scalp female pattern baldness

DHT related hair loss is focused around the crown on the scalp, similar to female pattern baldness. At a more advanced stage of hair loss, the gap between the parting widens.

If you have excessive levels of DHT in your body, you might experience a wide variety of symptoms such as acne, high muscle mass, low libido, deep voice, hair loss on the head etc. This is not an exhaustive list of symptoms, and if you suspect you have excessive levels of DHT, you should speak to your doctor to get a blood test and confirm whether you have levels of DHT. 

Treatment for DHT related hair loss

There are a few methods your doctor may advise to lowering DHT levels. One is through Spironolactone, a medicated drug which reduces the production of androgen (the group of male-sex hormones from which testosterone derives). This slows down hair loss in women. This drug is only given where minoxidil (the only mainstream drug to treat hair loss in women) has failed to work. It will not work for those who have any other type of hair loss.   

Another way can be via ingredients which have natural DHT blockers including saw palmetto and peppermint oil. This could be taken through anti-DHT blocking shampoo. Although evidence isn’t concrete enough, there are some studies which show an improvement to hair loss when used. One of the common ingredients mentioned is ketoconazole which can come in a 1-2% form. It is thought this ingredient prevents DHT from damaging hair follicles further. Remember to consult a medical professional first as any treatment related to hormone related hair loss can have consequences elsewhere. 

Beyond these, there are still lots of things you can do to nourish and take care of your hair. We recommend using a good shampoo, taking vitamins to boost hair growth if prescribed by your doctor, and keeping your hair clean and moisturised. You can also talk to your doctor about potentially being prescribed minoxidil, going for microneedling therapy, or Low Level Laser Light Therapy. This may help to regrow the lost hairs on your head. 

Polycystic ovary syndrome and hair loss

Woman with hands on stomach

Polycystic ovary syndrome (also referred to as PCOS) is an endocrine disorder which is characterised by high androgen levels, menstrual irregularities, and/or small cysts on one or both ovaries. The exact cause of PCOS is unknown, but it is thought to be related to hormone imbalances. PCOS affects around 7% of adult women, although it is difficult to estimate the exact number of women suffering with the disorder. This disorder affects women during childbearing age, which is around 15 to 45 years of age. 

PCOS is a complex condition that should be diagnosed and managed by your doctor. We are going to focus on the effects PCOS can have on your hair, rather than discuss all symptoms related to the disorder. PCOS can be caused by an excessive level of androgens (male hormones) in your body, which in turn may cause thinning hair and eventually hair loss. The hair loss is caused by a shortening of the hair’s growth phase (anagen phase), and an increase in time between the shedding of a hair (exogen phase) and the starting of a new hair cycle (anagen phase). The hair follicle also changes, becoming shorter and thinner. This means longer and thicker hairs are being replaced by shorter hairs and smaller hair follicles. 

Hair lifecycle Anagen Catagen Telogen Exogen Growth Transition Resting Shedding

This diagram shows the stages of the natural hair lifecycle. With PCOS related hair loss, the anagen phase is shortened and the exogen phase is lengthened, increasing the time for hair follicles to shed.

The hair loss is focused around the crown of the head, and it is very rare for a woman’s hairline to recede (this is only common with men), and women do not become fully bald. The pattern of hair loss with PCOS is the same as that of female pattern baldness. We would also like to point out that not all women are sensitive to androgens – there will be some women with PCOS who are not sensitive to androgens, and therefore may experience little to no hair loss. 

Treatment for polycystic ovary syndrome related hair loss

As you might have already guessed, the solution to stopping this type of hair loss is to resolve the underlying hormone imbalance. It also needs to be done in holistic way which addresses other issues, as there can be numerous health effects from PCOS such as weight issues. You should work on a treatment plan with your health professional or doctor. One option which may be discussed is the oral contraception, which fill hormone balancing, which may have a secondary effect on hair, as well as antiandrogens drugs. 

Another option your doctor may consider is Metformin. This drug is given to PCOS patients to help regulate insulin levels better but can have a positive impact on reducing hair loss. It can take anything from 6 to 12 months to see results. 

Other methods can include focusing on weight loss and diet. Making sure you have the right levels of vitamins to support healthy hair growth is important, particularly if iron, zinc or magnesium levels are too low. Those with PCOS can typically have low levels of ferratin and eating an iron rich diet, such as red meat and leafy green vegetables, or taking iron supplements, will help the blood circulation to the scalp thus improving hair loss. You can find out more about vitamin deficiencies and hair loss here, as well as recommended ideas on how to incorporate important vitamins and minerals into your daily diet.  

Menopause and hair loss

Smiling Elderly Woman

Many of us will be familiar with the term menopause. This is when a woman’s menstrual cycle ends, and is recognised 12 months after a woman’s last period. At this point you are no longer able to get pregnant naturally. In the years leading up to menopause, you may experience a variety of distressing symptoms such as night sweats, hot flushes, vaginal dryness, low mood, thinning hair etc. These symptoms may also continue after your last period, although this depends on the person.

If you believe you are going through menopause, you should speak to your doctor who will be able to provide advice and manage the transition. We are going to focus on hair loss, which is commonly reported during menopause. This is because during menopause, your hormones are changing. The levels of oestrogen and progesterone produced by your body declines, which results in thinning hair and hair loss. Your body may also become more sensitive to DHT, which contributes to further hair loss. 

All women experience some level of hair loss during menopause, typically between the ages of 50 to 60. However, this will very much depend on when your body goes through menopause. Some women will experience it an earlier age. This can be very distressing, especially when you are already suffering from other symptoms related to menopause. 

Treatment for menopause related hair loss

It can be a difficult time for those experiencing hair loss during menopause, as your body reduces the oestrogen and progestogen hormones which is linked to keeping your hair full. There are a number of ways to slow the impact of this. The first is increase your movement and exercise regularly. Exercise improves circulation, can boost your mood and help reduce other symptoms such as stress and bloating. Better control on this will help improve your overall health and the health of your hair.  

You can also put a greater focus on balancing your diet with fruit, vegetables, wholegrains and iron-rich and calcium-rich foods. As oestrogen drops, iron levels can be impacted. By replenishing your body with these important nutrients, you can reduce the impact on hair loss. Read our page for more on how you can incorporate key foods into your daily diet here.  Alternatively, you can look at boosting your vitamins via supplements. Some of the key vitamins and minerals include iron, zinc, biotin, magnesium etc. You can read more about the vitamins to focus on here. However, we do recommend speaking to a doctor beforehand before taking any new supplements.  

Exercise and Healthy Diet

Other ways include keeping your body well hydrated with water. You should be aiming for 2 litres or 8 glasses of water per day to keep your scalp and hair healthy and hydrated. You should also reduce your stress levels where possible, as heightened levels of stress can impact your hair. Finally, keep your scalp clean by using a mild shampoo regularly. This prevents blockages on the pores and build up, which can cause further hair loss. For a recommended list of mild shampoos suitable for those experiencing hair loss, click here

Thyroid disease and hair loss 

The thyroid gland is a small butterfly-shaped gland in the neck, which is responsible for creating a variety of different hormones which are used by your body. These hormones are very important, and if you make too much or too little of these hormones, you may be experiencing thyroid disease. If you have an underactive thyroid, you are producing too little hormones and you have hypothyroidism. Conditions that may cause hypothyroidism include Hashimoto’s thyroiditis, thyroiditis, iodine deficiency etc. If you have an overactive thyroid, you are producing too much hormones and you have hyperthyroidism. Conditions that may cause hyperthyroidism include Graves’ disease, nodules, thyroiditis etc. 

Thyroid disease is very complex and should be diagnosed and managed by your doctor. There are a variety of conditions related to thyroid disease, each with their own symptoms and treatments. We are going to be focusing on hair loss associated with thyroid disease. It is rare for mild hypothyroidism or hyperthyroidism to cause hair loss. However, if you have severe and prolonged thyroid disease, you may be more at risk of experiencing hair loss. This is because the thyroid plays a role in the development of new hairs, and if your thyroid is not working properly, the hairs you naturally lose every day may not be getting replaced by sufficient new hairs. Your hair may also become drier and thinner. Hair loss associated with thyroid disease is typically more uniform across the scalp, rather than being focused in patches. 

Treatment for thyroid disease related hair loss

The good news is that hair loss caused by thyroid disease is usually temporary. Once your doctor has identified what type of thyroid disease you are suffering from, and has prescribed a treatment plan to resolve the issue, your hair should naturally grow back to its original length and thickness.  

While your hair naturally recovers, there are lots of things you can do in the meantime. These include improving lifestyle habits, for example quitting smoking, reducing your stress levels, and improving your food intake through a Mediterranean diet. This can help boost your nutritional intake to benefit your hair.  

We also recommend using a good shampoo, taking vitamins for hair growth if prescribed by your doctor, and keeping your hair clean and moisturised. Take a look at the article Top 7 prescription-free products to boost hair growth for top products to boost hair growth. 

References

Please click below if you want to read the science behind this article.

Recommended for you

Woman washing hair under water shower

Read more about the best shampoos for hair loss.

Foods for hair growth

Read about minoxidil treatment and how it can help treat female pattern baldness.

Top view of micro mesoroller derma roller

Read more about help to create new hair growth from the scalp