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October 29, 2010 | Comments: 0

Hair-Raising Questions For Women

Hair loss is a normal part of aging not only for men, but for quite a number of women, too. Here’s why you might have hair loss and what you can do to reverse it.   

Just about everyone’s hair thins with age, but androgenetic alopecia (“andro” referring to androgen hormones, and “alopecia” meaning baldness) runs in families. Also called male- and female-pattern balding, it is the most common form of hair loss, affecting about 50% of people by age 50 to some degree—and as many as 50% to 75% of women over 65. People with hereditary hair loss produce too much of an enzyme that converts testosterone to dihydrotestosterone (DHT), a hormone that causes hair follicles to shrink and eventually shut down.

Do women show the same pattern of hair loss as men?

Generally, no. Women tend to have diffuse thinning, especially in the crown area, and not distinct bald areas. They may notice more scalp when the hair is parted, for instance. Hair loss increases with age in women, especially after menopause, but about 10% of premenopausal women have it as well. And though it’s called androgenetic alopecia in both men and women, many women with hair loss have normal blood androgen levels.

Can drugs help?

To some extent, in some people. Minoxidil (Rogaine and generics) is an over-the-counter topical solution approved by the FDA for treating hereditary hair loss in both men and women. (Another drug, Propecia, is approved only for men.) It may take several months to see results, and the effects vary greatly between people. If you stop, hair loss will resume. Minoxidil should be used with caution if you have heart or kidney disease. Women who are pregnant or breastfeeding should not use it. Many other remedies on the market are not approved by the FDA for hair loss and have little or no evidence to back them.

Why can’t women take Propecia?

Propecia is not approved for women—and women of childbearing age should absolutely not use it (unless they are on strict birth control), because of the risk of severe birth defects in male fetuses. They should not even touch the pills. Studies in women are inconsistent anyway, with some showing no benefits in postmenopausal women. Propecia acts to reduce androgen, so it may not help women as much as men, since most women with female-pattern hair loss do not have excess androgens. Some physicians may still prescribe it off-label for women with hair loss, or use estrogen to treat menopausal women or women with low estrogen levels, though this can have other health risks.

What are other causes of hair loss?

Hair loss can result from many things, including thyroid disease, anemia, iron or other nutritional deficiency, excessive vitamin A intake, crash dieting, severe infections, traumatic illness, certain medications (such as anti-clotting drugs and beta blockers), some cancer treatments, and severe emotional distress. Women may also experience some hair loss due to hormonal changes during pregnancy. Alopecia areata, which causes patchy and sometimes complete balding, is thought to be an autoimmune condition. Using bleaching products or relaxing agents and tightly braiding hair can also contribute to hair loss. In many cases, hair grows back once the underlying cause resolves or is corrected. 

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