Female pattern hair loss (FPHL) is a prevalent condition, particularly as women get older. Hair loss in women appears in a pattern that starts at the woman’s hair part and widens out. It can also present as diffuse hair loss all over the scalp.1
Now there are many causes hair loss in women but the most common cause in older women is menopause. Read on to learn more about the most common cause of hair loss in women over 50 and what can be done about it.
Read next: How to Choose the Best DHT Blocker Shampoo
Menopause
Menopause is also one of the most common reasons for hair loss in women over the age of 50.
It is a natural process that marks the end of a woman’s childbearing years. You are considered to have officially reached menopause twelve months after your last menstrual period. While it can start in a woman’s 40s or 50s, the average age of menopause in the United States is 51.
Hair loss during menopause is caused by the changes in hormone levels. During menopause, your ovaries produce less estrogen and progesterone. At the same time, your androgen levels remain the same, making the effects of androgens like dihydrotestosterone (DHT) more apparent. This effect is called relative androgen excess.2 DHT is a known cause of hair loss in men so it would make sense that it causes hair loss in women as well.
Is it the increasing relative levels of DHT that causes hair loss or the decreasing levels of progesterone and estrogen? Many researchers thought that the lack of estrogen contributes to hair loss because estrogen is helps maintain skin health by supporting collagen levels and thicker skin.3 But based on the evidence it appears that the relative increase in DHT plays a greater role in causing hair loss in women over 50.
Does Estrogen Cause or Contribute to Hair Loss?
One study aimed to determine if estrogen was one of the reasons for hair loss in women going through menopause. In the study, researchers applied topical treatments of 17-beta-estradiol to mice. The study found that the topical treatment actually forced the hair follicles to stay in the telogen (or resting) phase of hair growth. This means that treatment of hair follicles with estrogen stopped hair growth.
Treatment with an estrogenically inactive isomer, 17-alpha-estradiol, failed to inhibit hair growth like estrogen did. Furthermore, application of a pure estrogen receptor antagonist (estrogen blocker) resulted in hair follicles exiting the telogen phase and entering the anagen phase, supporting hair growth.4 This ultimately suggests that estrogen inhibits hair growth.
If estrogen actively inhibits hair growth and menopause is characterized by reduced estrogen levels, menopausal hair loss must be caused by something other than fluctuating estrogen levels. Let’s take a look at androgen hormones such as testosterone and DHT affect hair growth.
Does Excess DHT and Testosterone Cause Hair Loss in Women?
Hyperandrogenism refers to excessively high levels of androgens, or male hormones. These include testosterone and DHT. One study on females with diffuse female pattern hair loss tested 109 patients for hyperandrogenism along with a control group comprising 24 patients without hair loss.
Hyperandrogenism, defined in the study as increased androgen levels in the blood, was displayed in 38.5% of women with hair loss. This suggests that women with female pattern hair loss may have excess DHT.5
As mentioned earlier, even women who have normal levels of DHT and testosterone during menopause may experience a condition known as relative androgen excess during menopause.2 With relative androgen excess, the body is exposed to more androgens because there are fewer estrogens and progesterones. This increased exposure to androgens may contribute to female pattern hair loss. If this is true, women’s hair loss may be remedied by the use of DHT blockers.
Click here to see what the research says about using DHT blockers for women’s hair loss.
If you’ve tried DHT blockers and your hair loss continues to be an issue, talk to your doctor to determine the cause and figure out how to prevent hair loss in women and encourage natural hair growth.
Read next: DHT Blockers for Women's Hair Loss: Do They Work?
Sources:
- https://link.springer.com/article/10.2165/00128071-200304060-00001
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950016/
- https://link.springer.com/article/10.2165/00128071-200102030-00003
- https://www.pnas.org/content/93/22/12525.short
- https://www.sciencedirect.com/science/article/pii/S0190962288702418
About the Author:
Dr. Bryan Do, D.O. is an osteopathic physician whose research interests include gastroenterology, immunology, and dermatology. He is particularly interested in the role of probiotics in the gut-brain-skin axis and has written many articles on the topic. He graduated from University of California, Los Angeles (UCLA) before graduating from Marian University College of Osteopathic Medicine in Indianapolis, Indiana and becoming a Doctor of Osteopathic Medicine. Osteopathic physicians are taught to take a holistic approach to medicine and to consider mind, body, and spirit when treating a patient. Osteopathic physicians receive training in Osteopathic Manipulative Medicine (OMM) in addition to the standard rigorous medical school curriculum. Both physicians with a Doctor of Osteopathic Medicine (D.O.) degree as well as a Doctor of Medicine (M.D.) can practice medicine.