In order to find the best solution for you, you should understand the underlying cause of female hair loss. Many people think that female hair loss only happens after menopause, but the most common form of hair loss is actually due to a hormonal imbalance.
Androgens: The Hormones Behind Hair Loss
Hair loss can be caused by extreme stress from a major life event, illness or major surgery, but the most common form of hair loss is called androgenetic alopecia. Also known as male pattern baldness, androgenetic alopecia is a hereditary condition caused by the influence of the male sex hormones known as androgens.
Women produce androgens in the ovaries, adrenal glands and fat cells. They’re known as male hormones because of their testosterone production, but women also use them to create estrogen and help regulate the function of many organs including the reproductive tract, kidneys and liver. Androgen imbalances are among the most common hormonal imbalances in women today.
There is a specific androgen called dihydrotestosterone (DHT) that binds to hair producing follicles and shrinks them, killing healthy hair. When androgen levels get too high, more DHT is produced and can cause female pattern baldness. The resulting androgenetic alopecia affects more than 30 million women in the US alone.
Proven Hair Loss Solutions for Women
Below is a list of drug and drug-free solutions that are being used to treat women’s hair loss. Before you begin any drug or dietary supplement regimen, we recommend consulting a doctor or healthcare professional to ensure that it is suitable for you.
Hair Growth Supplements
Hair growth supplements work by supplying key nutrients to the follicle to extend the hair growth cycle. Essential growth vitamins like collagen, biotin, vitamins A, B and C, and fish oils are often missing from our diets, and can be the difference maker in healthy hair. Supplements are effective alone or they can be used alongside other treatments.
Every woman’s hair growth speeds and needs are different, but if you think your diet lacks any essential vitamins, products like Viviscal Professional hair growth supplement have been shown to reduce breakage and promote growth with regular use.
Minoxidil is an FDA-approved treatment for female pattern baldness. It was first used in pill form to treat high blood pressure, until it was noticed that it caused hair growth as a side effect.
Minoxidil is most commonly sold over the counter as Rogaine®, a topical foam applied directly to the scalp. The most commonly available solutions are 2% and 5% concentrations, and although the 5% concentration has not been approved for women, small clinical trials have shown it to be significantly better at growing and retaining hair than the 2% solution. It has also been shown to be more effective in women than in men. It’s also safe — the amount absorbed through the skin into the bloodstream is generally too small to cause internal side effects.
Although minoxidil is one of the effective hair loss solutions, treatment is inconvenient as it must be applied to the scalp twice a day. It can cause more hair loss when first starting out, and as with most treatments, it can take at least four months to see results. Also, once you begin a minoxidil treatment, you must continue with it indefinitely because when you stop taking it, your new hair growth will immediately fall out.
Prescribed commercially as Aldactone®, Spironolactone is used to reduce the amount of fluid in your body without having to lose potassium. Traditionally, it’s used to treat high blood pressure and swelling.
As a hair loss solution, Spironolactone works in two ways. It slows down the production of androgens in the adrenal glands and ovaries, and it also blocks the action of androgens by preventing DHT from binding to the androgen receptor. Studies have shown that a dose of between 100 and 200 mg per day will give the best results, but as with most treatments, it must be used indefinitely.
Cimetidine is a histamine blocker that is most often prescribed to treat heartburn and stomach ulcers. Known commercially as Tagamet®, Cimetidine has been shown to block DHT from binding to hair follicles. It has been studied in women with androgenetic alopecia with promising results, but it requires high doses for results.
Ketoconazole is available for prescription as an antifungal treatment called Nizoral®. It’s available as a cream and shampoo in 1% and 2% concentrations. As a hair loss solution, Ketoconazole focuses on controlling microflora on the scalp and can be used in combination with other treatment options to maximize effectiveness.
Most of the time you won’t need an antifungal treatment like Ketoconazole since hair loss is more often due to a hormonal imbalance.
Hormone replacement therapy
Hormone replacement therapy (HRT) is most commonly prescribed during menopause, which is when most women experience hair loss. Estrogen and progesterone pills and creams are the most common systemic (internal) form of treatment for women lacking estrogen due to menopause or other hormonal imbalances, but HRT will rarely be prescribed as a treatment for hair loss alone. You’ll likely need to undergo a hormones level check and gynecologic exams before these drugs are prescribed.
Birth control pills
Oral contraceptives decrease the production of ovarian androgens to help slow down hair loss and encourage growth. Be careful if you’re taking it solely for hair loss, rather than as a contraceptive. It’s important to only take low androgen index birth control pills when using as a hair loss solution, since high androgen index birth control can actually contribute to thinning hair.
A contraceptive known as Diane 35, Diane 50, or Dianette combines cyproterone acetate with another hormone called ethinyl estradiol and helps control hair loss. However, no varieties of this specific drug are available in the United States.
Remember: Safety First
You must never get pregnant while systemic treatments are affecting your hormones. Even if you’ve since stopped your anti-androgen treatment, you should still consult with your physician before trying for a baby. With most anti-androgens, potential side effects include a lower libido, dizziness, and breast tenderness. Always take the time to understand a treatment before moving forward with it.