For women, hair thinning and loss is often a major psychological blow.
That’s not to say that it doesn’t also cause distress to men when they experience a similar problem but for women, their hair is often a critical part of how they see their femininity and attractiveness.
What causes it?
There are many problems that can lead to hair loss and this area is still subject to widespread research.
For the sake of convenience, in this article we’ll concentrate on one form of hair loss – that is often called female pattern thinning (or female pattern baldness).
The mechanisms
It will come as little surprise to most women to learn that the causes of female pattern hair thinning are generally accepted to be far more complex than the similar condition that arises in men.
Although there is some evidence that things such as diet and stress may play a role, most research currently focuses on a combination of the female hormones and genetics.
What is known is that women may suffer major changes in their hormonal balances (other than in the case of illness) around the times of pregnancy and the menopause.
In both situations, a relatively high percentage of women report hair thinning.
In the case of pregnancy this appears to be frequently of limited duration and the position may recover. The exact mechanisms behind this are debated and the evidence sometimes confusing.
For example, some women report hair thickening during pregnancy and thinning afterwards. As estrogen in females increases through the term of the pregnancy and decreases afterwards, this would appear to support the model that suggests that increased estrogen levels are a key factor.
Some experts label the condition in women affected by these hormonal changes ‘estrogenic alopecia’ to differentiate it from the similar condition in men
It is also clear that estrogen levels decline during and after the menopause.
As this is also a common time for women to report hair loss, this also seems to conform to the estrogen attribution. Hair loss around the menopause may also have a tendency to be more widespread and of longer, perhaps permanent, duration.
However, confusingly, some women report hair loss during pregnancy itself – even while their estrogen levels are increasing.
It’s also the case that in the menopause, some women’s bodies may start to produce higher levels of androgens (the male hormones) for reasons that are not clear. Amongst other things, that may have the effect of exacerbating hair loss.
All in all, the position is extraordinarily complicated and poorly understood ‘in totality’.
What is clear is that the condition exists for many women and they will look for help.
The treatments – licensed
In the USA there are two products officially licensed by the FDA for use in treating hair loss:
• Minoxidil (marketed under various names including Rogaine);
• Finasteride (marketed as Propecia).
Propecia is only available under prescription and it is NOT typically prescribed to women. It is a powerful drug also used in the treatment of some forms of prostate problem.
It is dangerous for pregnant women or for women that may become pregnant and pills are coated to ensure that they are safe for women to handle under normal conditions. Whether you’re male or female, DO NOT use it without consulting your physician first.
By contrast, Minoxidil is available for women through a pharmacist – no prescription is required.
It comes in a preparation normally set at 2% for women (5% for males) and is applied to the scalp.
It is presumed to work by increasing blood flow to the follicles.
Results may be unpredictable and perhaps one third of users will see little improvement. However, two thirds may be able to anticipate some improvement and this may be significant in some cases.
Other treatments
If a woman is suffering hair loss due to significant hormonal imbalances, some treatments are available.
Some of these may have undesired side-effects and some physicians may be reluctant to use them due to the underlying doubts about whether HRT is entirely well understood.
The market is also flooded with literally thousands of other forms of treatments. The vast majority of these have little if any proven value.
Sometimes, the effects of hair thinning, particularly around the menopause, are far more serious in the mind of the sufferer than to anyone else – in fact others may not even be able to notice any change.
In such cases, counseling may be of some help.
In some, relatively rare, cases, female pattern balding may be linked to dietary deficiencies and stress. In both cases, vitamin supplements and stress reduction techniques may help, although they remain controversial in terms of their effectiveness.
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