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Which Hormones Contribute to Hair Loss in Women?

Hormones are pivotal in regulating various bodily functions, including hair growth. Thus, fluctuations in hormonal levels can significantly impact hair health and contribute to hair loss in women. Female pattern hair loss (FPHL) is the most common type of hair loss among women, affecting approximately 55% of women over 80 years old. FPHL results from a complex interplay of hormonal changes and genetic predisposition, but it's not the sole type of alopecia influenced by hormones.

In this article, we’ll explore the hormones associated with hair loss in women, including:

Key hormones linked to hair loss, hormones that promote hair growth. The timing of hormonal hair loss, The potential benefits of hormone replacement therapy (HRT), other factors contributing to hair loss in women and effective treatments for hormonal hair loss.

Key Hormones Linked to Female Hair Loss


Diagnosing hair loss in women can be multifaceted due to a variety of contributing factors such as dietary habits, hair care practices, and underlying health conditions. Nevertheless, hormonal influences are frequently significant. Below, we highlight the key hormones that may lead to hair loss in women.


Dihydrotestosterone (DHT)

Dihydrotestosterone is an androgen commonly associated with males but is also produced by females. Although women have lower levels of DHT than men, it remains a critical factor in the development of female pattern hair loss. DHT binds to androgen receptors in hair follicles, leading to their miniaturisation and, consequently, a reduction in hair production.


DHT’s Impact on Hair

Post-menopause, levels of oestrogen in women decline while DHT levels may remain stable or even increase. This shift can elevate the risk of hair loss during and after menopause.


Androstenedione and Testosterone

Androstenedione and testosterone are androgens that can further exacerbate hair loss. In women, a significant portion of testosterone is synthesized from androstenedione. Elevated levels of these hormones can lead to increased DHT production, thereby contributing to hair loss.

Conversely, these androgens can also convert to oestrogens through the action of the aromatase enzyme, which positively influences hair growth. Women with a genetic predisposition for heightened aromatase activity may experience less hair loss despite hormonal fluctuations.


Cortisol

Cortisol, known as the stress hormone, has been linked to hair loss in multiple studies. Elevated cortisol levels can correlate with diminished hair growth rates. Stress-induced hair loss, known as telogen effluvium, often presents as diffuse thinning rather than a patterned loss. This type of hair loss frequently follows stressful life events or periods of grief. Additionally, research suggests that women experiencing FPHL may have higher cortisol levels than those with a healthy hair density.


Thyroid Hormones

The health of the thyroid gland is crucial for maintaining hair growth. Both hyperthyroidism and hypothyroidism can result in various forms of hair loss. Studies indicate that a substantial proportion of women with FPHL may also exhibit signs of hypothyroidism. Thyroid hormones can impact hair texture and health by extending the resting phase of the hair growth cycle, leading to fragile and thinning hair.

Interestingly, thyrotropin-releasing hormone (TRH) can enhance hair shaft elongation and extend the growth phase of the hair cycle.


Prolactin

Prolactin, a hormone important for lactation and breast development, may also affect hair growth by shortening the hair growth phase. Elevated levels of prolactin are associated with increased rates of hair loss; however, significant effects are typically observed only in cases of extremely high prolactin levels.


Corticotropin-Releasing Hormone (CRH)

Corticotropin-releasing hormone is involved in activating the body’s stress response and increasing cortisol secretion. However, CRH can inhibit hair production and push hair follicles into the resting phase prematurely.


Dopamine

Dopamine, a hormone associated with pleasure and reward, can negatively influence hair growth when present in excessive amounts. Research indicates that high dopamine levels may cause hair follicles to enter the catagen phase prematurely and reduce melanin production, thereby affecting both pigmentation and growth.


Galanin

Galanin plays a role in various bodily functions, including pain response and appetite regulation. However, research has indicated that it may inhibit hair growth by shortening the growth phase and limiting hair shaft elongation.



Hormones that Promote Hair Growth in Women


While some hormones contribute to hair loss, others actively support hair growth. The following hormones are known to enhance follicle activity and overall hair health:


Oestradiol and Other Oestrogens

Oestradiol, the primary female sex hormone, positively influences hair growth. Healthy levels of oestradiol and other oestrogens facilitate normal hair growth rates. During pregnancy, women often experience increased levels of oestrogen, which can prolong the anagen phase of the hair growth cycle. However, a decline in oestrogen during and after menopause can contribute to the onset of FPHL due to hormonal imbalance.


Progesterone

Progesterone is essential for several reproductive functions, including menstruation and pregnancy. This hormone plays a role in limiting the production of certain androgens, thereby reducing the conversion of testosterone to DHT. Elevated progesterone levels may help prevent the onset of female pattern baldness.


Melatonin and Norepinephrine

Melatonin, primarily known for regulating sleep, also plays a significant role in hair growth by enhancing the anagen phase and mitigating oxidative stress. This oxidative stress is implicated in various forms of alopecia. Studies suggest that melatonin may be effective in treating androgenetic alopecia, with many patients reporting significant improvements after a few months of treatment.


Somatotropin (Human Growth Hormone)

Human growth hormone is crucial for hair growth, and in excess, it can lead to increased body hair in women. Rare conditions, such as Laron syndrome, can cause hair loss due to inadequate production of insulin-like growth factor 1 (IGF-1), which is essential for sustaining the growth phase of hair follicles.

When Are You Most Susceptible to Hormonal Hair Loss?


Women are particularly vulnerable to hormone-related hair loss during specific life stages:

  • Reproductive Age: Thyroid disorders can emerge, affecting both fertility and hair growth.

  • Pregnancy: Postpartum hair loss, a form of telogen effluvium, is commonly observed following childbirth.

  • Perimenopause and Menopause: The decline in oestrogen levels during these transitions can lead to FPHL and unwanted facial hair growth.


Can Hormone Replacement Therapy Help with Hair Loss?


Hormone replacement therapy (HRT) is frequently prescribed to assist women experiencing menopausal symptoms, including hair loss. By increasing oestrogen and/or progesterone levels, HRT aims to restore hormonal balance. Many women can effectively manage this through a daily tablet. If necessary, anti-androgen medications such as spironolactone may also be recommended to address hair loss.


Other Causes of Female Hair Loss


While hormonal factors are significant, they are not the sole contributors to hair loss in women. Other contributing factors include:

  • Nutritional Deficiencies: An inadequate diet lacking essential nutrients can lead to hair loss.

  • Damaging Styling Practices: Excessive heat styling or chemical treatments can weaken hair and lead to breakage.

  • Sudden Weight Loss: Rapid weight changes can deprive hair follicles of the necessary nutrients for healthy growth.

  • Medication Side Effects: Certain medications, including chemotherapy drugs, can trigger hair loss.

  • Health Issues: Conditions such as polycystic ovary syndrome and lupus can contribute to hair loss.


How to Treat Hormonal Hair Loss


Treating female hair loss can be complex, given the interplay of various factors. Here are some potential treatment options:

  • Spironolactone and Anti-Androgens: These medications can help reduce DHT and testosterone levels, minimising the risk of female pattern hair loss.

  • Hormone Replacement Therapy: HRT can help restore oestrogen levels to premenopausal levels, mitigating the effects of menopausal changes on hair.

  • Stress Management: Therapeutic interventions and medications that reduce cortisol levels may be beneficial.

  • Thyroid Management: Appropriate treatments for thyroid conditions can alleviate related hair loss symptoms.

  • Sleep Regulation: Establishing a consistent sleep routine can enhance melatonin production, thereby supporting hair growth.

  • Hair Transplant: for severe cases of hair loss then a hair transplant in the UK may provide the most effective long term solution. Not every person is suitable for this procedure, so a consultation with one of our trained Trichology team to assess and diagnose your requirements is recommended.


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