As many as 21 million women will experience hair loss at some point in their lives. Androgenetic alopecia (also known as Female Pattern Hair Loss or FPHL) is the most common type. It runs in families, and usually starts between the ages of 12 and 40. Although scalp hair is not biologically essential, the impacts of hair loss on how women feel about themselves is profound.
A 2002 study found that 55% of affected women displayed symptoms of depression. However, the effects of alopecia reach far beyond symptoms of depression and include anxiety, obsessions, dissatisfaction with one’s appearance, and low self-esteem. There can be significant disturbance in a patient’s social life because they may change their hair style, clothing, or avoid social meetings. One study reported that 40% of surveyed women described marital problems and 63% had career-related issues that they ascribed to their hair loss.
There are a range of conditions and situations that contribute to Female Pattern Hair Loss (FPHL) as well as telogen effluvium - the other type of hair loss. These include: nutritional deficiencies, poor quality nutritional supplements, endocrine imbalances, drugs, infection, disease, and malignancy. Stress can also lead to hair loss which often occurs about three months after the stressful event. Excess adrenaline, which is closely aligned with stress, can cut off blood supply to the scalp, similar to the way it cuts off blood supply to the hands, feet, intestines, and salivary glands. Lack of blood supply to hair follicles can lead to hair loss.
Women with Polycystic Ovarian Syndrome or PCOS have elevated levels of androgens due to the release of luteinizing hormone from the pituitary trying to stimulate the ovaries to raise progesterone levels. Unfortunately, the ovaries are unable to do so which is why the treatment of PCOS is to use a 5% progesterone cream.
In post-menopausal women when both progesterone and estrogen levels are significantly lower, there is the potential for imbalance between androgens and progesterone and estradiol. While maintaining adequate testosterone and DHEA levels is vital for a range of functions, ensuring that androgens are balanced with adequate estrogen and progesterone is a treatment consideration for a range of symptoms, including Female Pattern Hair Loss or FPHL.
In terms of treatment, please consider the following: Most vitamins are beneficial, which includes A, B, C, D, and E. Biotin is in the B vitamin category and deserves special mention.
Minerals are important, including zinc and selenium. Iron should be replaced if the levels are low.
Saw palmetto, pygeum, beta sitosterol, and nettles extract should be considered if DHT levels are elevated. These are usually found together in prostate supplements.
Essential oils massaged into the scalp have been found to be beneficial, such as: lavender, rosemary, and cedarwood.
Minoxidil (Rogaine) in a 5% strength is available OTC.
Spironolactone (Aldactone) - 100 mg/day - by Rx
Tretinoin (Retin-A) - can be mixed with Minoxidil
The following should be avoided: tight hairstyles, dyes, and heat on high settings and certain medications: antidepressants, beta blockers, NSAIDs