Androgenetic Alopecia in Women

Dr. Renu Kothottil | November, 13 2015 | 0 Comments

While hair loss can take place in men as well as women, the character of both is different. Conditions that can cause hair loss in men, might not affect women the same way. This is why, in order to treat hair loss in women effectively, it is important to judge it properly first. In this article, we will look at one particular type of hair loss in women, commonly known as androgenetic alopecia in women.

Let’s first gain a clear understanding of what androgenetic alopecia in women actually is:

In men, when there is male pattern baldness or androgenetic alopecia, there are only certain spots where the hair loss is prominent. There are also sites on the head, which are stable and will always provide a source of donor hair. In these areas, the hair follicles are not affected by DHT or dihydrotestosterone, which is what causes for the hair follicles to shrink on other parts of the head. In most cases, the men will start losing their hair from the front part of their head, while the hair on the sides and back will remain somewhat intact.

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However, in women who are suffering from pattern baldness, the so called donor areas it is unstable. The hair thins all over the head, and while there might be no obvious bald patches, the scalp will become very visible. In women, such a condition is often caused due to low oestrogen levels. Unlike men, women do not lose as much hair in the front part of the head as men. However, in them, the hair shafts start to become thinner by the day, and while the hair might not be losing in length; there is a very visible loss of hair volume.

It is because of reasons such as these that a hair transplant is much easier in men, as it is in women. In men, there are normally clear divisions between the donor areas and the recipient sites. However, with women, since there are no obvious bald spots, covering the same up is complicated. In most cases, women require a creation of volume on the top of the scalp, which is most often, difficult to achieve.

Now let’s take a look at how androgenetic alopecia in women actually works:

When a woman is said to be effected with androgenetic alopecia, it means that follicles have become sensitive to the androgens or hormones that are already existent inside the body. Inside each follicle there are androgen receptors and the androgens relay the message to the receptors that they should produce lesser hair. What this results in is that since the growing cycles are reduced, the remaining hair becomes thinner and loses volume as well. So, even there is no loss of follicles, hair production will come to an eventual stop.

Here is why pattern hair loss happens in women:

There is an enzyme which is known as 5 alpha-reductase – this enzyme exists within the hair follicle. When the hormone (normally testosterone, but also oestrogen in certain cases) attaches itself to the androgen receptor, the enzyme converts the hormone into DHT and it is this DHT that slowly destroys the production of new hair. This is why, any procedure or medication that prohibits the creation of DHT would be considered a legitimate method of tackling hair loss.

Some of the most prominent causes of androgenetic alopecia in women are:

The word androgenetic means that there is an underlying genetic reason for the condition. Some of the other reasons that could lead to this condition include irregularities in the menstrual cycle, acne, hirsutism and even a high level of testosterone, which could happen naturally in the body.

There are certain birth control pills that are known to accelerate hair loss, and then there are some birth control pills, which play havoc once you stop taking them. This is why it is crucial that you talk to your doctor, before starting or stopping any such medicines. However, it is pregnancy that is the most common cause of pattern hair loss in women. The stress that the body goes through, right before and after menopause also leads to the condition.

Moving onto how the condition can be handled and in certain cases, even treated:

Since there are numerous causes that could lead to pattern hair loss in women, most doctors will not suggest a hair transplant or restoration procedure immediately. In most cases, they will recommend medications that will stimulate hair growth, and if those do not work, they will move onto anti-androgens or DHT inhibitors. At times, the doctor might prescribe a combination of anti-androgens and growth stimulants, because it might help handle two issues at the same time.

However, it is important that the exact cause of the hair loss be determined, because the precise course of treatment can be decided only after that.

There are certain blood tests that might be prescribed in order to determine the exact cause of the hair loss:

Some of the most commonly prescribed tests include:

Complete blood count to determine haemoglobin/haematocrit levels
Total Iron Binding Capacity (TIBC) as well as iron and serum ferritin
DHEA and DHEA Sulphate
Follicle Stimulating (FSH) and Thyroid Stimulating Hormone (TSH)
Thyroid tests, such as T-3 and T-4
Androstenedione, Prolactin and Leutinizing Hormone
Total and free testosterone

Here are some of the most commonly used treatments, meant for women suffering from pattern hair loss:

Growth stimulants – In order to ensure that there is growth of new hair, most doctors will prescribe growth stimulants. If the hair loss has been caused due to imbalances in thyroid or due to pregnancy, the stimulants should take care of the same.
Anti-androgens and androgen blockers – Androgen blockers will ensure that over activity of the same does not play truant with your hair growth.
Anti-inflammatories – It is important that the scalp is always relaxed, because only then will there be proper hair growth. If there is any inflammation, such medicines will take care of the same.
Combining all three – In severe cases, the doctor might prescribe a combination of all three.