Hormonal Hair Loss: How to Identify and Treat It


While there are many possible reasons for shedding more than usual, hormonal hair loss can be among the hardest to address. That’s because hormones are involved in a ton of different functions throughout the body, from your stress response to menopause—and any change in them can result in more hair thinning or shedding than usual. But that doesn’t mean that you don’t have options.

In fact, there’s renewed attention on hormonal hair loss these days “in large part because there are more treatments available and more buzz about those various treatments on social media,” says Washington, DC dermatologist Tina Alster, MD. Trichologist and hairstylist Shab Caspara, who specializes in hair growth, has found that it’s the most popular topic among her clients due, in part, to nutritional deficiencies, which contribute to hair loss and can be rampant, she says.

With that, here’s everything you need to know about hormonally driven hair loss—and what exactly you can do to address it.

  • Tina Alster, MD is a board-certified dermatologist in Washington, D.C.
  • Shab Caspara is a certified trichologist, hairstylist, and founder of Leona hair growth solutions
  • Diane Gonzalez is a nurse practitioner who practices alongside board-certified Miami hair transplant surgeon Jeffrey Epstein, MD

What are the causes of hormonal hair loss?

As with many conditions—beauty-related or otherwise—consider your family. “Genetic factors play a large role,” says Dr. Alster. For instance, she says, “If a person’s mother or father experienced hair loss, then that person has a much higher risk of developing the same.” 

Stress can also play a role, triggering the release of the hormone cortisol (aptly dubbed the “stress hormone”). Your diet factors in, too. “Many people are nutritionally deficient in key minerals that help balance their hormones,” says Caspara, who likes to do a deep-dive into her clients’ diets, food restrictions and supplements when she assesses their issues. “I’ve witnessed such nutritional deficiencies lead to autoimmune disorders like hypothyroidism, which is known to make hair grow brittle and thin out.”

Because hormone levels can vary between men and women, different hormones can also impact them in distinct ways. For example, in men, “androgens, or ‘male’ hormones, are necessary for male-pattern hair loss to develop,” says Dr. Alster. “This typically begins at the start of puberty, which is associated with increased androgen levels.” Androgens control the hair cycle of growth, rest and shedding—but they can also stimulate the follicles too much, leading to a shorter growth period.

Women have androgens, too, but the relationship between androgens and female-pattern hair loss is hazy at best. “While hair loss in women has been observed in women with high male hormones, it is not always the case,” says Dr. Alster. That said, high levels of testosterone (which is a type of androgen) can be associated with polycystic ovarian syndrome, or PCOS.

The same goes for estrogen, which is the female hormone. “Decreasing estrogen levels in women after menopause has been linked to hair loss, but again, the exact role of estrogen in hair loss is unclear,” says Dr. Alster. Both fall under androgenetic alopecia, or female pattern hair loss, which tends to be chronic and progressive, says Diane Gonzalez, a nurse practitioner at Foundation for Hair Restoration in Miami, FL. “Women typically notice hair thinning and a widened part line after age 35, when hormone levels begin to shift slowly towards perimenopause,” she says.

Meanwhile, anything that causes a sudden shift in hormones may contribute to hormonally induced telogen effluvium, which is temporary and can resolve without treatment (as long as you don’t have aggravating factors for hair loss, like stress and nutritional deficiency), according to Gonzalez. Consider postpartum hair loss. This “occurs for most women as estrogen levels drop lower than ever, causing hair to prematurely get pushed into the shedding phase,” says Caspara. Hormonal hair loss can also result from external factors; for instance, the hormones and steroid derivatives used to promote ovulation and success in in-vitro fertilization can inadvertently cause hair loss, she adds.

That said, telogen effluvium can become chronic with thyroid dysfunction (like hypothyroidism), chronic stress, or even a vitamin D deficiency, according to Gonzalez—which is why seeing a doctor can be helpful.

How do you treat hormonal hair loss?

Because the hormones at play differ between men and women, so do many of the treatments. Dr. Alster recommends topical minoxidil and oral finasteride as the first-line treatments for men. (Topically speaking, minoxidil is the only topical ingredient with FDA approval for hair loss, putting it among the best hair-loss solutions out there; topical finasteride can also help, but it’s not FDA-approved for topical use.)

Oral finasteride, a prescription-only medication, isn’t advised for women due to contraindications with pregnancy, but it can be used off-label among post-menopausal women. And while topical minoxidil tends to get top billing, “most recently, oral minoxidil in low doses has proven helpful in both men and women without adverse reactions,” Dr. Alster says.

Both men and women who don’t want to or can’t use these medications can also try procedures for the condition, such as platelet-rich plasma (which delivers key growth compounds to the hair follicles), low-level laser light therapy (which may reactivate cells to spur growth), and scalp micropigmentation (which, like a tattoo, simply makes hair appear fuller), says Gonzalez.

Because your lifestyle, like your nutrition levels, can also play a role, Caspara recommends a multi-faceted approach, including supplements, topical medications, and lasers. This combination can help ensure that “your hair will grow back optimally and to protect your follicles for long-term damage from hormone related hair loss,” she says. Start with your nutrition, ensuring you’re getting the minerals that are directly tied to hormone levels. These include magnesium, potassium and sodium, she says.

Caspara also recommends natural remedies such as saw palmetto, Chinese peony, green tea and black cohosh, which “can block or manage excessive androgens that lead to hormone-related hair loss,” she says. Saw palmetto, for instance, is one of the primary ingredients in Nutrafol Hair Growth Nutraceutical.

How do you know if you’re experiencing hormonal hair loss?

For one, consider the timing, says Dr. Alster. If you have some other hormonal event happening—be it puberty, childbirth or menopause—then new or sudden hair shedding could be the work of hormonal hair loss. “Other causes of hair loss include stress, thyroid or autoimmune disease, certain medications, diabetes, or anemia, so it’s important to be evaluated by a board-certified dermatologist to ensure that proper tests are performed to rule out these possible causes,” she says.

It might also appear differently. Unlike other types of hair loss, which can come with a widening part, hormonal hair loss occurs throughout the scalp and might be more exaggerated around the hairline, “which is directly connected to hormonal hair loss,” says Caspara. You might also notice weak or brittle hair as a result.



Leave a comment