If I were to ask you to picture a balding head, nine times out of ten, you would imagine the balding crown of a middle-aged male. The uncomfortable truth is that women make up a significant percentage of the total number of hair loss sufferers. Some estimates suggest that up to forty percent of women begin to show the initial signs of hair loss by the time they turn forty years old. Nevertheless, in spite of the surprisingly high incidence of female baldness and its potential psychological damage, society as a whole likes to pretend it doesn’t exist.
For the most part, women who are unfortunate enough to have to deal with this insidious disease are forced to suffer silently. Because female baldness is not as widely accepted as male pattern baldness, the emotional and psychological effects can be far-reaching; and even though baldness is not a life-threatening condition, the stresses caused by it can absolutely adversely impact health. Because of this we would like to spread as much knowledge about this condition as we can, in the hopes of helping women around the world better deal with hair loss.
Female hair loss is life-altering, yet its underlying causes are not fully understood by the medical world. We know that female hair loss is influenced by factors as varied as genetics, hormonal, and environmental. Since 1942 however, when Dr. James Hamilton researched the issue, we have known that androgenic substances and male hormones play a rather significant role in the development of the disease. Let us take a closer look at the primary androgenic hormone and what role it plays in female baldness.
Testosterone is the primary male sex hormone, but men do not have a monopoly on its production; to a lesser degree, the ovaries of the female reproductive system as well as the adrenal glands, produce testosterone. In females more so than in males, testosterone synthesis is age-dependent. Although by age forty, female androgenic activity is significantly reduced, the ovaries will continue to secrete testosterone even after menopause.
Testosterone plays a highly significant role in various functions of the female body. It is essential for the strengthening of bones and the growth of muscle mass. Testosterone is also a necessary component of the female sexual drive and sexual pleasure. However, if testosterone levels fluctuate outside of the normal ranges, much more than the libido will be negatively affected.
WHEN TESTOSTERONE IS TOO LOW
Diagnosing low levels of testosterone in women can be a bit difficult and women suffering from low testosterone are often misdiagnosed. The fact that hormonal levels fluctuate with the menstrual cycle complicates the matter even further. Regularly the symptoms of low levels of testosterone are attributed to other conditions such as stress or emotional depression.
Recent studies suggest that the main factors contributing to low testosterone in women are genetic, but there are several other possible causes. Adrenal dysfunction, hypopituitarism, and an excess of estrogen have all been shown to be related to lower levels of testosterone in women.
WHEN TESTOSTERONE IS TOO HIGH
Diagnosing high levels of testosterone in women is easier since the symptoms associated with the condition are more apparent. After a physical examination of symptoms such as abnormal hair growth on the face and body, your primary care physician might ask you to take a blood testosterone level to confirm the diagnosis. Most cases of high testosterone in females are caused by hormonal disorders related to the adrenal glands and ovaries.
Too much testosterone in the female body will wreak havoc and cause symptoms such as:
- Excessive body hair growth
- Excessive acne
- Enlargement of the clitoris
- Diminished breast growth
- Altered menstrual cycles
- Low libido
- Androgenic alopecia
A derivative of testosterone called DHT, or Di-hydro-testosterone, has been identified as one of the most significant factors contributing to female hair loss. Testosterone is converted to DHT through a complicated enzymatic process involving 5-alpha reductase. Studies have consistently shown that it’s not the amount of testosterone circulating through the body that causes baldness but rather the level of DHT that is actively able to bind to hair follicle receptors found in the scalp.
When androgens like DHT act upon the follicle directly drastic miniaturization of the hair follicle occurs. Since DHT has an inordinate level affinity for the follicle’s androgen receptors, its presence can significantly impact the anagen, catagen, and telogen phases of hair follicle growth and cause the onset of female hair loss.
Of particular note is what happens to female bodybuilders and muscle growth enthusiasts about hair loss. Since testosterone plays such an important role in muscle fiber myogenesis and the development of lean muscle tissue, women tend to have a more difficult time gaining muscle mass. This often pushes these women into looking for alternative and artificial ways to increase their testosterone production. Testosterone injections, dermal creams, and supplements are all available and commonly used by female bodybuilders looking to gain an edge. All of this ends up having the compound effect of elevating blood DHT levels, and we already know how that works out. Female bodybuilders should be especially careful of testosterone injections as they will potentially cause thinning hair and eventual balding.
Hair growth and its eventual degradation into baldness is a complicated process, and not even the medical community is entirely sure how the process works. Nevertheless, more and more studies are beginning to elucidate the effect that androgenic substances such as testosterone have on the health and integrity of hair follicles. Although most women will not have to deal with hair loss until well into their fifties or sixties, it can definitely happen way earlier, so it is extremely important we do our best to understand this process in order to minimize the potential emotional and psychological effects it might cause.
- Orme, S., D. R. Cullen, and A. G. Messenger. “Diffuse female hair loss: are androgens necessary?.” British Journal of Dermatology3 (1999): 521-523.
- Olsen, Elise A. “Female pattern hair loss.” Journal of the American Academy of Dermatology3 (2001): S70-S80.
- Sinclair, Rodney, Mirjam Wewerinke, and Damian Jolley. “Treatment of female pattern hair loss with oral antiandrogens.” British Journal of Dermatology3 (2005): 466-473.
- Birch, M. P., S. C. Lalla, and A. G. Messenger. “Female pattern hair loss.” Clinical and experimental dermatology5 (2002): 383-388.
- Hamilton, James B. “Male hormone stimulation is prerequisite and an incitant in common baldness.” Developmental Dynamics3 (1942): 451-480.