Female hair loss can happen at virtually
any stage of life as a gradual or sudden process, depending
on the cause. Androgenetic
alopecia accounts for up to 75% of hair loss in women
and affects up to half of women in the USA by age 50 years.
Although this same condition in men is called “male pattern
hair loss,” in women it is usually characterized by a gradual
thinning of hair on the scalp, rather than a receding hairline
or bald spot.
The time of onset of androgenetic alopecia
is variable and may occur as early as a woman’s 20s. Up
to 13% of premenopausal women report some evidence of androgenetic
alopecia, although the incidence increases dramatically
after menopause, affecting as many as 75% of women over
age 65 years.
Hair Loss and Pregnancy
Because the hair
life cycle is hormone-modulated, the hormonal
changes of pregnancy can exert noticeable changes on hair
growth. When a woman is not pregnant, hair growth ( anagen
) is balanced by an equivalent rate of hair loss ( telogen
). During pregnancy, hormone-level changes cause the natural
rate of hair loss ( or “hairfall” ) to slow down, producing
a net effect of increased hair thickness. After childbirth,
this effect diminishes and within 3-6 months the hair usually
returns to its usual thickness.
Menopausal Hair Loss
Also known as genetic thinning, hair loss associated with
menopause is caused by declining estrogen levels and may
occur over several months to years. In pre-menopausal women,
the skin’s high estrogen levels oppose the effects of androgens
responsible for hair loss. During and after menopause, reduced
estrogen levels mean that more androgen is available near
the hair follicle, shortening the hair growth-cycle and
hair diameter, and eventually causing hair loss. Over time,
the follicle itself may shrink in size and entirely stop
hair production.
Importantly, undergoing a hysterectomy
will produce acute hormonal changes similar to those that
occur more slowly during menopause – including genetic hair
thinning.
Other
Causes of Female Hair Loss
Hair loss can be caused at almost any age by a variety
of circumstances and medical conditions. Fortunately, it
is temporary or reversible. Medications, including birth
control pills and chemotherapy anti-cancer agents, can cause
hair loss, as can a variety of illnesses, infections, dietary
deficiencies ( including “crash” diets ), and surgical procedures
that involve significant trauma and/or blood loss. Hair
salon treatments that involve strong chemicals or physical
stress on the hair shaft ( e.g., hair weaving ) may also
lead to temporary or permanent hair loss.
Treating
Hair Loss in Women
Effective medical treatments for women’s
hair loss are limited. For women with androgenetic alpecia,
Rogaine ( minoxidil )
is indicated ( but Propecia
[ finasteride ] is only for men );gentler styling methods
may also help to retain thinning hair. Dietary deficiencies
can be determined by your doctor, and diet changes and nutritional
supplements may reverse associated hair loss. Additionally,
a variety of natural hair loss treatments claim to have
beneficial effects, although most of these products have
not been subjected to rigorous FDA testing.
Many women find that, thanks to new styling
methods, the current generation of wigs
and hairpieces
are almost undetectable; a wide selection of high-quality
products is available. Women experiencing significant or
total hair loss ( e.g., caused by chemotherapy ) often choose
instead to wear hats or scarves.
Further Resources
Women
with Hair Loss.com
Menopause
and Hair Loss
Women's Institute
for Fine and Thinning Hair
Post-Natal
Hair Loss
Books About Women’s Hair Loss
The Truth About Women's Hair Loss: What
Really Works for Treating and Preventing Thinning Hair,
by Spencer David Kobren and Angela Christiano, McGraw-Hill,
2000.
Hair Savers for Women: A Complete Guide
to Preventing and Treating Hair Loss, by Maggie Greenwood-Robinson,
Crown Publishing Group, 2000.
The Hair Loss Cure: How to Treat Alopecia
and Thinning Hair, by Elizabeth Steel, Thorsons Publishers,
1999.
