Female Hair Loss Often Linked to Hormones

Q:  I have a question regarding female baldness. I am in my early 70s and for about the last five years, I've been gradually losing my hair. I've always had thick naturally curly hair. Now I'm developing a pattern of losing my hair the exact opposite way men lose their hair. I'm losing it like a halo effect above the forehead and around the lower sides above the ears and the back. The top and lower edges are still thick and curly.

Because of breast cancer in my family, I do not take any hormones as my doctor advised against it. I have been coloring my hair for about 20 years and was wondering if that might cause baldness. I am getting quite concerned because I seem to be losing it at a faster rate the last year or so. I am sure many other women are experiencing the same problems as many of my friends are also. Thank you for any help you can give me.

A:  Women have thinning hair as they get older, but it is usually on the top and sides of the scalp, so your hair loss pattern is most unusual. Unlike men who have receding hairlines on the forehead, women tend to retain the frontal hair. Hair has three growth cycles: anagen, the stage of active growth; catagen, a transition stage; and telogen, when the follicle releases the hair fiber. Of the 100,000 hairs on the average person, about 100 are in the telogen phase and fall out every day.

Hormones have a great effect on hair, which is why many women notice changes during and after pregnancy and around menopause. After menopause, the ovaries may produce more androgens (male hormones) than estrogen and this can result in hair loss. (Male baldness is related to increased testosterone). A dermatologist or plastic surgeon can do scalp biopsies and have the hair follicles studied, which may be helpful in determining androgen effects. Some medications, severe stress, malnutrition, iron deficiency and an underactive thyroid may all cause hair loss, so blood tests also are useful.

Repeated permanents and harsh bleaching may contribute to hair damage. Contrary to advertising claims, there are no herbs or hair products that thicken hair. In 1980 an advisory panel to the US Food and Drug Administration evaluated a number of substances used in hair products, including amino acids, aminobenzoic acid, ascorbic acid, benzoic acid, B vitamins, hormones, jojoba oil, lanolin, polysorbates, sulphanilamide, tetracaine hydrochloride, urea and wheat germ oil, and found that none of them prevented hair loss.

Minoxodil or Rogaine for women can be purchased over the counter. It may take applications twice a day for at least four months to see any hair growth, and most people are not satisfied with the "peach fuzz" results. When it's stopped, the hair gained usually will fall out within six months.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.