Female Pattern Hair Loss (FPHL) is a prevalent and distressing condition affecting a significant number of women globally. 

With a staggering 40% of women grappling with FPHL by the age of 50, this report unravels the nuances of its onset, age-specific patterns, and contributing factors. 

From the role of genetics to the impact of hormonal fluctuations and aging, we will discuss the multiple causes of FPHL. 

Additionally, the report sheds light on potential treatments, exploring the efficacy and considerations surrounding medications like Minoxidil, Finasteride, etc. 

Read on to unravel the complexities of Female Pattern Hair Loss, a journey through statistics and insights that seeks to empower and inform.

Prevalence of Female Pattern Hair Loss

Female Pattern Hair Loss is a common and distressing condition that impacts a significant proportion of women.

Globally, around 40% of women experience its effects by age 50. 

This condition, characterized by a gradual thinning of the hair on the scalp, often has a profound impact on the emotional well-being and self-esteem of those affected. 

FPHL typically manifests as a widening part, noticeable thinning at the crown, or an overall reduction in hair density. 

Unlike Male Pattern Baldness, FPHL tends to present as diffuse hair thinning rather than receding hairlines.

Onset of FPHL based on age

The timeline for the onset of Female Pattern Hair Loss varies across different age groups. 

According to a study, at 29 years old, 12% of women exhibit clinically detectable FPHL, marking an early introduction to this condition. 

The prevalence increases with age, as 25% experience FPHL by age 49, demonstrating a substantial rise in affected individuals during the transitional stages of adulthood. 

By age 69, 41% of women face clinically detectable FPHL, underlining the progressive nature of this condition. 

The data becomes even more pronounced at 79 years, with over 50% of women showcasing some form of FPHL. 

This temporal progression suggests that FPHL is not solely an aging-related concern but can emerge at various life stages. 

Understanding these age-specific patterns aids in developing targeted interventions and raises awareness about the diverse timelines of FPHL development among women.

Causes of Female Pattern Hair Loss

There are various causes of FPHL. Some of them are as follows:

Aging

Aging is a natural process that impacts various aspects of the human body, and hair is no exception.

Female Pattern Hair Loss is commonly initiated in midlife.

It typically affects women in their 40s, 50s, or 60s. 

This midlife onset is a pivotal aspect of FPHL, emphasizing its association with hormonal changes and aging. 

However, it’s crucial to acknowledge the variability in its commencement, as some women may experience FPHL earlier than the typical midlife timeframe. 

Did you know?
Female Pattern Hair Loss is the most common type of hair loss problem in women.

Changes in the Androgen levels

Androgens, the male hormones present in both men and women, can influence hair growth patterns. 

In a study involving 109 women with noticeable hair loss, especially in a spread-out pattern, researchers explored hormone-related issues. 

They found that 38.5% of the women (42 out of 109) had a condition called Hyperandrogenism. 

This means these women showed elevated levels of certain hormones in their blood, specifically: 

  • Testosterone
  • Non-binding Globulin-bound Testosterone
  • Dehydroepiandrosterone Sulfate
  • Androstenedione
  • Dihydrotestosterone

These hormones are associated with male characteristics and can affect hair growth. 

The study suggests a potential link between elevated Androgens and moderate to severe hair loss in women, providing valuable insights into the hormonal aspects of Alopecia.

Family history of male or female pattern baldness

Genetics plays a significant role in determining an individual’s susceptibility to Female Pattern Hair Loss. 

If there is a family history of male or female pattern baldness, the likelihood of experiencing FPHL increases. 

Researchers conducted a study in Poland to understand if Female Pattern Hair Loss in women has a genetic basis and if having a family history increases the risk of experiencing it earlier.

They examined the family backgrounds of 111 unrelated female patients with FPHL. 

The results showed that a significant majority, 69 (62.2%) of these patients, had a positive family history of FPHL. 

This suggests a notable genetic component in the development of FPHL among women. 

Heavy blood loss during menstrual periods

Excessive blood loss during menstrual periods can contribute to Female Pattern Hair Loss. 

Iron deficiency resulting from heavy menstrual bleeding may lead to Anemia, negatively impacting the hair growth cycle. 

Warning:
If iron deficiency Anemia is left untreated, it can pose serious risks. It may potentially lead to complications like a rapid heartbeat (Tachycardia) or heart failure.

Insufficient iron levels affect the production of Hemoglobin, a crucial component for transporting oxygen to cells, including hair follicles. 

Poor oxygen supply can weaken hair and contribute to hair loss.

Medicines for FPHL

Here are some of the medications commonly prescribed for Female Pattern Hair Loss:

Minoxidil

Minoxidil is one of the most widely used and well-known medications for treating Female Pattern Hair Loss. 

Originally developed as an antihypertensive medication, its hair-growing properties were discovered as a side effect. 

Minoxidil comes in various dosages and is applied directly to the scalp.

In a 48-week study involving 381 women aged 18-49 with Female Pattern Hair Loss, different strengths of topical Minoxidil solution were evaluated. 

The participants applied 5% Minoxidil, 2% Minoxidil, or a placebo (vehicle for 5% solution) twice daily.

The main focus was on three factors:

  • The change in novellus hair count at week 48 
  • Patient/investigator assessments of hair growth
  • Scalp coverage

Results showed that the 5% topical Minoxidil was more effective than the placebo on all three measures, while the 2% topical Minoxidil was superior to the placebo in some aspects. 

Additionally, the 5% Minoxidil group demonstrated statistical superiority over the 2% Minoxidil group in patient assessment of treatment benefit at week 48. 

However, the stronger solution also led to more itching, local irritation, and excessive hair growth compared to the 2% and placebo groups.

Finasteride

Finasteride, commonly known by its brand name Propecia, has been FDA-approved for treating Male Pattern Baldness. 

While it is not officially approved for use in women with FPHL, some healthcare providers may prescribe it off-label for certain cases. 

In a study, 37 women with Female Pattern Hair Loss were treated with Finasteride at a higher dose of 2.5 mg daily, along with an oral contraceptive containing Drospirenone and Ethinyl Estradiol. 

The effectiveness of the treatment was assessed using global photography, hair density scores from video-dermoscopy, and a patient questionnaire.

After a 12-month follow-up, 23 out of 37 patients showed improvement in their condition, with various degrees of enhancement: 

  • 12 were slightly improved
  • 8 were moderately improved
  • 3 were greatly improved

No improvement was recorded in 13 patients. One patient experienced a worsening of the condition.

However, it remains unclear whether the success was due to the higher Finasteride dosage or its combination with the oral contraceptive, which has antiandrogenic effects. 

The study suggests that further research is needed to determine which patterns of Female Pattern Hair Loss respond better to this treatment.

Cyproterone acetate

Cyproterone is a medication that inhibits Gonadotropin-releasing Hormone (GnRH) and blocks Androgen receptors. 

A research study was conducted on Diane-35, which contains Cyproterone and Ethinyl Estradiol.

In this study, researchers aimed to investigate the effects of Diane-35 on 25 women aged 31-35 with Alopecia. 

The women took one coated tablet of Diane-35 daily for 6-9 months, starting on the first day of their menstrual cycle. 

After completing one package, they paused the drug for 7 days, leading to the occurrence of menstrual bleeding.

The study found that using Diane-35 for 6-9 months significantly reduced hair loss and thinning of hair. 

The clinical and trichological examinations, including trichogram and hair loss assessment, were conducted before and after the therapy. 

These findings suggest that Diane-35 could be effective in addressing Alopecia symptoms in women.

However, it is crucial to understand that the FDA has not approved this medicine for treating Female Pattern Hair Loss.

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Spironolactone

Spironolactone is another off-label medication provided to women with Female Pattern Hair Loss.

It is an anti-androgen that works by blocking Androgen receptors and reducing the production of Androgens in the ovaries.

It is the most widely used treatment for FPHL in the USA.

In a study aimed at assessing the effectiveness of oral anti-androgen therapy for women with Female Pattern Hair Loss, 80 women between the ages of 12 and 79 participated. 

The study utilized standardized photographic techniques to evaluate changes, and the goal was to identify factors that could predict a positive response to the treatment.

The participants were divided into two groups:

  • One group receiving Spironolactone (200 mg daily)
  • The second group received Cyproterone acetate (either 50 or 100 mg daily for 10 days/month)

After a minimum of 12 months of therapy, there was no significant difference in the results or the trend between Spironolactone and Cyproterone acetate, and thus, the results were combined.

The results showed that 44% of the women experienced hair regrowth, 44% saw no clear change in hair density, and 12% continued to experience hair loss during the treatment period. 

Conclusion

Female Pattern Hair Loss is a prevalent and emotionally impactful condition affecting many women globally.

This condition, marked by gradual hair thinning, has various causes, including aging, hormonal fluctuations, genetics, and iron deficiency due to heavy menstrual bleeding. 

The onset of FPHL varies, beginning as early as 29 and increasing with age, emphasizing the need for targeted interventions.  

Medications like Minoxidil and off-label use of Finasteride and other anti-androgens show varying effectiveness, emphasizing the need for further research. 

Empowering women by providing insights into FPHL’s prevalence, causes, and available treatments helps foster awareness and informed decision-making.

Frequently Asked Questions

Is there any treatment for Female Pattern Baldness?

Yes, treatments used for Female Pattern Baldness include Minoxidil, Finasteride, Cyproterone acetate, and Spironolactone. Minoxidil, a topical solution, and Finasteride, an oral medication, have shown effectiveness. Cyproterone acetate and Spironolactone, though off-label, are used to block Androgens. However, individual responses vary, and ongoing research aims to enhance treatment options.

Can a dermatologist help with Female Pattern Baldness?

Yes, dermatologists can help address Female Pattern Hair Loss. They can assess the severity, identify underlying causes, and recommend treatments such as Minoxidil, Finasteride, or other interventions based on individual needs. Seeking advice from a dermatologist is essential for personalized care and effective interventions for female hair loss.

What is the best treatment for pattern baldness?

The most commonly recommended treatments for pattern baldness are Minoxidil and Finasteride. Minoxidil, a topical solution, promotes hair growth, while Finasteride, an oral medication, inhibits the hormone linked to hair loss. However, individual responses vary, and consulting with a healthcare professional is essential.

Can females take Finasteride?

While Finasteride is FDA-approved for Male Pattern Baldness, its use in females is off-label and controversial. Some healthcare providers may prescribe it for certain cases of Female Pattern Hair Loss. However, its safety and efficacy for women are not well-established, and potential risks and benefits should be thoroughly discussed.

Which Minoxidil is best for females?

The best concentration of Minoxidil for females is typically 2%. While both 2% and 5% formulations are available, studies have shown that the lower concentration is effective with a lower risk of side effects. However, individual responses may vary, and consultation with a healthcare professional is advisable for personalized recommendations.

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