Also called female pattern baldness or female androgenetic alopecia, female pattern hair loss (FPHL) is a condition causing scalp hair shedding and thinning in women. In other words, the hair follicles shrink and lose their ability to grow out thick, healthy hair. Generally, only the top portion of the head undergoes thinning, but all scalp areas could get targeted. FPHL usually sets in women who are 40 years or older, typically post menopause. However, younger women may also be affected by the condition.

Female pattern hair loss. Image credit: Wikimedia Commons
Female pattern hair loss. Image credit: Wikimedia Commons

Though androgens play a major role in male pattern hair loss, their connection with FPHL is not clear. Affected women typically experience scalp hair thinning or volume reduction. In some rare cases, the follicles shut completely and cause baldness. Baldness or a receding hairline is much more common with male pattern hair loss though.

Women’s risks of female pattern baldness goes up during menopause and the resulting hormonal changes. Their scalp hair gets thinner and facial hair more noticeable and coarser. The hair follicles, however, don’t wither away, ruling out possibilities of complete baldness. Unlike during male pattern baldness, women don’t develop a receding hairline. The crown part usually gets thinned out.

Causes

The underlying cause for androgenetic alopecia in women is primarily hereditary. In other words, many genes could contribute to FPHL. And those genes could have been inherited from either one parent or both. However, there could be few other triggering or secondary causes, which could amplify the existing condition.

  • Thyroid disease, anemia, or polycystic ovary syndrome
  • Hormonal changes, generally after menopause
  • Aging

Effects

Like most other hair loss conditions, FPHL doesn’t directly cause medical issues, but it can affect women psychologically. In other words, women with female pattern hair loss are more susceptible to emotional problems such as depression, low self-esteem, and introversion.

Diagnosis

For diagnosis, the doctor basically looks into the patient’s medical history, besides studying the pattern and appearance of hair loss. To ensure excessive male hormone presence or to rule out other hair loss causes, the doctor could examine:

  • Abnormal body hair growth
  • Menstrual period changes and clitoris enlargement
  • Any fresh acne

Unlike male pattern hair loss, the diagnosis isn’t self-evident and a dermatologist evaluation is essential to determine the cause. The diagnosis helps get rid of the confusion with other hair loss types such as telogen effluvium or alopecia areata.

Treatment

Though there isn’t complete FPHL cure, stopping or slowing down hair loss progression is possible. In some cases, regrowth or fresh hair growth can happen. Minoxidil (topical medicine) helps address FPHL. Oral medications such as finasteride, cyproterone, flutamide, and spironolactone can help block the androgenic effects. Long-term or indefinite usage of these prescription drugs could be necessary for sustaining the benefits.

Non-conventional treatments include FDA-approved helmets (for hair loss), laser combs, etc. The camouflages include hairsprays, wigs, hair weaves, and hair building fibers. Hair transplantation offers a long-term solution. A hairstyle change is the least expensive way to hide the problem. Hair loss supplements (such as biotin), shampoos, etc. may also help. Currently, female pattern baldness cannot be prevented.