Nearly one-third of women experience some type of hair loss (alopecia) at some point in their lives (usually after puberty, with occurrences increasing with age) (1). Moreover, this figure increases to as much as two-thirds of women who will suffer from some type of hair loss/thinning post-menopause (2)(3). While hair loss is for the most part is common, a key consideration here is that while both men and women experience hair loss/thinning, it has a greater impact on the latter as it is less socially acceptable (4). In this article, we’ll explain what female pattern hair loss is, it’s cause and three hair loss treatment options that are available for women.
Female Hair Loss – Quick Facts
- Up to 40% of all people suffering from hair loss are women (4)
- Hair loss can occur throughout a woman’s life, with the risk increasing with age (4)
- It has been shown that post menopausal women tend to experience increased rates of hair loss due to the reduced production of estrogen and progesterone (5)
Symptoms

Female pattern hair loss is a broad term used to describe hair loss that is caused by a wide variety of factors (6). In particular, these factors can be, but are not limited to the various forms of alopecia, stress, menopause and hormone imbalances (6).
Causes
Alopecia
There are many forms of alopecia which simply means “hair loss (7).” Firstly, it is not contagious and secondly, it can be caused by anything from an individual’s environmental factors, the way they care for their hair as well as their genetics (7). Here are four of the most common forms of alopecia that most women suffer from.

Alopecia Areata
Alopecia Areata (AA) is a condition where the individuals own immune system targets and disturbs their hair follicles which consequently, negatively impacts the natural cycle of hair growth and formation (8).
Traction Alopecia
Traction Alopecia (TA) is described as hair loss caused primarily by constant pulling force being applied to the hair (9). This is common among individuals who frequently wear their hair in ponytails, braids or other similar styles (9).
Androgenic Alopecia
Androgenic Alopecia (AGA) on the other hand, is a common form of hair loss in both men and women. It is caused by androgen's in genetically susceptible men and women (10). The thinning begins between the ages 12 and 40 and is inherited from an individuals parents(10). It is for these reasons that androgenic alopecia symptoms are commonly associated with the actions of hormones. Examples of this can be seen during pregnancy, when taking androgen index birth control pills and during/after menopause (10).
Traumatic Alopecia
Traumatic alopecia (TMA) is hair loss caused by injuries to the scalp (11). These injuries are usually caused by grooming methods that aim to straighten natural wavy/curly hair (11). These grooming practices include using hot combs, tightly wound rollers, braiding, chemical bleaches and styling products (11).
Stress Can Cause Hair Loss
It is a known fact that our body consists of a complex network of interdependent systems (12). In other words, if any health related issues do appear, a small number of them would be due to a single system (12). Stress is no exception and so, many forms of stress begin in our minds and then move on to have significant negative effects on our physical health (12). We’ll go through two of the most common forms of hair loss caused by stress.

- Telogen effluvium is a form of hair loss that is temporary in nature and is due to excessive shedding of resting or telogen hair, which can be characterized as losing 300 hairs a day instead of 100 (13). Telogen effluvium can be triggered by a wide variety of different events including but not limited to stress, major physical trauma, extreme weight loss, and abrupt hormonal changes (including those associated with child birth/menopause) (13).
- Trichotillomania also referred to as “hair-pulling disorder”, is a mental disorder that involves recurrent, irresistible urges to pull out one’s hair from their scalp, eyebrows or other areas of their bodies (14).
Hair Loss, Menopause and Hormonal Imbalance
Menopause
Menopause is a period that all women go through at some point in their lives, typically when they reach their late 40’s and early 50’s (15). It is a time of significant hormonal changes and due to these changes many different physical symptoms can appear, namely, menopausal hair loss (15).
Generally, as women age, fewer eggs are available to mature and be released by the ovaries (16). As this occurs, the ovaries begin to decrease the amount of estrogen that is produced (16). This change results in an increase in the production of the male hormone androgen(15). This hormone is what causes hair follicles on a woman’s scalp to shrink which eventually leads to hair loss (16).
Hormonal Imbalance
Hormonal imbalance is a broad term coined to cover instances where the balance of hormones in an individuals body becomes disrupted (17). This results in many physical symptoms to appear namely, hair loss (17). Some examples of hormonal imbalance can be seen below.

- Pregnancy is often associated with an overabundance of hair growth due to high levels of growth factor hormones paired with an increase in blood circulation (18). However, after giving birth it is common for women to lose a significant amount of hair as the growth factor hormones and increase in blood circulation fall to pre-pregnancy levels(18).
- Hypothyroidism and hyperthyroidism or in other words an under/over active thyroid can cause many symptoms, chief of which is hair loss (19). Both conditions can cause dry, brittle/thinning hair not just on an individuals scalp but their body as well (19).
- Poly-cystic ovary syndrome is a common hormonal disorder among women of reproductive age (20). Women with this condition produce higher than normal amounts of the male hormone androgen (20). This imbalance is what causes hair loss on the scalp however, this imbalance also leads to hair growth on the face and the rest of the individuals body (20).
How is it Diagnosed?

At some point in our lives many of us have those days where after running your hands through your hair, you make a startling discovery. Looking at your hands, you find a what seems to you as a large amount of your hair. While it may be a shocking site to most people, it is actually normal for us to lose on average 100 hairs a day (21). However, when you notice that an abnormal amount of hair loss is occurring, the best thing you can do is remember to act rationally, do not self diagnose/treat (21). With this in mind, make an appointment with your doctor or a dermatologist if you have access to one.
Before the medical professional makes a diagnosis, they will most likely run you through a physical examination process which includes questions about your diet, hair care practices as well as your medical and family history (21). During this process it is common to have one or more the following tests done in order to properly understand and define the cause.

Diagnosing Hair Loss
- Pull and/or Tug Test is a simple test that measures the severity/presence of hair loss (22). During this a pull/tug test, a medical professional will grasp and tug small sections of hair, approximately 30-50 stands from different areas of the scalp (22). If six or more stands are pulled out, you would be told that you have active hair loss (22).
- Card Test is another simple test used to both examine the health of hair shafts and to determine the number of new hairs that are growing (23). The medical professional would create a part in the hair and using a card that contrasts the individuals hair (23). Because of this, new/broken strands of hair can be counted and examined (23).
- Blood tests are helpful as they help uncover medical conditions that can cause hair loss (24).
- Light microscopy is a test that makes use of a special instrument in order to examine hair follicles cut at the scalp level (25). This procedure evaluates the shafts of hair follicles in order to uncover the presence of any disorders (25).
Hair Loss, Three Treatments For Women

There are many hair loss treatment options available to address the various forms of hair loss. Below, you’ll find the three most common and widely used hair loss treatment options for women.

Finasteride (Propecia)
Finasteride is a DHT blocker (26). DHT (dihydrotestosterone) is the primary cause of male pattern baldness (26). This is relevant to women suffering from androgenic alopecia which we described above (26).

Minoxidil (Rogaine)
Minoxidil was initially developed as a treatment for high blood pressure however, the people that took it began to note that they had hair growing where it hadn’t been before (27). It wasn’t long before minoxidil was being prescribed to be used directly on the scalp to stimulate hair growth (27).
While it does produce results, those results are not apparent over night (27). Instead, it will take at least two months before noticeable results appear (27). One thing to consider however is the fact that if you see positive results you need to continue to use it in order to maintain it (28). If you stop, you will begin to lose your hair again where it will eventually return to the point where hair loss would have been if you hand’t used it (28).

Nutritional Supplements
Nutritional supplements, more specifically Iron supplements may be necessary to treat hair loss in women (29). In order to see whether or not this is true, it is recommended that women visit their local physician and have their blood-iron level tested (29).
When you lack a satisfactory level of iron in your system, your body can’t produce enough hemoglobin in your blood (30). Hemoglobin carries and transports oxygen along with other molecules that are responsible for the growth and repair of cells in your body, this is true for the cells that stimulate hair growth (30). Thankfully, both hair loss due to iron deficiency as well as the condition itself can be treated and its effects can be reversed (30).
Other nutrients that have a positive effect on hair growth include but are not limited to Vitamins A, C, D and E, B-Vitamins, Zinc and Protein (31). It is for this reason that a healthy and responsible diet must be maintained in order to ensure that the body receives the nutrients it needs (31). It is important to note that a blood test can give you a clear picture as to where you stand with respect to the aforementioned nutrients as well as many others (31).
Scalp Micropigmentation, An Emerging Treatment Option
Female Pattern Hair Loss Vs Scalp Micropigmentation
In the video below a young woman suffering from Alopecia areata, patchy hair loss throughout the scalp. After trying many hair loss treatment options she came to find scalp micropigmentation (smp) as a potential hair loss treatment option. After months of research, she decided to choose Gerow Hair Ink as her SMP provider. Have a look at her video below.
Scalp Micropigmentation (SMP) is an advanced hair loss treatment option. It involves the creation of follicular hair unit sized impressions in the scalp that perfectly mimic an individuals own hair follicles.
Scalp micropigmentation is the fastest growing solution in the history of hair loss prevention/treatment– that is a fact. From thinning hair and male pattern baldness to scarring and the various forms of alopecia, scalp micropigmentation is the only solution that provides results.
In just the last decade, the industry has grown from zero to over 1500 technicians worldwide. With more than 170,000 men and women now thought to have had the procedure, the industry is experiencing an unprecedented rate of growth.
Female Hair Loss Takeaway
Just as with male pattern baldness, female pattern hair loss is the sum of many complex yet inter-related parts. These causes range from a sensitivity to DHT as seen in male pattern baldness to hormonal imbalances, illnesses and nutrient deficiencies (7-20)(26-31).
What ever the cause may be, one thing that is certain is that there are many hair growth treatment options available for women. If you or anyone else you know is suffering from female hair pattern baldness, seek out the opinion of medical professionals for an accurate diagnosis of the cause as well as potential treatment options.
Gerow Hair Ink
View this post on InstagramA post shared by Gerow Hair Ink (@gerowhairink) on
At GEROW HAIR INK we’ve always said that we love what we do and that seeing our clients happy was our only satisfaction. When we started on this journey, scalp micropigmentation was a grass roots movement.
And to this day we remain committed to make hair loss a thing of the past and provide both Men & Women with a better option that doesn’t involve invasive and in most cases damaging surgery.
Resources | 1-10:
1. Sinclair R, Patel M, Dawson TL Jr, et al. Hair loss in women: medical and cosmetic approaches to increase scalp hair fullness. Br J Dermatol. 2011;165 Suppl 3:12-18. doi:10.1111/j.1365-2133.2011.10630.x
2. Goluch-Koniuszy ZS. Nutrition of women with hair loss problem during the period of menopause. Prz Menopauzalny. 2016;15(1):56-61. doi:10.5114/pm.2016.58776
3. https://www.health.harvard.edu/staying-healthy/treating-female-pattern-hair-loss
4. Dinh QQ, Sinclair R. Female pattern hair loss: current treatment concepts. Clin Interv Aging. 2007;2(2):189-199.
5. Brough KR, Torgerson RR. Hormonal therapy in female pattern hair loss. Int J Womens Dermatol. 2017;3(1):53-57. Published 2017 Feb 24. doi:10.1016/j.ijwd.2017.01.001
6. Ramos PM, Miot HA. Female Pattern Hair Loss: a clinical and pathophysiological review. An Bras Dermatol. 2015;90(4):529-543. doi:10.1590/abd1806-4841.20153370
7. Al Aboud AM, Zito PM. Alopecia. [Updated 2020 Feb 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538178/
8. Pratt CH, King LE Jr, Messenger AG, Christiano AM, Sundberg JP. Alopecia areata. Nat Rev Dis Primers. 2017;3:17011. Published 2017 Mar 16. doi:10.1038/nrdp.2017.11
9. Pulickal JK, Kaliyadan F. Traction Alopecia. [Updated 2019 Nov 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470434/
10. Ho CH, Zito PM. Androgenetic Alopecia. [Updated 2019 Nov 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430924/
Resources Continued | 11-20:
11. Billero V, Miteva M. Traction alopecia: the root of the problem. Clin Cosmet Investig Dermatol. 2018;11:149-159. Published 2018 Apr 6. doi:10.2147/CCID.S137296
12. Hadshiew IM, Foitzik K, Arck PC, Paus R. Burden of hair loss: stress and the underestimated psychosocial impact of telogen effluvium and androgenetic alopecia. J Invest Dermatol. 2004;123(3):455-457. doi:10.1111/j.0022-202X.2004.23237.x
13: Rebora A. Telogen effluvium: a comprehensive review. Clin Cosmet Investig Dermatol. 2019;12:583-590. Published 2019 Aug 21. doi:10.2147/CCID.S200471
14. Grant JE, Chamberlain SR. Trichotillomania. Am J Psychiatry. 2016;173(9):868-874. doi:10.1176/appi.ajp.2016.15111432
15. Mirmirani P. Managing hair loss in midlife women. Maturitas. 2013;74(2):119-122. doi:10.1016/j.maturitas.2012.10.020
16. Salam A, Tziotzios C, Fenton DA. Hair loss is an important symptom of the menopause. BMJ. 2018;360:k245. Published 2018 Jan 24. doi:10.1136/bmj.k245
17. Trüeb RM. Hormone und Haarwachstum [Hormones and hair growth]. Hautarzt. 2010;61(6):487-495. doi:10.1007/s00105-009-1890-2
18. Thom E. Pregnancy and the hair growth cycle: anagen induction against hair growth disruption using Nourkrin® with Marilex® , a proteoglycan replacement therapy. J Cosmet Dermatol. 2017;16(3):421-427. doi:10.1111/jocd.12286
19. Vincent M, Yogiraj K. A Descriptive Study of Alopecia Patterns and their Relation to Thyroid Dysfunction. Int J Trichology. 2013;5(1):57-60. doi:10.4103/0974-7753.114701
20. Quinn M, Shinkai K, Pasch L, Kuzmich L, Cedars M, Huddleston H. Prevalence of androgenic alopecia in patients with polycystic ovary syndrome and characterization of associated clinical and biochemical features. Fertil Steril. 2014;101(4):1129-1134. doi:10.1016/j.fertnstert.2014.01.003
Resources Continued | 21-32:
21. Fabbrocini G, Cantelli M, Masarà A, Annunziata MC, Marasca C, Cacciapuoti S. Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review. Int J Womens Dermatol. 2018;4(4):203-211. Published 2018 Jun 19. doi:10.1016/j.ijwd.2018.05.001
22. Dhurat R, Saraogi P. Hair evaluation methods: merits and demerits. Int J Trichology. 2009;1(2):108-119. doi:10.4103/0974-7753.58553
23. Jackson AJ, Price VH. How to diagnose hair loss. Dermatol Clin. 2013;31(1):21-28. doi:10.1016/j.det.2012.08.007
24. Zhang X, Caulloo S, Zhao Y, Zhang B, Cai Z, Yang J. Female pattern hair loss: clinico-laboratory findings and trichoscopy depending on disease severity. Int J Trichology. 2012;4(1):23-28. doi:10.4103/0974-7753.96082
25. Adya KA, Inamadar AC, Palit A, Shivanna R, Deshmukh NS. Light microscopy of the hair: a simple tool to "untangle" hair disorders. Int J Trichology. 2011;3(1):46-56. doi:10.4103/0974-7753.82124
26. Iamsumang W, Leerunyakul K, Suchonwanit P. Finasteride and Its Potential for the Treatment of Female Pattern Hair Loss: Evidence to Date. Drug Des Devel Ther. 2020;14:951-959. Published 2020 Mar 2. doi:10.2147/DDDT.S240615
27. Suchonwanit P, Thammarucha S, Leerunyakul K. Minoxidil and its use in hair disorders: a review [published correction appears in Drug Des Devel Ther. 2020 Feb 10;14:575]. Drug Des Devel Ther. 2019;13:2777-2786. Published 2019 Aug 9. doi:10.2147/DDDT.S214907
28. Koperski JA, Orenberg EK, Wilkinson DI. Topical minoxidil therapy for androgenetic alopecia. A 30-month study. Arch Dermatol. 1987;123(11):1483-1487.
29. Park SY, Na SY, Kim JH, Cho S, Lee JH. Iron plays a certain role in patterned hair loss. J Korean Med Sci. 2013;28(6):934-938. doi:10.3346/jkms.2013.28.6.934
30. Trost LB, Bergfeld WF, Calogeras E. The diagnosis and treatment of iron deficiency and its potential relationship to hair loss. J Am Acad Dermatol. 2006;54(5):824-844. doi:10.1016/j.jaad.2005.11.1104
31. Guo EL, Katta R. Diet and hair loss: effects of nutrient deficiency and supplement use. Dermatol Pract Concept. 2017;7(1):1-10. Published 2017 Jan 31. doi:10.5826/dpc.0701a01
Images:
Figures 1-10 were taken from free resources with full commercial use rights – no attribution necessary. Gerowhairink.com
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