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Female Hair Loss (Alopecia)

Medically reviewed by Susan Kerrigan, MD, Karyn Eilber, MD and Marianne Madsen on January 3, 2023

Hair loss (alopecia) has traditionally been associated with men. From hiding it with wigs or hairpieces to embracing baldness as sexy, alopecia is often thought to be almost exclusively a male condition. However, according to some sources, around 40 percent of Americans who suffer hair loss are women.

 

This may not be news to some women who have been fishing clumps of hair out of the drain every day, so it is first essential to define what is meant by hair loss and how it differs from hair shedding.

 

Hair Loss and Hair Shedding

 

Humans typically shed between 50 to 100 single hairs every day. This is part of the natural hair regeneration process as new hairs replace older ones as part of a cycle.

 

Hair loss occurs when the older hair falls out and is not replaced or less new hair grows in its place. If you are shedding more than 125 hairs per day, you are probably suffering from hair loss. You don’t need to count–if you notice that your hair is getting thinner or the texture is changing, contact your doctor to see if there is an underlying cause of your hair loss.

 

Causes of Female Hair Loss

 

There are several reasons for hair loss, which can be categorized into sex hormone changes and non-sex hormone changes.

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Hair Loss - Causes

Hair Loss - Causes

Hair Loss Associated with Sex Hormone Changes

 

  • Menopause. During menopause, your body goes through several changes caused by a fluctuation in hormone levels. One of the common symptoms of these changes is hair loss. Your body naturally produces estrogen and progesterone, which helps hair to grow and remain strong. Hair loss during menopause is often due to estrogen and progesterone levels dropping, causing hair to grow slower and thinner and possibly change in texture. Simultaneously, as these hormones decrease, there is an increase in androgens that shrink your hair follicles. Hormonal changes cause almost all hair loss during menopause.
  • Pregnancy. In the first trimester of pregnancy, the balance of hormones in your body shifts dramatically towards your growing baby. This may cause your body to enter a stress mode, which is one reason for telogen effluvium, where your hair is pushed into the resting phase of its cycle. The result is that hair is replaced more slowly, causing a thinning that might take a few months to become evident. Some women may experience additional hair loss in the months after giving birth. This hair loss is caused by a drop in estrogen and is more akin to a period of excessive shedding. Hair loss from pregnancy typically lasts around six months and usually doesn’t result in permanent hair loss. However, your hair may still be thinner until your hormone levels return to normal.

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Hair Loss - Types

Hair Loss - Types

Hair Loss Associated With Non-Sex Hormone Changes

 

  • Thyroid Issues. Suppose you are suffering from an over-active thyroid (hyperthyroidism) or an under-active thyroid (hypothyroidism). In that case, you may also experience hair loss. Your thyroid helps your body develop new hair at the root level. If you have issues with your thyroid, the supply of new hair will be affected, causing thinning, baldness, and changes in hair texture. Any hair loss due to thyroid issues is usually only temporary. Once you and your doctor have  identified and treated the cause of your thyroid problems, the “break in the supply chain” will be fixed, and your hair should start to grow again.
  • Stress. Rising stress levels in your body can force your hair into the telogen phase, the final phase of your hair growth cycle. This means that hair begins to fall out before the next cycle is ready to begin. This stress can be from physical or psychological sources, such as surgery, illness, trauma, etc. Once the stress has been relieved, your hair should grow back.
  • Rapid Weight Loss. Like stress, rapid weight loss may cause a shock to the body that affects your hair growth and forces your hair cycle into the telogen phase. This is likely caused by a sudden and significant drop in calories and micronutrients. If you lose weight slowly, this should not occur. Once your body has adjusted, your hair should grow back. 
  • Iron Deficiency. A deficiency in iron can cause the same type of thinning as telogen effluvium. Once your iron deficiency has been corrected, your hair should grow back.
  • Hairstyle. Styling your hair in a way that pulls on the roots, such as tight ponytails or cornrows, may cause traction alopecia. This happens when the follicles are being pulled out of the scalp by the tension of the hairstyle. In some cases where the follicles themselves become damaged, the hair loss may become permanent.

 

Conclusion

 

There are several reasons for female hair loss. Some are associated with hormonal changes, and some are caused by other conditions. Most hair loss associated with hormonal changes due to age is permanent, but the other types of hair loss may be reversible by correcting underlying conditions. Talk to your physician or a healthcare professional to understand what might be causing your hair loss and discuss a treatment plan.

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