The Top Causes Of Hair Loss In Women

Hair loss is a common topic among men, but it’s not only a men’s issue. Hair thinning and loss impact an estimated 40 percent of women by age 50, with that number reaching 50 percent among women 70 and older. 

Unfortunately, there is such stigma around hair loss in women that it’s rarely talked about openly. In fact, one 2020 review published in Journal of Patient-Reported Outcomes found that most women with hair thinning and loss report feeling shame and embarrassment about their hair, as well as fear of judgment from others. 

Given its prevalence and psychological impact, it’s high time that hair loss in women finally gets some attention. Here, health experts break down the most common causes of hair loss in women, plus how to treat—and even reverse—the shedding.

• ABOUT OUR EXPERTS: Ross Kopelman, M.D., is a hair transplant surgeon at Kopelman Hair Restoration in New York and New Jersey. Shendy Engelina, M.D., is a board-certified dermatologist with Dermatica and ZipHealth in London. Hardik Doshi, M.D., F.A.C.S., is a double board-certified plastic surgeon and hair restoration specialist with Ample Hair hair restoration clinic in New York City.

The Hair Loss-Hormone Connection 

Hair loss in women is often spurred by hormone changes, such as those that occur during menopause or pregnancy, says Ross Kopelman, M.D., a hair transplant surgeon at Kopelman Hair Restoration in New York and New Jersey. Hormone imbalances caused by an underlying endocrine (hormonal) condition like a thyroid disorder or PCOS can also lead to hormone-related hair loss. That’s because “hair growth patterns are influenced by hormones, especially estrogen and androgens,” explains Shendy Engelina, M.D., a board-certified dermatologist with Dermatica and ZipHealth in London. 

Broadly speaking, estrogen supports hair growth, Engelina says. The hormone binds to high-affinity estrogen receptors in the scalp, which extend the growth phase of that hair follicle. As such, the more circulating estrogen an individual has, the stronger, thicker, and longer their hair usually is. In fact, one small 2023 study published in the International Journal of Women’s Dermatology found female hormone replacement therapy (using estrogen) improved the rate of hair growth and frontal hairline thinning scores in as little as six months. Meanwhile, another study published in The Journal of the European Academy of Dermatology & Venereology found that women report that their hair feels thicker and healthier when pregnant. This is likely because estrogen levels are at their highest during pregnancy.

Read More: What To Expect During Perimenopause

Androgens, the category of hormones responsible for so-called “male” characteristics, can also impact hair growth—albeit in the inverse way that estrogen does. Androgens (like testosterone) work on intracellular receptors (called dermal papilla cells or DPCs), which play a role in hair regeneration and growth. Research has found that androgens cause these DPC cells to mature more quickly, which results in hair loss. Given that, it makes sense that women with hyperandrogenism (a.k.a. high levels of androgens) would be prone to balding, as was found in one study published in the International Journal of Molecular Sciences. 

Other endocrine conditions that are marked by abnormally high levels of androgens, such as polycystic ovary syndrome (PCOS) and congenital adrenal hyperplasia, are also known to cause balding and hair loss in women. 

Where Genetics Come Into Play 

While hormones can play a big role in hair loss in women, genetic makeup still matters. Currently, research is still out on exactly which genes impact female pattern baldness. One 2023 overview published in Genes reported that female pattern baldness is caused by a different set of genes than male pattern baldness, and that the genes involved may vary between ethnic groups. 

However, the consensus amongst doctors is that genetics can make an individual hypersensitive to one particular androgen in the body (called dihydrotestosterone, or DHT), says board-certified dermatologist and hair-loss specialist Peter Young M.D., the medical director of Nurx Dermatology. The hypothesis is that the scalp “registers” more of this androgen in people with certain genes than in others. This fast-tracks the hair growth cycle, which ultimately leads to hair loss, according to Young.  

Usually, when a woman has genetics-based hair loss, her hair thins on top of her head as well as at the crown, as first identified by a widening center part, according to Mount Sinai. (Colloquially, this is known as the Christmas tree pattern of hair loss). 

The Interplay Of Genetics and Hormones 

Hormones and genetics may be the two most common causes of hair loss in women, but it’s not always obvious which of the two is causing the issue, as they often interact. 

“It is very common for women to have hereditary susceptibility to hair loss, for example, but not to experience actual loss until they undergo hormone changes,” says double board-certified plastic surgeon Hardik Doshi, M.D., F.A.C.S., a lead surgeon and hair restoration specialist with Ample Hair hair restoration clinic in New York City. Actually, female pattern baldness is also known as androgenetic alopecia, to reflect the fact that hormonal (androgens) and genetic factors are involved, according to Young. (Again, the gene influences the extent to which the hormone DHT impacts the hair follicle.) 

Further, individuals can be predisposed to some of the endocrine conditions (like PCOS, hypothyroidism, and Graves’ disease) that may lead to hair loss. 

How To Find The Cause Of Your Hair Loss

If you notice changes in your hairline, hair texture, or hair density, talk to your healthcare provider. Depending on what other symptoms you are experiencing, they might perform a blood test to measure your hormone levels, advises Young. 

High levels of androgens could signal either female pattern hair loss or PCOS, while low levels of estrogen could suggest that an individual has entered perimenopause or is postmenopausal and experiencing hair loss related to that, he says. “The healthcare provider might also look at your thyroid hormones, as both too little thyroid hormone (hypothyroidism) and too much thyroid hormone (hyperthyroidism) can lead to female pattern baldness,” he explains. 

Read More: 7 Surprising Signs That Something Is Off With Your Thyroid

They might also perform an ultrasound to check the individual’s ovaries, as “women with PCOS typically have polycystic ovaries, or enlarged ovaries that contain many small fluid-filled sacs surrounding the eggs,” says Young. 

Hair Loss In Women Can Be Treated Medically

Ultimately, the treatment plan that will work for your hair loss depends on its underlying cause, says Kopelman. 

In the case of PCOS, your provider could recommend any number of lifestyle changes or prescribe any number of medical treatments, such as birth control pills or long-acting hormonal contraceptives (like the IUD), letrozole, or an insulin-sensitizing agent. For other high-androgen conditions, an androgen receptor blocker, which keeps the androgen from working on the hair follicle, might be prescribed. Meanwhile, if an individual is experiencing hair loss related to the hormone fluctuations of menopause, the provider may suggest estrogen replacement therapy to help keep estrogen levels steady. 

If the provider suspects that genetics are impacting hair loss, “they might recommend medications like finasteride, which reduces DHT levels,” notes Kopelman. A medication called minoxidil, which stimulates hair growth, could also be an option here 

Lifestyle Changes That May Help Women’s Hair Loss 

Numerous lifestyle factors can influence hair growth and loss, and should be incorporated into any action plan geared toward reversing hair loss in women.

One key area is stress management. “Alongside medications, reducing stress through activities like yoga or meditation can also be very effective at treating hair loss in women,” says Kopelman. These practices can help regulate levels of the stress hormone cortisol and thus promote overall hormone balance, he explains. Your supplement regimen can contribute to these efforts if you include adaptogenic herbs like ashwagandha that work to keep cortisol in check.

Nutrition also plays a vital role in ensuring your body has the tools needed for supporting healthy hair growth “Maintaining a balanced diet rich in vitamins and minerals that support hair health, such as iron, zinc, and vitamins A, C, D, and E, is also important,” says Engelina. (If you don’t consume ample amounts of these nutrients via your diet, consider a quality multivitamin or targeted supplements like Viviscal or Zhou Nutrition Hairfluence, which are formulated with specific nutrients that support healthy hair growth.) Avoiding smoking and limiting alcohol consumption are also key, as both habits increase the toxic burden on the body, she adds. 

Read More: 6 Natural Ways To Help Your Hair Grow

Finally, how you care for your hair can also help more of it stay on your head. “Hair strength can be maintained and breakage minimized by following gentle hair care regimens,” says Engelina. That means avoiding excessive use of heat and chemical treatments, as both damage the hair follicle. “Regular scalp massage may help promote hair growth by enhancing blood flow to the scalp and hair follicles,” she adds. In fact, one 2016 study in the journal Eplasty looked at the effect of a four-minute-per-day scalp massage and found that participants reported stronger hair after six months. 

Ultimately, however, because hormonal changes are such a common cause of hair loss in women, the most important habit women can get into is regularly visiting their healthcare provider for hormonal evaluation, Engelina says. Not only will this be good for your overall health, but your hair health, too.