Hair Loss — Are Hormones to Blame?

Aim of the study: Androgenetic alopecia (AGA) is the most common form of alopecia, affecting up to 80% of men and 50% of women during their lifetime. AGA is caused by a gradual reduction in the diameter, length and pigmentation of the hair.

Results: Male pattern hair loss is characterized by recession of the hairline at both temples, followed by diffuse thinning at the crown. Today, scalp dermoscopy is routinely used in patients with androgenetic alopecia. It helps diagnose the condition and distinguish it from other diseases, assess its severity, and monitor its progress over time and the response to treatment. AGA is a progressive disease that tends to worsen over time. Medical treatments for AGA include topical minoxidil, antiandrogen agents and 5-alpha reductase inhibitors.

Aim of the study: Menopause, defined as the cessation of menstruation, may be preceded by hormonal fluctuations during the transition to menopause, which can begin up to 10 years earlier. During this time, hormonal changes—including a relative increase in androgens and the end of ovarian estrogen production—directly affect the hair follicle, which is an estrogen-sensitive tissue.

Results: These hormonal fluctuations can alter the hair shaft and hair cycle, including reducing hair density and thickness and changing hair texture. In addition, the loss of estrogen after the onset of menopause may lead to suboptimal metabolic and vascular function in the hair follicle. The overall decline in hair density, appearance and manageability can have a significant emotional impact and affect mental health, causing stress, anxiety and lower self-esteem. Along with the physiological changes that can occur in hair follicles during menopause, certain hair disorders—including female-pattern hair loss, telogen effluvium and frontal fibrosing alopecia—have been reported more often in postmenopausal women.

Aim of the study: Menopause, which usually occurs between the ages of 45 and 55, is associated with falling estrogen levels as the ovarian follicles are depleted. Its effects on the cardiovascular system and bone density are well documented; however, further research is needed to establish its effects on the skin and hair.

Results: Androgens and estrogens help regulate the hair cycle, and a reduction in hairs in the anagen phase is seen in postmenopausal women. Female-pattern hair loss and frontal fibrosing alopecia have both been associated with the perimenopausal and postmenopausal states. It is clear that menopause and changes in hormone levels affect the hair cycle and common hair conditions. However, further research is needed, particularly to understand treatment targets and the role of hormone therapy.

Aim of the study: Androgenetic alopecia (AGA) affects nearly 50% of women during their lifetime, making it the most common form of chronic hair loss in this population. Despite its high incidence, AGA in women remains underdiagnosed and undertreated, with significant psychosocial consequences, including lower self-esteem, impaired social functioning and reduced quality of life—often greater than the effects seen in men.

Results: Off-label treatments include low-dose oral minoxidil, antiandrogens such as spironolactone and 5-alpha reductase inhibitors (finasteride and dutasteride), as well as hair transplantation. Additional treatments such as low-level light therapy and platelet-rich plasma may further improve results and are often best used alongside medical therapies. Important gaps in research remain, including the lack of randomized controlled trials of AGA that include female patients. There is an urgent need for more FDA-approved treatments for AGA in women to improve access to treatment and reduce its psychosocial burden.

Aim of the study: Female androgenetic alopecia (FAGA) is the most common cause of hair loss in women. Although its prevalence varies between populations, studies consistently show that its incidence increases with age.

Results: Nevertheless, the cause of the disease remains unclear, as current studies have failed to prove a link between total and free testosterone levels and the prevalence of FAGA. This article reviews the effects of hormones on the hair cycle and their role in postmenopausal women. In particular, it focuses on the roles of androgens, estrogens, progesterone, stress hormones and hormones released by adipose tissue in AGA. It also reviews risk factors for FAGA in postmenopausal women, such as insulin resistance, high body mass index and metabolic syndrome, and explains their possible role in the development of the disease.

Aim of the study: An 18-month-old southern hairy-nosed wombat (Lasiorhinus latifrons) was presented with progressive alopecia. Histopathological examination revealed atrophic hair follicles in the telogen phase.

Results: Histopathological examination revealed atrophic hair follicles in the telogen phase. Thyroid hormone levels were lower than in age-matched controls. Treatment with thyroxine improved the coat. This case highlights the need to consider congenital endocrine disorders as a cause of noninflammatory alopecia in young wombats.

Aim of the study: Psychological stress-induced alopecia is becoming increasingly common in younger populations; however, effective nutritional interventions remain limited. This study investigated the therapeutic effects and underlying mechanisms of the natural product component oleanolic acid (OA) in stress-induced alopecia.

Results: Oral administration of OA significantly reduced anxiety-like behavior and reversed the stalling of hair growth in CUMS mice. Pharmacokinetic analysis confirmed that OA was distributed in both brain and skin tissues. Mechanistically, OA rebalanced neurotransmitter levels (reducing the 5-HIAA/5-HT and Glu/GABA ratios) and lowered hypothalamic-pituitary-adrenal (HPA) axis hormone levels (corticosterone, cortisol). In the brain, OA reduced neuronal degeneration and oxidative stress through the BDNF/CREB signaling pathway. In the skin, OA reduced inflammation and oxidative damage, promoted hair follicle regeneration, and increased skin thickness by activating the Wnt/β-catenin pathway and increasing GAS6 levels. In addition, in vitro studies showed that OA reduced corticosterone-induced ferroptosis-like changes (restoring SLC7A11 and GPX4 levels) in HT22 cells.