Hair Loss in Women

Long, short, bouncy, or sleek, for most women hair is way more than a bundle of fibers. It’s an expression of women style, personality and some places can even reflect the cultural background.

Alopecia, medical term for excessive or abnormal hair loss. There are different types of alopecia. It can be an annoying experience for any woman and unfortunately, for some women, it becomes a life long struggle.  Sometimes, the medical community treats the issue of women’s alopecia with little attention as it is not a life threating disease but, it seems to be the psychological damage that cause by hair fall and feeling unattractive can be just as devastating as any serious disease, and in fact, can take an emotional toll that directly affects physical health.  For that, today, we are considering the hair loss in women a serious life altering condition that can no longer be ignored by the medical community.

What are the symptoms of alopecia in Women?

Unlike in men, women hardly begin their FPHF while they are teens as it is prevalent in women who are aged between 30 to 60 years but especially in their post-menopausal. However, although rare, it can affect young girls as young as 19 years old when you have this condition, your hairline will begin thinning and afterward, your follicle will cease growing hair. However, women are likely to suffer this condition after menopause, especially, when it is connected to hormonal changes.

What are the types of Women Hair Loss?

Can be temporary or long lasting.

Temporary that easy to treat when its cause is identified and dealt with, or

Long lasting; difficult when it is not immediately clear what the cause is. Temporary if incorrectly diagnosed and treat, can change to long lasting type.

  • Androgenic (Androgenetic) Alopecia or Female Pattern Hair Loss FPHL” or Female Pattern Baldness “FPB”;

It is a most common type of hair problem in women as it is affecting up to 70% of women by age of 50 and even before. A condition that occur in women who suffer diffuse thinning on all area of the scalp (men rarely have diffuse thinning but instead have more distinct patterns of baldness). It is due to the action of androgens, male hormones that are typically present in only small amount in women body and it can be caused by a variety of factors related to the actions of hormones, including some ovarian cysts, taking high androgen index birth control pills, pregnancy and menopause. Just as in men, the hormone DHT appears to be at least partially to blame for the thinning (miniaturization) of hair follicles in women suffering with female pattern baldness. Heredity plays a major factor in the disease. 

In men the thinning hair and baldness in certain areas of their scalp such temples and crown, in women with FPB notice hair thinning all over their scalp with increased and obvious hair fall on the top of the head. This FPHL causes balding at the center of the head.

  • Telogen Effluvium “TE”:  Thinning all over, as a diffuse thinning of hair on the scalp, which may not be even all over. It can be more severe in some areas of the scalp more than others. Most often, the hair on top of the scalp thins more than it does at the sides and back of the scalp. There is usually no hair line recession, except in a few rare chronic cases.

 When woman goes through something like traumatic; severe infection, major surgery, childbirth or extreme stress it can impact on hair growth cycle, 90% of hair are in growing (anagen) phase can under this stressful condition shift all at once into resting (telogen) phase.

• It may appear as bald spot at the crown of the head.

Receding hairline, less common than in men in women, it is known as Frontal Fibrosing Alopecia can be seen as a condition where a woman’s hairline recedes and in some extreme cases, for up to 5 inches. It mostly, affects all around the scalp, forming a band like the pattern of hair loss. Although this condition is rare in women and much common in men, it does happen to women too. Thyroid-stimulating hormone TSH is also important in knowing if any thyroid glands dysfunction could be causing the hairline receding.

What are the common Causes of Women Hair Loss?

What all hair loss has in common, whether it’s in men or women, is that it is always a symptom of something else that’s gone wrong in your body. That’s mean having a healthy hair on your head mean in way or way a sign of a healthy body.  

  No single cause that trigger hair fall, they are as many as 30 or more. Most common ones mentioned by researchers are genes, Androgenic Alopecia “AGA” “Female Pattern Baldness” aging play a role, along with hormonal changes.     

So, in women, beside genetics, external factors may also be important for development of Female Pattern Hair Loss (FPHL). Among the common causes, we have the following:

  1. Aging is a very important factor causes FPB. With increasing age, the hormones also start changing and reacting differently which could result in rapid FPB.
  2. Pregnancy: Some women noticed that their hair seems fuller during pregnancy due to hormone levels keep resting hairs from falling out but, as the woman deliver, and hormonal level readjusted to normal levels, those strands of hair will fall out quickly. Women may lose a lot of hair at once and may take up to 2 years to go back to normal level of hair falling.
  3. Menopausal: most women lead to hair thinning.
  4. Hormonal level changes; can be physiological like menopause & pregnancy, or due to medical problems like polycystic ovarian syndrome (can be thinning hair is the obvious sign of PCOS) and thyroid problems. The same effect can be seen when stop taking contraceptive pill specially if there is family history of hair loss. Low level of estrogen has been found to accelerate the problem and high testosterone and/or DHEA
  5. Chemotherapy and radiation therapy are both known to cause hair fall as these treatments may target the hair follicles, but almost always short-term and once the treatment is finished, hair usually grows back.

6. Skin diseases lead to damage of the hair follicle, Infectious diseases such as eczema, acne and fungal infections like ringworm fungus which can affect the scalp, it triggers a distinct hair loss pattern, itchiness, round bald patches, and might look red and scaly. This need dermatological treatment and can be contagious, so check your family members for the same symptoms.                                           

Autoimmune disorders; Immune system can cause alopecia areata by attacking healthy hair follicles by mistake (hair fall out in big patches), In most cases the damage is not permanent and may grow back in 6 months to a year.

7. Nutritional disorders; whether due to fad diet to lose more weight or after bariatric surgery to treat morbid obesity especially gastric sleeve. Both groups may show hair fall few months down the road due to protein, iron, vitamin B and zinc deficiencies. this can be temporary, and hair will return back to normal when the women be on healthy diet.

8. Excessive Processing hair, the breaking of hair, over doing of any cosmetic treatments to the hair can cause severe loss of female scalp hair.

9. Excessive pulling hair, tight hair style: Other factors which are known to cause hair fall but, not proven by researchers like tight hairstyles like wearing cornrows or tight ponytails can irritate the scalp and cause hair to fall out. the same goes for using tight rollers, this type of hair fall is reversible except when it is used for very long time as these types can scar the scalp and end with permanent hair loss.

10. Trauma, especially burns on your hairline might make it never to grow back.

11. Birth control pill (they deplete zinc, which is essential for hair growth, and are high in male hormones).

12. Drugs has shown increase incidence of hair fall like blood thinners medication. Other drugs may have related to increase hair fall or thinning of hair like some high blood pressure, heart diseases, arthritis, and depression.

13. Extreme stress due to serious illness or major surgery, trauma involving blood loss, severe emotional distress or even, high level physical stress can cause suddenly hair fall of huge amount. The process may last 6-8 months. 

14. Tumors like ovarian tumors or adrenal glands tumors


Interestingly, A US study conducted in 2012 with 98 female identical twins, raised several environmental factors possibly related to FPHL. These included: testosterone levels, psychological stress, hypertension, diabetes mellitus, smoking, multiple marriages, lack of photoprotection, higher income and little physical activity. However, the actual role of these factors in the causal model of FPHL still need be determined.

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