Hair Loss in Women: Common Causes and Treatment Options

Hair loss is often considered a men's issue, but it's estimated that more than 50% of women will experience noticeable thinning or loss of hair at some point in their lifetime, particularly as they age. Female pattern hair loss (FPHL), the most common cause of female hair loss, affects some 30 million women in the U.S.¹

Some types of female hair loss may respond well to treatment if started early, so discussing options with your doctor if you're concerned about thinning hair is important.

Signs of Hair Loss in Women

Symptoms of hair loss can vary widely. Though it's normal to lose 50 to 100 hairs day-to-day, an excess of hair in the shower drain or collected in a hairbrush are often the first signs of hair loss that many women notice.¹ The medical term for hair loss is alopecia, which is when hair is shed in a normal cycle, but less hair grows back in.¹

Other signs of hair loss in women include:²

• Gradual thinning of hair at the crown of the head
• A broadening of the part in their hair
• Frontal fibrosing alopecia, or a receding hairline
• A loosening of the hair, causing handfuls to come out when washing, brushing or tugging on the hair
• Patchy circular bald spots which may become itchy or painful before the hair falls out
• Hair breakage or noticeably thinner, smaller ponytails
• More visible scalp around the top of the head

Common Causes of Hair Loss in Women

Hair loss in women falls into three categories: anagen effluvium, telogen effluvium and female pattern hair loss, a hereditary condition.¹

1. Anagen effluvium: Hair loss caused by a medication or treatment (such as chemotherapy)
2. Telogen effluvium: An increasing number of hair follicles reach the telogen stage of hair growth and replacement — the stage in which the hair follicles fall out
3. Female pattern alopecia or FPHL: The most common type of hair loss in women wherein the hair thins on the top and sides of the head

While any female can be affected by hair loss at any age, below are some common causes of female hair loss.

Stress

Chronic or extreme stress can cause hair thinning in women, as the body cycles through the stages of “survival mode," reserving its energies for essential functions. Stress-induced hair loss may be caused by emotional distress from a job loss, bereavement or a relationship breakup, for example. It might also have physical causes such as surgery, illness, pregnancy and childbirth, or physical trauma.³

Hormonal changes³

Going on or off some types of birth control, pregnancy and childbirth, and perimenopause and menopause are examples of how hormonal changes can have an effect on hair growth and loss.

Higher levels of progesterone can trigger hair loss, and women who use progesterone-based contraception such as birth control patches, injections, implants or vaginal rings may be more likely to experience thinning hair.

Similarly, high levels of estrogen — such as those associated with pregnancy — can support thicker, fuller hair growth. Postpartum women may experience temporary hair loss as their hormone levels rebalance and estrogen levels drop. Older women experiencing menopause or perimenopause may notice hair thinning or hair loss due to dropping estrogen levels as well.

Health problems

Some hair loss can be attributed to health problems that cause hormonal imbalances, such as hypothyroidism, polycystic ovary syndrome (PCOS), congenital adrenal hyperplasia, anemia or other nutritional deficiencies.⁴

Autoimmune diseases such as alopecia areata can cause patchy hair loss, while systemic lupus erythematosus can cause hair thinning and bald patches that may scar.³

Medications used for cancer treatment, such as chemotherapy or radiation therapy, can cause temporary hair loss, or, in some cases, hair to regrow differently than before treatment.¹

Read our article about important women's health screenings to learn more about how to be proactive about potential health issues.

Family history

Genetics is the most common cause of FPHL, with genes for hair loss likely inherited from either parent. Women commonly start to notice hereditary hair loss — usually a widening of their part or a receding hairline — after the age of 40. Almost 40% of women have some type of hair loss or thinning by the age of 50.³

Hair styling

We might love the way certain hairstyles look, but wearing your hair for extended periods in tight ponytails, braids, weaves or buns can stress or damage the hair follicles, potentially causing permanent damage or hair loss. The same goes for harsh styling methods that use high heat or harsh chemicals.³

Hair Loss Treatments for Women¹

A dermatologist can determine the right course of treatment based on the underlying cause of the hair loss itself. They may order blood work, test hormone levels or require a scalp biopsy to diagnose the root cause of the hair loss.¹

For hair loss due to pregnancy and childbirth, temporary cancer treatment or other medications, no treatment is necessary as hair will usually regrow post-pregnancy, post-treatment or once you stop taking the medication. Likewise, if styling practices such as tight ponytails, braids or harsh chemicals are contributing to hair loss, reducing or eliminating those practices should result in hair regrowth.¹

Below, we outline some additional hair loss treatment options to consider.

Supplements and multivitamins

Supplements may be recommended to address nutritional deficiencies caused by diet changes or conditions like anemia. Three to five milligrams of biotin daily is often recommended in addition to a multivitamin. Ask your doctor about other supplements for B, C and D vitamins, as well as iron and zinc, which may promote hair growth.⁵

Hair loss shampoos

Some shampoos are formulated with ingredients that may treat thinning hair, while others provide a temporary cosmetic solution to give the appearance of fuller hair. Look for shampoos with ingredients such as:⁶

• Histidine
• Phyto-caffeine
• Niacin (vitamin B3)
• Biotin (vitamin H)
• Essential oils such as peppermint, rosemary, lemongrass, lavender or thyme
• Minoxidil

Topical medications

Hereditary hair loss like FPHL is often treated with topical medications. Over-the-counter minoxidil, popularly known as RogaineⓇ, comes in a liquid, foam or shampoo form and is generally applied once daily to the scalp for women. It may take some users up to six months to know if the treatment is working for them to prevent further hair loss and promote new hair growth. If successful, minoxidil will need to be used indefinitely to continue to see results. It's important to note that pregnant women or women who want to become pregnant should not take minoxidil.²

Follicle stimulation devices

Some devices such as low-light laser helmets, caps, headbands and combs that are used to promote hair growth by stimulating the hair follicle and blood flow have been approved for in-office and in-home use by the FDA.¹

Platelet-rich plasma therapy

Platelet-rich plasma (PRP) injections are a relatively new treatment to stimulate hair growth. In this procedure, a doctor takes a blood draw from the patient, separates it into its component parts, then recombines the plasma with highly concentrated blood platelets and reintroduces the solution back into the scalp.⁷

Microneedling

Microneedling is a cosmetic procedure that uses a roller with thin needles to create small injuries in the skin, which are thought to stimulate stem cells in the hair follicles and promote thicker regrowth. Microneedling may also be used in conjunction with other products used to treat hair loss, such as minoxidil, PRP injections or topical steroids, improving their absorption.⁸

Hair transplant surgery

Hair transplant surgery takes small sections of scalp with healthy hair follicles from the back of the head and transplants them to areas of the head that are bald or where hair is thinning.

Surgical hair replacement may require more than one session to be effective, and has risks associated with surgery, such as infection, folliculitis and the possibility that the transplant may not be successful. Some patients will see new growth within six to nine months, but for other patients, new growth may not appear for a year. Hair transplant surgery is not usually covered by insurance.¹

Hair Loss Treatment Costs⁹

Hair Loss Prevention for Women³

While hair loss due to age, heredity, disease or other physical trauma can't be prevented, other types of hair loss can be avoided. A healthy lifestyle is an important factor in preventing or slowing hair loss, and for regrowing hair that has been thinned or damaged.

Here are some specific lifestyle tips to help prevent hair loss:

• Eat a well-balanced diet and address any nutritional deficiencies with the right vitamins and supplements.
• Limit harsh chemicals, styling products or treatments used on your hair.
• Rotate tight hairstyles such as ponytails, braids and buns.
• Stop smoking.
• Avoid brushing your hair when wet — use a wide-toothed comb instead.
• Use the right products designed for your hair type.
• Protect your hair from sun damage.

Don't delay seeing a dermatologist if you're concerned about excessive shedding, thinning or bald spots. They can help determine the cause of hair loss — the important first step before recommending the right treatment for you.

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Author Bio

Anne-Marie Kennedy is a freelance writer with more than 20 years of experience covering health and wellness, personal finance, and real estate/investing.