Hair Loss in Women: Symptoms, Causes & Treatment Options

For women, it isn’t always clear whether they’re experiencing normal hair shedding or something more serious. Female pattern hair loss tends to manifest as overall thinning, which is different and less blatant than male pattern baldness. Nevertheless, there are telltale symptoms to watch out for and effective treatments for the various causes.  

What Is Hair Loss?

Anyone who owns a hairbrush knows it gets full over time. Occasionally, you pull the clumps of lost strands from the bristles and throw them away. It’s completely normal to shed strands from your scalp. Most people lose anywhere from 50-150 hairs each day.

But with typical shedding, you usually don’t see bald and thinning patches. Your hairline doesn’t recede. If you sport ponytails they stay the same size, and you don’t notice progressively smaller ones. Everyone can expect hair shedding because hair follicles go through four separate growth cycle phases.

The anagen phase is when strands are actively growing. After this phase comes the catagen or transition stage, and then the telogen or rest phase. Hairs shed when the telogen phase is complete. Some sources count the shedding phase as a fourth stage of the growth cycle, calling it the exogen phase. With normal hair shedding, enough follicles are in the growth phase, so you never notice the loss from your scalp.  

Actual hair loss happens when there aren’t enough strands to replace the ones you’ve shed. You begin to see visible thinning at the hairline or on other areas of your scalp. Your part may get wider, revealing more skin between each section. You’ll also lose more than the typical number of hair strands each day. It may come out in larger clumps when you take a shower or brush your mane.

Other Factors

While hair shedding is normal, having thicker and longer hair can make you notice it more. Frequently washing your hair may make hair shedding more noticeable as well. Therefore, losing a few strands isn’t necessarily a sign your hair is thinning. Knowing what other symptoms to look for will help you decide whether it’s time to see a doctor.

What Are the Symptoms of Hair Loss in Women?

When it comes to distinguishing the symptoms of hair loss from normal shedding, it may be simpler for men. Male pattern hair loss can happen for some of the same reasons as female pattern hair loss. However, males tend to see receding hairlines and bald spots toward the back of their heads. In men, a receding hairline resembles the shape of the letter M.

But with women, hair loss isn’t always as obvious. Female pattern hair loss may occur all over. You could see increased thinning at the top and crown of your scalp. Yet, you may not develop any bald spots. For women, hair loss usually begins as a widening part. If you part your hair in the middle, you may see each side isn’t as close together, and there’s more visible scalp skin.

Those who part their hair in other ways might see their scalp where they didn’t before. Women can experience a receding hairline, but it’s not as pronounced as it is for men. For most females, the “normal,” natural hairline stays intact. Older women may notice what’s known as age-related hairline recession. This could be unrelated to excessive hair loss or coincide with it.

The pattern of female hair loss is what makes it challenging to spot. Women over 40 may wonder whether it’s part of the aging process. With hair loss in women, it’s easier to dismiss symptoms. But besides a widening part and thinning areas, you might experience additional telltale signs. These include thinner ponytails, seeing an increased amount of hair fall out, and weaker strands.

What Causes Hair Loss in Women?

Hair loss in women can happen because of genetics, illnesses, diets, hormones, and stress. At times, more than one cause may contribute to hair loss. An example is hypothyroidism and insufficient iron intake. The thyroid disorder may be the primary reason for hair loss, but a nutritional deficiency may exacerbate it. A few causes can result in temporary hair loss, while others require ongoing treatment.

Androgenetic Alopecia

Androgenetic alopecia is inherited from your biological family tree. It is the most-common cause of hair loss for both women and men. Androgenetic alopecia can develop any time after puberty, but it’s more likely after age 50 for women.

With this condition, hair follicles are increasingly sensitive to androgens. These are usually known as “male hormones.” Nonetheless, females have them in lesser amounts. The hair follicle’s heightened sensitivity to androgens makes hair strands come out finer. Eventually, the hair follicles get smaller and stop producing new strands.  

Illnesses and Diets

The most common illnesses that lead to hair loss in women are polycystic ovary syndrome, anemia, and thyroid disorders. Both hypo and hyperthyroidism may result in hair loss. Contrary to popular belief, having an overactive thyroid may cause hair loss when the strands become more brittle. Weaker, finer hair tends to break off easily during washing, brushing, and styling.

Anemia can be a standalone illness, such as sickle cell anemia. But it can also develop from nutritional deficiencies, including low iron and vitamin B12 intake. Vegans and vegetarians are examples of those at increased risk of iron and B12 deficiencies. It’s harder to get enough of these nutrients from plant-based foods, and the body doesn’t absorb non-heme sources of iron as readily. Non-heme sources come from plants, while heme sources come from animals.

Iron-deficiency anemia is the most prevalent type, impacting four to five million Americans each year. Menstruation can increase a woman’s risk of developing iron-deficiency anemia, especially if she follows a restrictive diet. Over time, anemia may lead to hair loss as the strands and follicles weaken.

Polycystic ovary syndrome is an illness that increases the amount of androgens in the body. Similar to androgenetic alopecia, hair gets thinner and eventually stops growing. The follicles may not have a genetic predisposition to overreact to androgens. However, the increase in androgens is too much for the follicles to withstand. According to the Centers for Disease Control and Prevention, polycystic ovary syndrome impacts 6% to 12% of U.S. women.    

Hormones and Stress

Hormone fluctuations during pregnancy and menopause are associated with hair loss in women. Taking birth control is another hormone-related factor linked to female hair loss. This doesn’t mean getting pregnant, going through menopause, or taking birth control will lead to hair loss. Hormones, particularly rapidly fluctuating ones, are just another potential cause.

Significant physical or emotional stress can cause shock to the body’s normal functions, including hair growth, and prematurely push a large number of your hair follicles from the growing phase into the resting phase. Within a few months, the affected hairs start falling out.  This condition is called telogen effluvium, which fortunately is nearly always reversible several months after the physical or emotional stress to your body is reduced.

What Are Some Ways To Prevent Hair Loss in Women?  

Some hair loss and thinning are inevitable, particularly with age. But there are lifestyle behaviors you can practice to keep your head of hair as healthy as possible. Some have to do with nutrition and diet. Others include the way you style and care for your hair. And, of course, reducing your stress levels helps.

The hairs on your head depend on certain nutrients for growth. Besides iron, you need adequate protein. Eating a balanced diet and enough calories can ensure your hair follicles stay healthy. You don’t have to go from vegetarian to carnivore but try to get enough essential nutrients through food and supplements. This may include boosting your iron intake during menstruation.  

Certain hair care products and styling practices can weaken your strands, making them prone to breakage. You might want to use sulfate-free shampoos and gentler formulas. Leave-in conditioners with shea butter and olive oil can lock in moisture, preventing brittleness. Abandoning hot oil treatments, store-bought hair dye, and at-home chemical treatments will help you avoid loss from dried-out, weaker strands.

Reducing your use of flat irons, blow dryers, and tight ponytails are additional ways to prevent hair loss. Consistently wearing your hair in tight styles such as buns and braids may lead to traction alopecia. These hairstyles pull on your strands, causing them to fall out and leading to sometimes irreversible hair follicle damage.

What Are the Best Treatments for Hair Loss in Women?  

Temporary causes of hair loss, such as pregnancy or cancer medications, may not require treatment. Once your body starts to recover, your hair should grow back. Even so, several root causes of hair loss in women require treatment to restore growth. The most appropriate solution will depend on what’s causing your hair loss.

Topical minoxidil is an over-the-counter treatment you can try that comes in both foam and solution versions. It’s best to start using it when you first notice thinning patches. While minoxidil can stop future hair loss and encourage growth, it can take six months to a year to see results. The treatment can help address hair loss from a wider range of causes, including androgenetic alopecia.  

For women with androgen-associated hair loss, an oral medication called spironolactone might be an effective treatment. While spironolactone is FDA-approved for treating high blood pressure, it is also frequently used off-label to treat female androgenetic alopecia. One study showed 42% of female participants experienced a mild improvement when they took the medication. About 31% reported increased thickness in their hair.

Alternatives to medications include laser therapy, microneedling, and transplantation. Some forms of laser therapy are done in a dermatologist’s office. But there are at-home options, such as a laser comb or cap. Microneedling involves stimulating the hair follicles to promote growth while transplantation relocates smaller strips of hair from fuller areas.

What Should I Expect From Hair Loss Treatment?

Topical minoxidil can be successful at preventing hair loss, but it doesn’t work for everyone. Doctors typically recommend women use either the 2% or 5% solution. Still, you have to keep using it to see results, and it usually only slows down or prevents hair loss. Minoxidil will not necessarily restore hair growth, although it does in a smaller percentage of people. In these individuals, new growth typically consists of fine hair strands.

Anti-androgen treatments like spironolactone can also take some time to work. Like minoxidil, you must keep taking the medication to see results. Taking anti-androgens may reduce the effects of excess male hormones. Once you stop, there’s a good chance that your hair loss will return. These treatments aren’t without side effects. Some of the most common are headache, upset stomach, dizziness and fatigue. Taking anti-androgens may require you to go on birth control.

Non-medication alternatives like transplantation can produce permanent results. But you may have to undergo multiple procedures, which can get expensive. For women who don’t respond to prescription treatments, transplantation may give them the results they’re after. Risks include scarring and skin infections. Laser therapy may increase hair thickness but does require repetitive, long-term treatment.   

When Should You Consult With a Doctor About Hair Loss?

You know your body better than anyone else. So, if you have concerns about the amount of hair you’re losing, it’s time to see a doctor. You may want to make a list of your symptoms, such as increased shedding and scalp visibility, before your appointment. It also helps to gather details about any family history of female pattern hair loss and related disorders like polycystic ovaries.

Other factors to list are recent life changes, such as moving to a new home or starting a physically demanding job. Stressors may explain hair loss if blood tests and exams eliminate other reasons. Let your doctor know when your hair loss started and any concurring symptoms to help narrow down potential causes like lupus.  

Treat Your Hair Loss

It’s natural to shed some hair every day. But if the number of strands you’re losing raises alarm bells, it’s best not to ignore them. A consultation with a medical professional can get to the bottom of what’s causing your hair loss. From there, you can start a personalized treatment plan to help prevent your symptoms from getting worse.