Hair Loss and Women’s Health

Pattern hair loss in female androgenetic alopecia, AGA, also known as common alopecia affects approximately 20 million American women. AGA in women is caused by processes similar to those that cause pattern hair loss in men. In both sexes, the onset of AGA can occur in adulthood, although women tend to have signs and symptoms somewhat later than men. Recent studies suggest that women with some markers of insulin resistance have a significantly increased risk of female AGA. Furthermore, a parental history of hair loss can be a strong predictor of female AGA. Female pattern hair loss has also been associated with both hyperandrogenism and hirsutism. More recently, hair loss female pattern has also been associated with polycystic ovary syndrome, PCOS, even though epidemiological documentation of this association is still not statistically convincing. However, the association between PCOS and insulin resistance is well documented. What really causes pattern hair loss in women? From a standpoint of susceptibility, the inheritance pattern hair loss female pattern is polygenic and the emergence and disease incidence is parallel to that observed in men. The disorder begins in the hair follicles sensitive to dihydrotestosterone, DHT, androgen receptor binds the formation of a molecular trigger which begins the process of hair loss in motion. The 5 alpha-dihydrotestosterone, the hormone receptor complex translocates to the nucleus of cells susceptible hair follicles, initiating a program of gene activation that begins the gradual transformation of large terminal follicles to miniature follicles. This process occurs within a genetically predetermined anatomical region, or the pattern of the scalp. Hair out of this pattern was not affected. Therefore, the disorder is called pattern hair loss. Surprisingly, both men and women diagnosed with hair loss have increased levels of 5-alpha reductase 5AR in frontal hair follicles compared to occipital scalp back behind ears. Other predisposing factors as the difference in the levels of cytochrome P450 compared with non-susceptible hair follicles are less susceptible clearly drawn, but may have contributory relevance as well. The diagnosis of AGA in women with the support of a pattern of increased thinning of the scalp frontal / parietal with greater density in the occipital scalp, retention of juvenile hairline, and the presence of miniaturized hairs Within the area of loss. Most women with AGA normal menstruation and pregnancy. Extensive hormonal testing is usually not indicated unless signs and symptoms of androgen excess are present such as hirsutism, severe cystic acne unresponsive, virilization, or galactorrhea. In most cases, the differential diagnosis of AGA is based on patient history and clinical presentation. The typical differences include alopecia areata, trichotillomania, and less commonly hair loss associated with disorders such as lupus erythematosus, scabies and skin are manifested disease processes. Scalp biopsy and laboratory testing may be useful in the elucidation of a third pattern hair loss etiology but, in such cases generally should only follow an initial clinical evaluation of a qualified physician. Treatment options from a treatment perspective, the mono-therapeutic interventions against female pattern hair loss include minoxidil, oral spironalactone, flutamide and other oral medications. Surgical hair restoration can sometimes be an option, but care must be exercised, as in some people, the pattern of loss is sometimes spread over much of the entire scalp, causing hair transplantation less clinically effective. Recently, botanically-derived substances such as HairGenesis have also been investigated as potentially useful agents against the disease.