The causes of female pattern hair loss

What causes female pattern hair loss? Is it hereditary or environmental? How does it affect women differently from men?

Female pattern hair loss (FPHL) affects approximately 50% of women over 40 years old. This condition usually starts at puberty and progresses throughout life. The cause of FPHL is unknown. Some studies suggest that genetic predisposition plays a role, while other researchers believe that hormones play a major role.

There are several treatments available for FPHL. These include topical minoxidil, oral finasteride, laser therapy, and scalp micro pigmentation. Each treatment has its pros and cons. In addition, some patients choose to undergo surgery.

Female Pattern Hair Loss

Women lose hair all over their heads, but the hairline usually stays put. This type of hair loss occurs most commonly in older women. There are many treatments available to help you look younger longer.

Evidence Acquisition:

A New Type Of Search Engine Optimization Strategy

A few weeks ago I wrote about how one of my favorite search engines, Bing, had changed its algorithm to favor sites that use evidence acquisition strategies over those that don’t. This week, I’m writing about another popular search engine, Google, which has been making changes to its algorithms to better serve searchers. In fact, it recently announced plans to change the way it ranks webpages.

The reason why both Bing and Google are changing their algorithms is because they want to make sure that people find what they’re looking for faster. They realize that many people just aren’t willing to wait around while they look for something online. So, they’ve come up with ways to speed things up. But there’s a problem with some of the methods that they’re using to do this. And that’s where evidence acquisition comes into play.

What Is Evidence Acquisition?

In short, evidence acquisition refers to the process of gathering information like reviews, ratings, comments, and social media posts to help you decide whether a particular product or service is worth buying. You’ll see examples of this throughout the article, but here’s a quick example: If you wanted to buy a laptop computer, you might start searching for “laptop computers.” Then, you’d probably notice that most of the laptops that show up in your searches are either very expensive or very cheap. But maybe you wouldn’t mind spending $1,500 on a laptop, so you could check out different models and prices.

If you did that, you’d likely end up finding a review of a laptop called the HP Pavilion 15t. It includes several positive features, such as a 15.6 inch screen, 4GB RAM, and Windows 10 Home Edition. However, it also mentions that the battery life isn’t great, and the keyboard doesn’t feel sturdy enough. So, even though the price seems reasonable ($499), you might think twice before purchasing it.

This is basically what evidence acquisition does. Instead of relying solely on the information that appears on a webpage, you can gather additional information from other sources. For instance, you might read reviews written by actual customers of the products or services that you’re considering. Or, you might ask friends and family members what they think about the products that you’re interested in.


1. “The most common causes of alopecia are listed here.”

2. “Other conditions that might present similarly include…”

3. “Alopecia Areata is an autoimmune disease where the body attacks itself.”

4. “Hair follicle abnormalities are often caused by genetic disorders such as…!”

5. “Aging is associated with changes in skin coloration and texture.”

6. “If you have been diagnosed with Alopecia Areatra, it is important to seek treatment immediately.”

7. “You may want to ask about how long the problem has lasted.”


Topical Minoxidil is the ONLY FDA Approved Treatment for Female Pattern Baldness.

Off Label Alternatives Include:

5Alpha Reductase Inhibitors – Finasteride

Antiandrogens – Flutamide

Estrogen Therapy – Estradiol

Prostaglandin Therapy – Latanoprost

Laser Therapy – Laser Therapy

Light Therapy – LED Lights

Hair Transplantation

The most common off-label treatments are antiandrogens and estrogens. These drugs work by blocking testosterone receptors in hair follicles. They are often used together because they both target the same receptor sites. However, there is no evidence that combining these medications increases effectiveness.

1. Female Pattern Hair Loss

Female pattern hair loss (FPHL), also known as female androgenetic alopecia, affects about half of all women over 40 years old and is one of the most common forms of hair loss. In fact, it is the most common type of hair loss among women. While men experience balding due to male hormone changes during puberty, women usually don’t lose their hair until later in life.

The causes of FPHL are still unknown, although genetics play a role. Androgens are hormones produced primarily by the ovaries that affect hair growth. They stimulate hair follicles to grow and produce hair. As we age, our levels of circulating androgens decline. This leads to less stimulation of hair follicles and eventually fewer hairs.

There are three main patterns of FPHL: frontal, central and verticl. Frontal FPHL occurs mainly in the front part of the head, while central FPHL involves both sides of the crown area. Vertex FPHL refers to hair loss around the temples.

2. Epidemiology

The prevalence of female pattern hair loss is approximately 20%. This translates into over 40 million women affected in the United States alone.

Women tend to lose hair faster and experience it earlier than men. About half of all women with hair loss are under age 50.

Hair loss occurs most often before perimenopause, although some patients report symptoms even during pregnancy.

3. Etiopathogenesis

The etiology of FPHL is unknown. However, it appears to be multifactorial. Genetic factors are probably important; however, environmental factors might also contribute to the development of FPHL.

A number of studies suggest that hormonal imbalance plays a critical role in the pathogenesis. This hypothesis is supported by the fact that women with FPHL usually present with hyperandrogenism, whereas men with FPHL often show hypogonadotropic hypogonadism.

There is evidence of altered metabolism of sex hormones in FPHL. Excessive levels of circulating free testosterone have been reported in patients with FPHL.

Androgens stimulate proliferation of granulosa cells and induce differentiation of preantral follicles into antral follicles. Therefore, high concentrations of androgens could lead to increased numbers of small antral follicles. These follicles produce estrogen and progesterone. As a consequence, elevated serum estrogen and progesterone levels have been found in women with FPHL.

In addition, the presence of large amounts of androgen receptors in the ovarian stroma suggests that androgens directly affect the ovary.

The exact mechanism leading to FPHL is still unknown. However, several hypotheses have been proposed. First, androgens increase the sensitivity of the hypothalamic–pituitary axis to gonadotropin releasing hormone (GnRH). Second, androgens promote the growth of ovarian stromal cells. Third, androgens decrease the expression of aromatase activity in granulose cells. Fourth, androgens inhibit the secretion of inhibins A and B. Finally, androgens reduce the expression of FSH receptor in granulosa cells.

4. Clinical Features

Hair loss can be classified into 3 main categories based on clinical findings: diffuse thinning, a Christmas tree pattern, and fronto-midline recessions. Diffuse thinning refers to a general decrease in hair density throughout the scalp without specific areas of baldness. This type of hair loss affects both sexes equally. In contrast, male pattern baldness involves a progressive increase in hair follicles along the crown area, resulting in a “Christmas tree” or horseshoe shape. Female pattern baldness occurs in the vertex and parietals, and it usually starts around 30 years old. Frontal midline recessions occur in the frontal part of the head, and it is most commonly seen in females.

Diffuse Alopecia

The term diffuse alopecia describes hair loss that does not follow a particular pattern, such as female pattern baldness, male pattern baldness, androgenetic alopecia, telogen effluvium, trichotillomania, and others. Diffuse alopecias include scarring alopecia, postpartum alopecia, traction alopecia, discoid lupus erythematosus, lichen planopilaris, and pseudopelade.

Ludwig’s Pattern

In 1884, Dr. Wilhelm Ludwig described a distinct pattern of hair loss in women. He called this pattern “Hamilton’s pattern.” It is characterized by a central band of hair loss surrounded by a ring of hair loss. The hair loss is often asymmetric and may involve the eyebrows, eyelashes, and periocular skin. The pattern appears to progress over time.

Hamilton’s Pattern

This pattern of hair loss was named after American dermatologist William Hamilton, MD. It is characterized by a band of hair loss surrounding a circle of hair loss. The pattern tends to progress over time. Male pattern baldness is similar to female pattern baldness except that it is limited to the vertex and parietal areas of the scalp.

5. Diagnosis

Alopecia areata (AA) is one of the most common types of hair loss. It affects about 2% of people worldwide. Although it occurs in both men and women, it tends to affect males more often. People with AA tend to lose hair from small round areas of skin called “patches.” These patches typically occur on the head, face, neck, arms, legs, chest, and groin area. Hair loss progresses slowly and generally stops spontaneously without medical treatment. However, some people experience rapid progression of hair loss, particularly during stressful periods.

The cause of AA is unknown. Some researchers believe that genetics play a role. Other experts think that stress plays a part. Still others think that certain medications could trigger AA.

A person with AA will usually present with multiple small patches of hair loss over his or her scalp. This pattern of hair loss is what distinguishes AA from other forms of hair loss.

There are several tests that doctors use to diagnose AA. For example, a doctor might take a sample of hair from the affected area and look under a microscope to see whether hairs are missing. Doctors also examine the scalp closely to determine whether there are red spots on the surface of the skin. If the doctor finds no evidence of inflammation, he or she may suggest that you try a medication called prednisone. Prednisone is used to treat conditions like asthma, allergies, arthritis, cancer, Crohn’s disease, and ulcerative colitis. Your doctor may prescribe prednisone to help reduce the inflammation associated with AA.

If your doctor determines that you do not have AA, he or she may refer you to a dermatologist. Dermatologists specialize in treating diseases of the skin, nails, and hair. They are trained to recognize signs of hair loss and recommend appropriate treatments.

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6. Laboratory Tests

Hair loss can be caused by many different factors. Some patients are genetically predisposed to develop certain types of hair loss. Others suffer from autoimmune diseases such as alopecia areata or telogen effluvium, where the body attacks itself. Still others experience stress-related conditions like postpartum depression or anxiety. And some people lose their hair because of medical treatments, including chemotherapy and radiation therapy. In addition, medications, nutritional deficiencies, thyroid disorders, vitamin B12 deficiency, iron deficiency, and low blood sugar levels can contribute to hair loss.

The most common type of hair loss is male pattern baldness, which affects about half of men over age 50. This form of hair loss is often hereditary and involves miniaturization of the follicles. There are several ways to treat hair loss, including topical products, oral medications, laser therapy, and surgery.

Laboratory tests are used to help determine the underlying cause of hair loss. A complete blood count (CBC), electrolytes, calcium, magnesium, phosphorus, creatinine, urea nitrogen, uric acid, liver enzymes, cholesterol, triglycerides, glucose, thyroid stimulating hormone (TSH), free thyroxine (T4), and testosterone levels are routinely checked. Other lab tests include a urine analysis to check for proteinuria, and a pregnancy test to detect elevated estrogen levels during perimenopausal periods.

Patients with an abnormal laboratory test must be evaluated further by an Endocrinologist. If no clear reason for the hair loss is found, it could be due to a medication side effect. Hair loss resulting from a drug interaction is called pseudotumor cerebri.