What is hair loss in women?

Hair loss in women is just that—when a woman experiences unexpected heavy loss of hair. Generally, people shed from 50 to 100 single hairs per day. Hair shedding is part of a natural balance—some hairs fall out while others grow in. When the balance is interrupted—when hair falls out and less hair grows in—hair loss happens. Hair loss is different than hair shedding. The medical name for hair loss is alopecia.

Hair goes through three cycles:

  • The anagen phase (growing phase) can last from two years to eight years. This phase generally refers to about 85% to 90% of the hair on your head.
  • The catagen phase (transition phase) is the time that hair follicles shrink and takes about two to three weeks.
  • The telogen phase (resting phase) takes about two to four months. At the end of this phase, the hair falls out.

How common is hair loss in women?

Many people think that hair loss only affects men. However, it is estimated that more than 50% of women will experience noticeable hair loss. The most significant cause of hair loss in women is female-pattern hair loss (FPHL), which affects some 30 million women in the United States.

Who is affected by hair loss in women?

Any girl or woman can be affected by hair loss. However, it is usually more common in:

  • Women older than 40
  • Women who have just had babies
  • Women who have had chemotherapy and those who have been affected by other medications
  • Women who often have hairstyles that pull on the hair (like tight ponytails or tight braids) or use harsh chemicals on their hair.

What causes hair loss in women?

  • Family history (heredity): Causes thinning of hair along the top of the head. This type of hair loss is female-pattern hair loss. (FPHL is also called androgenetic alopecia or androgenic alopecia.) This type of hair often gets worse when estrogen is lost during menopause.

  • Hair style: Causes hair loss when hair is styled in ways that pull on roots, like tight ponytails, braids, or corn rows. This type of hair loss is called traction alopecia. If hair follicles are damaged, the loss can be permanent.

  • Extreme stress or shock to the body: Causes temporary hair loss. This category includes events like losing a lot of weight, surgeries, illness, and having a baby. This type of hair loss is called telogen effluvium. It happens to hair in the resting stage.

  • Toxic substances, including chemotherapy, radiation therapy, and some medications: Cause sudden hair loss that can occur anywhere on the body. This type of hair loss is called anagen effluvium. It happens to hair in the growth stage. Sometimes, this type of hair loss can be permanent if the hair follicles are damaged.
  • Other medical conditions:
    • Alopecia areata is an autoimmune skin disease that causes patchy hair loss on the head and possibly other places on the body. It is usually not permanent.

What is the relationship between hair loss in women and menopause?

During menopause, you might see one of two things happen with your hair. You might start growing hair where you did not have it before. Or, you might see the hair you have start to thin. One cause may be changing levels of hormones during menopause. Estrogen and progesterone levels fall, meaning that the effects of the androgens, male hormones, are increased. Other factors, such as stress, your diet, and heredity, may contribute to hair loss.

The aging process may mean that some women experience female-pattern hair loss (FPHL). This is also called androgenetic alopecia or androgenic alopecia. This type of hair loss may get worse due to hormone changes.

During and after menopause, hair might become finer (thinner) because hair follicles shrink. Hair grows more slowly and falls out more easily in these cases. FPHL often means that thinning hair is centered at the crown and top of the head.

Your healthcare provider will do a thorough examination and take a detailed history to help you deal with changes in hair growth. You may be directed to have your iron levels or thyroid hormone levels tested. Your medications might be changed if what you take is found to affect hair loss or growth.

Antiandrogens might be prescribed for either excess hair (hirsutism) or for hair loss, but the studies on usage are not clear. For hair loss, minoxidil lotion or shampoo combined with antiandrogen drugs like spironolactone is one approach. Another is to use antidandruff shampoos with ingredients like ketoconazole and zinc pyrithione. You might also be told to try things that do not actually repair hair loss but do allow you to hide it.

If you are already taking hormone therapy (HT) for menopausal symptoms, you might see an improvement in the condition of your hair. However, HT is not recommended solely to treat hair loss.

What are the symptoms or signs of hair loss in women?

  • Seeing more hair fall out daily either on your brush, on the floor, in showers, on your pillows, or on the sink
  • Seeing noticeable patches of thinner or missing hair, including a part on the top of your head that gets wider
  • Having smaller ponytails
  • Seeing hair break off

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