Understanding the Hormonal Links to Female Hair Loss

Hair loss is often discussed as a male experience, but for many women—particularly those in their 30s and 40s—it can be equally significant. Female pattern hair loss (FPHL), the most common type of hair thinning in women, is influenced by a combination of genetic, hormonal, and metabolic factors. Despite its prevalence, research into female hair loss remains comparatively limited, leaving gaps in understanding and treatment.

A recent peer-reviewed publication in Cureus, titled “Effects of Hormones and Endocrine Disorders on Hair Growth” by Hasan et al. (2022), provides a structured review of the hormonal mechanisms influencing hair growth and loss for both genders. The article presents its findings within a scientific framework, offering an evidence-based overview of the endocrine factors that affect the hair growth cycle.

How Hormones Influence Hair Loss

Hair growth occurs in recurring stages of activity (anagen), transition (catagen), and rest (telogen). Hormones influence each of these phases, and fluctuations in hormonal balance often lead to visible changes in growth patterns, texture, and density.

Hasan and colleagues describe how androgens, including testosterone and dihydrotestosterone (DHT), play a central role in regulating follicular activity. Elevated androgen levels—or heightened follicular sensitivity—can lead to miniaturization of the hair follicles, resulting in shorter, finer hairs over time. This mechanism underlies male and female pattern hair loss, most commonly presenting as diffuse thinning across the crown or part line.

In contrast, estrogen helps maintain hair density by extending the anagen (growth) phase. Higher estrogen levels during pregnancy can lead to thicker hair, while postpartum or menopausal estrogen decline may cause noticeable shedding (telogen effluvium).

Progesterone may counterbalance androgen activity by inhibiting the enzyme 5α-reductase, which converts testosterone into DHT, though more research is needed to confirm its precise influence in women.

The Broader Hormonal Landscape

The Cureus review also outlines the influence of several additional hormones on hair growth:

• Thyroid hormones (T3 and T4) regulate follicular metabolism. Both hypothyroidism and hyperthyroidism can lead to thinning, breakage, or texture changes.

• Cortisol, the body’s primary stress hormone, may suppress follicular stem cell activity when chronically elevated, contributing to diffuse shedding.

• Prolactin excess (hyperprolactinemia) can suppress follicular growth and is sometimes associated with thinning.

• Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) promote follicular cell turnover and regeneration; low levels can reduce growth rate and strand thickness.

The authors emphasize that hair follicles act as “mini endocrine organs,” both responding to and producing local hormone signals. This makes them uniquely sensitive to shifts in systemic hormonal balance.

Endocrine Disorders and Hair Loss in Women

The review identifies several endocrine disorders commonly associated with female pattern hair loss and other forms of diffuse shedding:

• Polycystic ovarian syndrome (PCOS): Elevated androgens and insulin resistance contribute to scalp thinning and excessive body hair growth.

• Thyroid disease: Imbalances in thyroid hormones can disrupt the hair growth cycle, leading to generalized thinning.

• Cushing’s syndrome: High cortisol exposure can weaken follicles and cause brittle or sparse hair.

These findings underscore that hormonal hair loss in women often reflects broader systemic changes rather than isolated scalp issues.

Research Gaps and Future Directions

While Hasan et al. consolidate current understanding, they note that most studies on hormonal hair loss have focused on men. There remains a need for robust, gender-specific research exploring the hormonal mechanisms and treatment responses unique to women.

The review highlights the importance of studying hormonal fluctuations across a woman’s life—including pregnancy, postpartum recovery, contraceptive use, and perimenopause—to clarify how these changes affect the hair growth cycle and follicular health.

Clinical Perspective

As a Nurse Practitioner, Certified Trichologist, and the Founder of Elysian Head Spa, 50% of my hair loss clients are female and nearly all report experiencing hair and scalp changes that correspond closely with these age related hormonal fluctuations. Because limited robust research exists specifically addressing hormonal influences on female hair growth, I have found the Hasan et al. (2022) review particularly informative and gives a high level understanding of these changes.

I am sharing this publication as a scientifically grounded and unbiased resource to help clients better understand the physiological basis of female pattern hair loss and other hormonally influenced hair changes. The article offers a structured, evidence-supported overview of how hormones interact with the hair follicle, providing a helpful context for interpreting these common yet complex experiences.

Conclusion

The publication “Effects of Hormones and Endocrine Disorders on Hair Growth” contributes meaningfully to the ongoing exploration of endocrine function in hair biology. By clarifying the multifactorial hormonal influences on follicular growth and shedding, Hasan et al. provide a foundation for future research aimed at understanding and addressing hormonal hair loss in women.

Reference

Hasan R, Juma H, Eid FA, Alaswad HA, Ali WM, Aladraj FJ. Effects of Hormones and Endocrine Disorders on Hair Growth. Cureus. 2022 Dec 20;14(12):e32726. doi: 10.7759/cureus.32726. PMID: 36578854; PMCID: PMC9788837.