What’s the Link Between Testosterone and Hair Loss?

Testosterone gets a lot of bad rap when it comes to hair loss. Androgenetic alopecia comes from the presence of the hormones testosterone and dihydrotestosterone. These hormones are the primary cause of hair loss in males.

However, many people are unsure of the link between testosterone and hair loss. There is a link, but how does it exactly work? And are all males going to lose their hair because of the presence of the hormone testosterone? 

Ovaries in the female reproductive system also produce the hormones oestrogen and testosterone. Although the quantity is fairly small, the presence of the hormone should mean that women should also lose their hair. However, that’s not always the case.

Not all men or women lose their hair simply because of the hormone testosterone. So, how exactly is it responsible for hair loss in both men and women, and is it even responsible? Here, we mean to answer just that question and clear up any confusion that you might have regarding the link between testosterone and hair loss.

What is Testosterone? 

It’s a sex hormone, yes, that’s found in both males and females. It is responsible for the development of secondary sexual characteristics in males such as deepening of the voice, pubic hair, facial hair (beard), and strengthening of bone and muscle mass. Other than that, it also regulates the sex drive (libido) and fat distribution in males. 

The hormone is even used for the treatment of certain illnesses as well, such as hypogonadism. High levels of the hormone testosterone also come with health benefits for males, for instance, a lower risk of a heart attack. But, on the other hand, it can also increase risk-taking behaviour in both males and females. 

What’s confusing is that some say that very high or very low levels of testosterone and hair loss are related. There are also different types of testosterone present in the body. Some roam freely without being bound to any proteins, and then there are others, such as dihydrotestosterone (DHT). 

Now, be careful about not confusing the hormone dihydrotestosterone with testosterone. Testosterone converts into dihydrotestosterone with the help of the enzyme 5-alpha reductase. 

However, dihydrotestosterone is far more potent, 5 times to be exact, and a lot of the time, the effects of testosterone on the body take place after its conversion into dihydrotestosterone. The hormone dihydrotestosterone is present in the skin, liver, hair follicles, and prostate. 

Its presence in hair follicles is why it’s blamed for hair loss, and rightfully so. When getting treatment for hair loss in males, they usually begin by targeting the testosterone hormone. 

For instance, finasteride is usually prescribed to stop hair loss. It works by stopping the action of 5-alpha reductase, the enzyme responsible for converting testosterone into dihydrotestosterone. But is that all there is to it? 

Pattern Baldness: How Does Testosterone and Hair Loss Occur? 

Those who’re suffering from male pattern baldness experience a recession in their hairline, with more hair loss occurring at the sides in the shape of an M. It also progresses in other areas of the scalp, such as the vertex or crown of the head. However, hair on the sides and the back stays put. This is the donor hair that’s used for hair transplant surgery.

What’s difficult to understand is that the sensitivity of the hair to the testosterone hormone in certain areas of the body leads to hair loss. However, that’s not always the case with testosterone and hair loss. Hormonal changes can lead to the growth of thicker facial hair even as the person continues to lose hair on their scalp. 

The freely flowing dihydrotestosterone in the bloodstream easily travels to the hair follicles in the scalp region and binds to the receptors there. Hair loss proceeds in a manner where a person notices a decrease in the thickness of the hair. The hair growth cycle shortens. 

Hair miniaturizes while becoming shorter and finer/thinner. People with pattern baldness have fewer quantities of testosterone in circulation as more of that hormone gets converted into dihydrotestosterone. 

High levels of the dihydrotestosterone hormone can cause more than just a few problems in males. To begin with, it can cause acne, receding hairline, loss of hair at the crown and temple regions of the scalp, prostate cancer, heart disease, etc. 

A low level of this hormone is also problematic. It can cause underdevelopment of the sexual organs, leading to the development of swollen and enlarged breasts in males (gynecomastia), and cause prostate tumours.

The illnesses arising due to an imbalance in the DHT hormone and their treatments can also cause hair loss. 

Does Testosterone Cause Hair Loss? 

You shouldn’t exactly blame this hormone. Testosterone and hair loss has more to do with your genetics. The levels of the dihydrotestosterone hormone increase as more circulating testosterone converts into it. The receptors on the hair follicles of the scalp are more sensitive to the presence of this hormone which comes from the conversion of testosterone. 

The sensitivity of those receptors in actuality leads to the loss of hair. Yes, the presence of testosterone triggers it, but that’s because of the greater receptivity of those receptors on the hair follicles, so they are easily affected.

Other than your genetics, stress, age, lifestyle, and health also determine whether you’ll lose your hair or not. However, it remains true that your genes play the most significant role. 

If you’re experiencing hair loss due to stress, it will be something that won’t affect those related to you. Genetics, on the other hand, doesn’t work that way. If you’re balding, the chances are that your children and grandchildren will also go bald.

Research has also shown that premature male pattern baldness is also linked with lower levels of testosterone, epitestosterone, follicle-stimulating hormone (FSH) and a protein, SHBG (sex hormone-binding globulin). 

How Do You Know If You Have Low Testosterone Levels in Your Body?

As you age, your hair will start falling out, but low testosterone levels will also cause you to permanently lose it.

Additionally, it affects the sex drive as well as your mood. You may feel more irritable and anxious, in addition to feeling fatigued. Even after getting a good rest, you’ll feel that your energy is low. If testosterone levels drop significantly, you may also have erectile dysfunction.

If you’re experiencing any of these problems, it’s time you get yourself checked. Waiting will not help in any way because your body is suffering and needs treatment.

How To Treat Testosterone Hair Loss? 

Topical minoxidil and finasteride are usually prescribed for the treatment of permanent testosterone hair loss. One works by dilating the blood vessels, thus increasing the flow of blood to the hair follicles. This entails a greater supply of oxygen and other nutrients to the hair, which helps them grow. 

Finasteride, as mentioned above, nips the evil in the bud by not allowing the conversion of testosterone to DHT. That’s because you actually have low levels of testosterone and hair loss happening at the same time. 

One of the most effective treatments against testosterone and hair loss is hair transplant surgery. The hair on the back and sides of the head are not sensitive to the effects of the dihydrotestosterone hormone, which is why they don’t fall away.

You’ll notice that people who are bald have a ring of hair on the lower region of the scalp. That’s what the surgeons take advantage of. Because of their resilience against dihydrotestosterone, they won’t fall after the hair transplant surgery takes place, so you can continue enjoying the results of your surgery for a lifetime.  

Wrapping Up the Discussion 

There’s still a lot of confusion out there about the link between testosterone and hair loss. For instance, it’s still a mystery why hair follicle receptors in certain regions of the body are more sensitive to the hormone dihydrotestosterone.

Even in the same region, such as the scalp, some hair follicles are more sensitive to it than others. But the problem remains, and to deal with it, surgical treatments, topical solutions, PRP therapies, and medications are available. 

Of them, hair transplant surgery offers permanent, lifelong results, which is why it is widely popular. If you’re suffering from a similar problem or want a consultation with our expert Patient Consultants about your problem. 

Reviewed and Approved by Dr. Hassan Soueid.

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