Hair Loss and the Pill

After reading this article on the class blog about male balding, I wanted to look more into hair-loss in women. Ironically, a friend of mine told me recently that her hair has been falling out. Was this due to stress, medical issues, or something else altogether? I’m going to try to figure it out.

In the article mentioned above, Androgenetic alopceia as that name of the common balding pattern in men. However, American Hair Loss Association uses the term when talking about baldness in both men and women. The AHLA article reports that while testosterone is at the center of the balding process, Dihydrotestosterone (DHT) is the real problem. DHT binds to receptors in scalp follicles, shrinking them so healthy hair is unable to survive. Though women have lower levels of testosterone to begin with, this can still lead to DHT-triggered hair loss. Hormonal balance is incredibly important when discussing hair-loss because testosterone levels are one leading cause of this problem. AHLA writes, “Androgenic alopecia can be caused by a variety of factors tied to the actions of hormones, including, ovarian cysts, the taking of high androgen index birth control pills, pregnancy, and menopause”.

This leads me to wonder if perhaps my friend’s birth control could be the cause of her hair-loss. On this page, AHLA describes how contraceptives suppress ovulation by using various levels of estrogen and progestin. They report that those who are predisposed to hormonal-related hair loss or are hypersensitive to hormonal changes could experience hair-loss when on the pill or more commonly, when they stop taking the pill. I do not think many women are aware of the this potential side effect. It is common knowledge that contraceptives can relieve period pains, and clear skin, but the potential for hair-loss is not as commonly known. Maybe this is because only those who are predisposed to hair-loss are more commonly affected, therefore, doctors do not discuss such potentials unless the patient’s medical history calls for it.  The AHLA recommends that women wanting to use the pill merely to avoid contraception, should take low-androgen index pills. Remember, testosterone and DHT are different kinds of androgen.

jcad_5_11_28-g002aBefore

jcad_5_11_28-g004a After

 

 

 

The Bernstein Medical Center for Hair Restoration writes in this article that oral contraceptives can cause hair loss and be a treatment for it. They list drug-induced shedding and facilitating female pattern genetic hair loss as two mechanisms by which birth control pills cause hair loss. In the case of helping hair growth, the pill prolongs the anagen phase (growing phase), however, these higher estrogen-level pills have a greater incidence of other side effects. In a study found here, researchers looked into “the ability of an oral supplement to increase hair growth in women with thinning hair”. This randomized double-blind, placebo-controlled trial took healthy women ages 21 to 75 and gave them either Viviscal® Maximum Strength or the placebo twice a day for 180 days. A large number of variables were controlled for and even excluded a lot of participants. Surprisingly, those with androgenetic alopecia who, by the opinion of the researcher, might be at greater risk or interfere with clinical evaluations were excluded from the study. The mean number of terminal hairs in the test area in placebo patients was 256 to begin with and it ended with 242.2 after 180 days. Conversely, patients who took the medication began with 271 and ended with 609.6. This supports their hypothesis that Viviscal® increases hair growth in women with thinning hair. At the end of the article it reports that larger studies are underway to look into this drug’s effect on hair counts and thickness.

Upon looking at both sides of this interesting topic, I think it is safe to say that the potential for hair loss due to birth control pills is low enough that most women should not worry about it. However, that does not mean they should not be cautious. Those that have a delicate hormonal balance or are predisposed to hair loss, should consult their doctor. For everyone else, if the worry is still there, stick to a lower androgen level pill. Lastly, for those with hair loss, maybe birth control will be the new remedy in the future!