In my practice I focus on women’s health and hormone balance. So you would imagine that I spend most of my day talking about the lady garden. But women’s health is so much more complicated than that. Our hormones influence everything that happens in our bodies. From how much energy we make, to our moods, our libidos, our appetites, and our appearance. Hormones make sh*t happen.
And sometimes we don’t like what happens. When our hormones are out of balance all kinds of symptoms can arise. Acne, weight gain, fatigue, no sex drive, mood swings, depression, anxiety, and hair loss (among about a thousand other symptoms).
For now we’re going to focus on the hormonal impact on hair loss. But if you’re curious about a million other ways hormones are impacting your life, bounce over to my website at www.drlisawatson.com and spark your curiosity.
Hormones and Hair Loss
Hair loss can happen to a woman at any age, and while it may be more common as we get older, that doesn’t mean that it is a normal occurrence at any age. Keep in mind – common is not the same as normal! In this article I’m going to focus on the hormonal causes of hair loss, some of the most common causes I see in my practice.
Your thyroid is a small but mighty gland located in your neck, near your voice box. The primary role of the thyroid is to encourage energy production by the body. When the thyroid isn’t functioning optimally, there can be consequences throughout the body, including the hair. Hair loss can occur with too little thyroid hormone (hypothyroidism) or too much (hyperthyroidism). A condition known as alopecia areata is also linked to autoimmune thyroid disease, or Hashimoto’s thyroiditis.
Conventional testing for thyroid function is not always adequate to identify an underlying thyroid condition. If you suspect your thyroid may be contributing to your hair loss, get a comprehensive thyroid panel completed with your Naturopathic Doctor, functional medicine doctor or MD. This test will look beyond TSH and test for free T3, free T4 and thyroid antibodies.
One of the most common causes of hair loss in women and men, high levels of testosterone can lead to hair loss, especially at the frontal hairline and the top of the head – we’ve all seen this balding pattern in men. While typically thought of as a man’s hormone, women produce testosterone as well. The real issue isn’t testosterone specifically, but a metabolite of testosterone called dihydrotestosterone, or DHT. This form of testosterone is much more powerful than regular testosterone and binds strongly to hair follicles on the scalp, face, back and chest – leading to hair loss on the scalp, and acne on the face, back and chest.
Many women can have lab testing for testosterone that looks normal, but DHT levels may still be high. It is important to have both these hormones tested, especially if you have other signs of high androgens such as acne or irregular periods, or have been diagnosed with PCOS.
Progesterone is a super important hormone. The natural balancer to both estrogen and testosterone, many hormonal imbalances are a result of low progesterone. Progesterone is able to block testosterone from accessing receptors, preventing it from leading to hair loss. Progesterone is also the reason women’s hair grows so thick and healthy during pregnancy!
The three times in a woman’s life when low progesterone are most common are:
- If she is using the birth control pill. On the pill you do not ovulate, and do not produce progesterone (the synthetic progestins in the pill are not the same thing)
- If she has PCOS and does not ovulate
- As she ages. Progesterone production drops through your 30s and many women in their 40s are not making enough to balance their estrogen and testosterone levels. Women in menopause make hardly any progesterone at all.
Stress is another common cause of progesterone deficiency, as the body will steal all the available progesterone to make cortisol, our body’s main stress hormone.
Insulin and Blood Sugar Imbalances
No hormone acts on the body in isolation. They all influence each other. Insulin, the hormone produced to encourage our cells to take up sugar and regulate the levels of sugar in our blood, can have an impact on hair loss when it is imbalanced.
When your diet is too high in refined or processed carbohydrates, your cells can become resistant to insulin, causing higher circulating levels of blood sugar. When this occurs your ovaries can become resistant as well, an imbalance which disrupts healthy ovulation and causes your ovaries to produce more testosterone and DHT.
Stress and Cortisol
You may pull your hair out when you are stressed, or stress may cause it to fall out. Stress can cause increased or decreased cortisol levels, both of which can contribute to hair loss. Excessive stress can also cause your hair to enter its telogen, or hair fall phase, prematurely. This will often result in hair loss 2-3 months after the stressful event.
High cortisol will also deplete progesterone and allow for more testosterone to bind to hair follicles, which can further exacerbate hair loss. If you have significant stress, consider what changes need to be made to help lessen your stress, and explore whether cortisol testing may help to reverse and resolve your hair loss.
Stopping Hair Loss
Understanding the hormonal causes of hair loss for women is just the first step. To get to the root cause of your hair loss comprehensive testing is almost always necessary. The problem is that many doctors don’t take hair loss seriously. You may need to pay out of pocket to get the level of testing that you need, but in the end, that knowledge can help you put an end to your hair loss and allow you to regain not only your hair, but balance your hormones and give you your quality of life back.
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Randall VA. Hormonal regulation of hair follicles exhibits a biological paradox. Semin Cell Dev Biol. 2007;18(2):274-85. https://www.ncbi.nlm.nih.gov/pubmed/17379547
Levy LL, Emer JJ. Female pattern alopecia: current perspectives. Int J Womens Health. 2013;5:541-556. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769411/
Dr. Lisa Watson delivers health care that supports balanced and attainable health at all ages and stages of life. Of primary importance is health care that nurtures the body, mind, spirit, family and community. As a Naturopathic Doctor and mother, Lisa believes that health care and a healthy lifestyle are intrinsically linked and that each serves to support the other. Dr. Watson practices at the Integrative Health Institute in Downtown Toronto.
Check out Dr Watson’s blog: www.drlisawatson.com