There are many different reasons for female hair loss. That’s why there’s no one treatment that works for everyone. To find your hair loss solution, you’ll have to do a bit of detective work.
Here’s what you need to know.
Blame your birth control
Older types of birth control contain a progestin (synthetic progesterone) that is very similar to testosterone, and so gives male hormone side effects such as acne and hair loss. The most “testosterone-like” progestins are medroxyprogesterone, norgestrel, etonogestrel and levonorgestrel. (Not sure which progestin you’ve been taking? Read the label on your birth control pack.)
Birth control-induced hair loss is gradual, so you might not even notice it for many months (or even years). Your doctor’s solution will be to switch you to different progestin such as drospirenone, but drospirenone-pills have their own problems (depression and blood clots), and they also prevent ovulation, which is the very thing you need to recover your hair (see the next point).
For more information about high androgen index birth control, please read my latest post: 4 Causes of Androgen Excess.
Ovulate to make “hair-hero” hormones estrogen and progesterone
Your hair loves estrogen and progesterone, and the only way to make those hormones is to ovulate each month, and to have a natural cycle. Getting some nice estrogen and progesterone is another reason to stop hormonal birth control, but take care: Stopping birth control might temporarily worsen hair loss. Why? Because a sudden hormonal change can trigger hair loss (that’s why hair loss is so common after childbirth). Pill-withdrawal hair loss should improve after a few months, as long as you start to ovulate and have regular cycles.
Rule out PCOS
Polycystic ovarian syndrome (PCOS) is a hormonal condition with a high level of androgens (male hormones) that cause hair loss, acne and hirsutism (facial hair). If you think you might have PCOS, please speak to your doctor about having a blood test. (PCOS must be diagnosed by blood test—not ultrasound.) Fortunately, PCOS responds well to natural treatment and diet changes.
Check your thyroid
Thyroid disease is another common cause of hair loss. Your doctor will order a basic test called TSH, but it’s not always the most reliable test. If you have symptoms of thyroid disease, or if you have a family history of thyroid disease, then talk to your doctor about another blood test called “thyroid antibodies”. It’s the best marker of autoimmune thyroid disease.
Your hair requires a lot of iron, so no matter what your cause of hair loss (birth control, PCOS, thyroid), you’ll need adequate iron to recover. Talk to your doctor about a test called “iron studies”. Your “serum ferritin” should be at least 50 ng/mL. If it’s lower than that, consider supplementing 25 mg of a gentle iron such as iron bisglycinate.
Inflammation hyper-sensitizes hair follicles to androgens (male hormones), which is why chronic inflammation can cause androgen hypersensitivity or androgenetic alopecia. A simple way to reduce inflammation is to avoid inflammatory foods such as sugar, wheat and dairy.
Eat more carbs
A low carb diet can make your hypothalamus think you’re starving, which convinces it to shut down ovulation and hormones. Low calorie and low carb dieting can both result in hair loss in women. See Are You Eating Enough to Get a Period?
Zinc is good for hair because it promotes ovulation, reduces inflammation, and blocks androgens. Zinc also directly stimulates hair growth. Common causes of zinc deficiency include a vegetarian diet and hormonal birth control. The best food sources of zinc are red meat, pumpkin seeds and oysters. If you decide to supplement, then a safe dose is 25 mg per day after food.
Even with the best treatment, you can’t expect to see any results for at least three to six months. Why? Because your hair has a telogen (resting) phase, which is like a waiting room. Once your hair has entered the telogen phase, it is destined to fall two to six months later, no matter what you do. In other words, you have a lot hair in the telogen phase now. Even with the best treatment, all of those hairs are going to fall. Stay calm, be patient, and stick with your treatment.
Yours in health,