Struggling with hair loss? There’s no one-size-fits-all treatment because there’s no one-size-fits-all cause.
To find your hair loss solution, you need to think through nine different factors.
Blame your birth control
Contraceptive drugs such as levonorgestrel cause hair loss because they have a high androgen index, which means they are more similar to testosterone than they are to progesterone.
The American Hair Loss Association (AHLA) warns about the risk of hair loss from hormonal birth control. In 2010, they stated:
“It is imperative for all women especially for those who have a history of hair loss in their family to be made aware of the potentially devastating effects of birth control pills on normal hair growth.”
Have you been taking a testosterone-like type of birth control? Read the ingredients.
Progestins with a high androgen index include medroxyprogesterone acetate, levonorgestrel, norgestrel, and etonogestrel. They cause hair loss by shrinking (or miniaturizing) hair follicles, which is a slow process. You could be on the birth control for many months—or even years—before you start to notice hair loss. Progestins with a high androgen index can also cause acne.
Progestins with a low androgen index include drospirenone, norgestimate, and cyproterone. They do not cause hair loss when you take them, but they can cause hair loss when you stop them because they cause a rebound surge in androgens and androgen sensitivity.
For more information about hair-loss causing types of birth control, read 4 causes of androgen excess.
Ovulate to make estrogen and progesterone
Your hair loves estrogen and progesterone, and the only way to make those hormones is to ovulate and have a natural cycle. Making your own estrogen and progesterone for hair is another reason to stop hormonal birth control, but take care: Stopping birth control can temporarily worsen hair loss. Why? Because pill-withdrawal can trigger temporary hair loss.
Rule out PCOS
The high androgens (male hormones) of PCOS can cause hair loss, acne, and hirsutism (facial hair). If you think you might have PCOS, speak to your doctor about having a blood test.
👉 Tip: PCOS cannot be diagnosed (or ruled out) by ultrasound.
Check your thyroid
Thyroid disease is another common cause of hair loss. If you have symptoms of thyroid disease, or if you have a family history of thyroid disease, check with your doctor for a blood test.
No matter what the cause of hair loss (birth control, PCOS, thyroid), you’ll need adequate iron to recover it. On a blood test, 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. If you have gut problems or a food sensitivity such as wheat or dairy, then addressing that underlying problem could help your hair.
Eat more carbs
Any kind of dieting, including low-calorie and low carb, can cause hair loss. Read Have you lost your period to a low-carb or keto diet?
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. Read Why zinc is my favorite prescription for healthy periods.
Play the long game
Even with the best treatment, you won’t see any results for at least two months. Why? Because of the lag time with hair and its telogen phase. The telogen phase is like a “hair waiting room.” Once hair gets pushed into the telogen phase by birth control or nutrient deficiency or any other factor, it is destined to fall two to four months later–no matter what you do.
In other words, if you have a lot of hair in the telogen phase now, your hair will keep falling for a couple more months even after you start the correct treatment. But then it should start to settle down.
Stay calm, be patient, and stick with your treatment.