Causes of, and Treatment Options for, Hair Loss in Women
By Mila McManus MD
Losing hair has to be at the top of the list of “scariest things” for a woman. Hair growth has 3 phases: the growth phase, resting phase, and shedding phase. One of the most common causes of hair loss is stress, whether emotional or physical. This can create a vicious cycle since losing hair is so stressful!
A very common phenomenon related to hair loss is called Telogen Effluvium, where a stressor causes more hair than usual to enter the telogen (resting) phase. The shedding phase occurs when the growth phase starts again and pushes out the old ‘resting’ hairs from the follicles. During the condition of Telogen Effluvium, hair shedding may occur before the new growth starts. Telogen Effluvium typically lasts approximately 6 months, but may last 18 months or longer in some. This type of hair loss will not cause complete balding, and hair thickness usually recovers. The hair loss can start 1 to 6 months after the inciting event, with an average start time of 3 months.
Some causes of Telogen Effluvium include:
- Emotional stress
- Physical stress (e.g. pregnancy, febrile illness, immunizations)
- Toxin exposure, especially heavy metals
- Iron deficiency or iron excess
- Other nutrient deficiencies, such as a low protein diet, or deficiencies in B vitamins
- Excess vitamin A intake
- Hormone changes such as discontinuing OCPs, menopause
- Medications, such as anti-depressants, methotrexate, beta blockers, blood thinners, and NSAIDS
- Thyroid dysfunction-low OR high (even if your labs are normal!)
- Crash dieting
- Chronic illness such as Lupus, malignancy, liver disease
Another cause of hair loss is called Androgenetic hair loss
- Androgen (e.g. hormones such as testosterone and DHT found in both men and women) receptors get activated around menopause which leads to shrinking of the hair follicles and hair shedding.
- Hair continues to thin with age
Other causes of hair loss in women:
- PCOS (polycystic ovarian syndrome)-due to excessive production of androgens, and imbalance of other hormones.
- Over-styling with heat, chemicals, and pulling of hair into pony tails, etc.
Since causes of hair loss vary, the ideal treatment for hair loss does as well. In general, though, treatment options include:
- Repletion of nutrients (consider a functional nutrient analysis that we offer at TWIHW including Spectracell FIA and Genova Metabolomix)
- Spironolactone (relatively benign, safe medication that was first FDA-approved as a diuretic (aka fluid pill), and was then found serendipitously to block androgens at the hair follicle. (available by prescription only)
- Address hormone imbalance (test yourself for hormone imbalance here: https://woodlandswellnessmd.com/test-yourself.html). We recommend balancing hormones using bio-identical hormones, nutritional interventions, and/or detoxification. Also keep in mind that blood tests often fail to reveal hormone imbalances and deficiencies. Labs can lie. Symptoms don’t.
- Some herbal/nutritional blends may be helpful. Read about Cosmedix and its ingredients.
- Topical treatments such as Rogaine, Nioxin, and topical solutions specially formulated at compounding pharmacies (available by prescription only)
- PRP (platelet-rich plasma) which involves drawing your blood, separating out the ‘platelet-rich plasma’ and injecting it into the scalp
- Laser therapies such as a laser cap (worn as a hat on your head for specified amounts of time)
- Stress management
- Avoid over-styling, over-heating, and over-treating your hair
- Consider testing for heavy metals (at-home urine collection test available at our facility)
Call 281-298-6742 and speak to a Wellness Consultant about how we can help!