What are the causes of female hair loss?

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From the Guidelines

Female hair loss is primarily caused by a combination of hormonal changes, genetic predisposition, and nutritional deficiencies, with iron deficiency being a significant factor, as evidenced by studies such as 1 and 1. When considering the causes of female hair loss, it's essential to look at the various factors that can contribute to this condition. These include:

  • Hormonal imbalances, particularly during menopause, pregnancy, or due to polycystic ovary syndrome (PCOS)
  • Genetic predisposition, such as female pattern hair loss (androgenetic alopecia)
  • Medical conditions like thyroid disorders, autoimmune diseases such as alopecia areata
  • Nutritional deficiencies, particularly iron, vitamin D, zinc, and B vitamins, as highlighted in 1 and 1
  • Certain medications, including chemotherapy drugs, blood thinners, antidepressants, and birth control pills
  • Stress, both physical and emotional, which can trigger telogen effluvium, a temporary shedding condition
  • Hairstyling practices involving tight hairstyles, heat styling, and chemical treatments, which can damage hair follicles and cause traction alopecia

Treatment options depend on the underlying cause and may include:

  • Topical minoxidil (typically 2% or 5%)
  • Oral medications like spironolactone or finasteride (in specific cases)
  • Hormone therapy
  • Nutritional supplements
  • Platelet-rich plasma therapy, which has shown promise in treating androgenetic alopecia, as seen in 1
  • Hair transplantation in severe cases It's crucial to note that early diagnosis and intervention typically yield better outcomes for managing female hair loss. The most recent and highest quality study, 1, suggests that platelet-rich plasma therapy can be an effective treatment option for female hair loss, particularly when combined with topical minoxidil.

From the Research

Causes of Female Hair Loss

The causes of female hair loss are multifactorial and can be attributed to various factors, including:

  • Hormonal imbalances, particularly an excess of androgens 2, 3, 4
  • Genetic predisposition 2, 5
  • Aging 2, 5
  • Polycystic ovary syndrome (PCOS) 6, 4
  • Thyroid disorders 3
  • Stress 3
  • Nutritional deficiencies, such as vitamin D, iron, and zinc 4
  • Menopause 3

Types of Female Hair Loss

There are different types of female hair loss, including:

  • Female pattern hair loss (FPHL) 2, 5, 6, 4
  • Androgenetic alopecia 2, 3
  • Telogen effluvium (TE) 3
  • Alopecia areata (AA) 3
  • Female androgenetic alopecia with male pattern (FAGA.M) 2

Diagnosis and Treatment

Diagnosis of female hair loss is made through clinical history, clinical examination, and laboratory tests 2, 5, 4. Treatment options include:

  • Minoxidil 2, 5, 4
  • Anti-androgens, such as spironolactone and finasteride 2, 3, 4
  • 5-alpha-reductase inhibitors 3, 4
  • Hormonal therapies, such as estrogen and progesterone 3
  • Surgical options, such as hair transplantation 5
  • Cosmetic concealment, such as hairpieces and extensions 2, 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Hair loss in women.

Seminars in cutaneous medicine and surgery, 2009

Research

Female pattern hair loss.

Indian journal of dermatology, venereology and leprology, 2013

Research

A practical approach to the management of hair loss in patients with polycystic ovary syndrome.

Journal of the European Academy of Dermatology and Venereology : JEADV, 2023

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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