Wegovy and Testosterone for Female Hair Loss
Neither Wegovy (semaglutide) nor testosterone replacement therapy are established or recommended treatments for female hair loss, and no evidence supports their use for this indication.
Evidence for Wegovy (Semaglutide)
No evidence exists in the medical literature supporting Wegovy or any GLP-1 receptor agonist for treating female hair loss—this medication is FDA-approved only for weight management and has no documented role in hair restoration 1, 2.
Wegovy is not mentioned in any hair loss treatment guidelines or research studies as a therapeutic option for alopecia in women 3, 1, 2.
Evidence for Testosterone Replacement
Testosterone may paradoxically improve hair growth in androgen-deficient women, but this represents a highly specific clinical scenario that contradicts conventional understanding of female pattern hair loss 4.
In a study of 285 women treated with subcutaneous testosterone implants for androgen deficiency symptoms, 63% of those with pre-existing hair thinning (48 out of 76 women) reported hair regrowth on testosterone therapy, with no patients reporting scalp hair loss as a result of treatment 4.
Women reporting hair loss prior to therapy had significantly lower baseline serum testosterone levels compared to those without hair loss (P=0.0001), suggesting that androgen deficiency—not excess—may contribute to hair loss in select cases 4.
Critical limitation: This beneficial effect was observed only in women with documented androgen deficiency being treated for deficiency symptoms, not in women with typical female pattern hair loss where androgens are thought to drive follicular miniaturization 4.
Standard Treatments for Female Hair Loss
FDA-approved treatments remain limited to topical minoxidil and oral Janus kinase inhibitors for specific types of alopecia 5.
Female pattern hair loss (androgenetic alopecia) affects over 50% of postmenopausal women and up to 40% of healthy women, with prevalence increasing with age 6, 5.
Oral antiandrogens (which block testosterone effects) combined with topical minoxidil represent the standard medical approach, with treatments more effective at arresting progression than stimulating regrowth 6.
Early diagnosis and treatment initiation is critical, as therapeutic response often takes 12-24 months, and all treatments must be continued indefinitely to maintain effect 6.
Diagnostic Workup Required
Before considering any hormonal intervention, comprehensive laboratory evaluation should include serum ferritin, vitamin D, zinc, thyroid stimulating hormone (TSH), and in women with signs of androgen excess (acne, hirsutism, irregular periods), total or free testosterone and sex hormone binding globulin (SHBG) 2.
Vitamin D deficiency shows strong association with hair loss, with 70% of alopecia areata patients having levels <20 ng/mL versus 25% of controls 2.
Iron deficiency (assessed via serum ferritin) is the most common nutritional deficiency worldwide and a sign of chronic diffuse telogen hair loss 2.
Critical Pitfall to Avoid
Do not prescribe testosterone for typical female pattern hair loss—the conventional understanding is that female pattern hair loss is androgen-dependent, meaning androgens (including testosterone) drive the condition, making testosterone supplementation potentially harmful in most cases 6.
The single study showing benefit was in women with documented androgen deficiency, a distinct clinical entity from typical female pattern hair loss where androgen sensitivity (not deficiency) drives follicular miniaturization 4.
Testosterone therapy in women without documented deficiency carries risks including virilization (facial hair growth was reported in 92% of treated women), voice deepening, and other masculinizing effects 4.