There’s a common concern regarding the relationship between testosterone and hair loss, as thinning hair is a common sign of aging among older adults — particularly in men with low testosterone levels. About half of women and more than 80 percent of men experience significant hair loss. However, thinning hair isn’t inevitable with aging.
This article explores and clarifies whether testosterone directly causes hair loss and how to reduce the risk of balding.
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What is Testosterone?
Testosterone is a sex hormone and chemical messenger responsible for numerous body functions in men and women, including muscle and bone health, mood, masculine characteristics, reproduction, sex drive, cognitive function, and sperm production. It’s also vital for ovarian function in women. The testicles in men and ovaries in women both produce testosterone.
Having the right balance of hormones is essential to maximizing body functioning and reducing the risk of bothersome or debilitating symptoms.
Testosterone to Dihydrotestosterone(DHT) Conversion
An enzyme called 5-alpha reductase converts testosterone to dihydrotestosterone (DHT), a hormone that contributes to sexual structure development and masculine characteristics in men.
Adults convert about 10% of testosterone into DHT, which takes place in the prostate, liver, genital skin, and other parts of the body.
However, DHT levels can be as much as 10 times greater than testosterone in the human body. An imbalance of DHT can cause various health issues.
DHT affects prostate health and hair, including body hair. During puberty in boys, DHT promotes genital, prostate, and hair growth (body, pubic, and facial hair).
Testosterone Levels and Hair Loss
Does testosterone cause hair loss? There are many myths and realities regarding whether high or low testosterone levels cause hair loss. DHT plays more of a role, as some people are genetically sensitive to this hormone.
Research suggests that increased hormone sensitivity or androgen receptor density, rather than total blood hormone concentrations, most affects hair loss in men.
However, higher DHT levels may contribute to male androgenetic alopecia, also known as male pattern baldness. Men with this form of alopecia are genetically predisposed to higher levels of the 5-alpha-reductase enzyme and androgen receptor activity among hair follicles, while individuals with an enzyme deficiency are less prone to male pattern baldness.
How DHT Influences Hair Loss
DHT plays an important role in the functioning of hair follicles. Increased DHT activity in these follicles is partly responsible for thinning hair. Excess levels of DHT tend to shrink hair follicles (miniaturization) and decrease the length of hair growth cycles, resulting in baldness. It causes hair to grow for shorter time periods and be finer, smaller, and lighter.
Factors Contributing to Hair Loss
Many factors contribute to hair loss, not just testosterone and DHT levels. Examples include:
Genetic Predisposition
Genetics play a vital role in determining sensitivity to DHT and male pattern baldness. For example, individuals with a family history of hair loss have a higher risk of balding.
Other Contributing Factors
Other contributing factors to hair loss include:
- Aging
- Poor nutrition
- Vitamin and mineral deficiencies
- Recent surgery or illness
- Stress
- Significant or rapid weight loss
- Thyroid diseases
- Diabetes
- Lupus
- Sexually transmitted infections (STIs)
- Other health conditions
- Scalp fungal infections
- Pulling hair tightly
- Hormone fluctuations
- Chemotherapy
- Some medications
- Perms or bleaching
- Lack of certain nutrients: protein, biotin, zinc, or iron
- Stress
- Polycystic ovary syndrome (PCOS) in women
- Scalp psoriasis
- Scarring alopecia
- Smoking
Both women and men can experience male-pattern baldness. They may experience gradual thinning at the top of the head, a receding hairline, or a circular patchy bald spot.
Does High Testosterone Equal Increased Hair Loss?
Higher testosterone levels don’t directly cause increased hair loss, as DHT sensitivity plays a more crucial role in thinning hair. DHT levels that are too low or high may lead to hair loss.
Impact of Testosterone Replacement Therapy
There are misconceptions regarding the effects of testosterone replacement therapy (TRT) on hair loss. Increased testosterone levels often contribute to higher levels of DHT. However, TRT can reduce symptoms of hormone imbalance, such as erectile dysfunction (ED) in men, low libido, and loss of muscle mass.
TRT doesn’t directly cause hair loss, but higher testosterone levels may increase the risk of hair loss in individuals with a genetic sensitivity to DHT. Individuals who don’t experience DHT sensitivity likely will not experience thinning hair when undergoing TRT.
Fortunately, there are several ways to reduce the risk of hair loss in genetically sensitive individuals to DHT.
Preventing and Treating Hair Loss
Effective methods of preventing and treating hair loss include:
Medical Treatments
Medical treatments that interact with testosterone and DHT pathways can reduce male-pattern baldness. Examples include finasteride (5-alpha-reductase inhibitors) and topical minoxidil, which is an arterial vasodilator. Research shows that oral 5-alpha-reductase inhibitors decreased or reversed hair loss in about 99% of study participants.
Other medical hair loss treatments include hair transplant surgery, laser therapy, and platelet-rich plasma (PRP) injections.
It’s vital for individuals with underlying medical problems, such as thyroid disease or diabetes, to properly manage their condition and address with a healthcare provider any medications or medical treatments that may contribute to hair thinning.
Lifestyle Changes and Natural Remedies
Lifestyle adjustments and natural remedies that can help manage or slow down hair loss include:
- Eat a healthy diet rich in iron, biotin, zinc, vitamins D and C, vitamin A, protein, omega-3 fatty acids, and calories.
- Avoid rapid weight loss in favor of slower, steady weight loss.
- Minimize stress using acupuncture, yoga, meditation, tai chi, or other methods.
- Avoid pulling hair tightly, such as in a tight ponytail.
- Avoid the use of bleach or other harsh hair care products.
- Dietary supplements that enhance hair health include vitamin and mineral or omega-3 supplements.
- A cooling cap during chemotherapy.
- Routine hormone testing to ensure testosterone and DHT levels are within recommended ranges.
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Key Takeaways
Does testosterone cause hair loss? While there is a relationship between testosterone and hair loss, this link is more specifically related to a sensitivity to DHT, a hormone that contributes to sexual structure development and masculine characteristics in men.
Maintaining a healthy balance of testosterone, DHT, and other hormones can minimize the risk of hair loss. Routine hormone testing is crucial.
Individuals at risk of or struggling with male-pattern baldness should consult with a healthcare professional regarding personalized medical advice and lifestyle-change recommendations that minimize hormone imbalance and hair loss.
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