A common yet highly unspoken symptom of the menopause, postpartum and a hormone imbalance are changes to the hair – thinning, hair becoming brittle and easy to break, or even looking a little wonky at the hairline. This is what we call Female Pattern Hair Loss (FPHL) which can be very concerning and upsetting for women.  After all, for lots of us, hair is an important aspect of our identity.

 

What is female pattern hair loss?

Female pattern hair loss (FPHL), often referred to as androgenic alopecia, is a common condition characterised by a gradual thinning of hair in females. It is the most prevalent cause of hair loss in females and typically follows a distinct pattern, unlike male pattern baldness.

FPHL (or androgenic alopecia) is influenced by genetics and hormones. It occurs when our hair follicles become smaller and producer finer and shorter hairs with each growth cycle. The process usually begins around the crown and the top of the head, resulting in a widening of the parting or more visible scalp. We can also notice thinning at the wider edges of the hairline, sometimes pushing the hairline back. Unlike other forms of hair loss, the hairline should remain intact.

 

How do I know if I have Female Pattern Hair Loss?

It is important here to note, FPHL may not be noticeable to other people, however if you notice it yourself, it may be worth getting it confirmed. Trying to confirm this can be quite the task!

Here are some ways FPHL can be identified:

  • More hair in the brush than what is usual for you
  • More hair going down the drain in the shower or bath than what is usual for you
  • Thinning of the hair around your hairline and general hair thickness (add photo)
  • Hair line moving backward slightly
  • Brittle and weak hair, which is easily damaged and snapped
  • Your parting is wider than before, or you can see your scalp a lot more than before (this is especially noticeable with wet hair)

Take a look at the Ludwig Scale, a three step classification system used by dermatologists and healthcare professional to categorise the severity of female pattern hair loss.

How does Female Pattern Hair Loss differ from Male Pattern Hair Loss?

Female Pattern Hair Loss (FPHL) and Male Pattern Hair Loss (MPHL) are both conditions that are affected by genetics, aging and hormone levels, and result in the hair thinning. Whilst both share similarities in terms of pattern and progression, there are some key differences between the two.

One major difference lies in the pattern of hair loss. MPHL typically starts with a receding hairline at the temples, followed by thinning at the crown of the head; eventually leading to partial or complete baldness. Different to this, FPHL usually presents as more widespread thinning across the scalp, with the hairline remaining intact. Women with FPHL may notice wider part lines and a general increase in hair density.

 

 

Hair Types

The difference in hair loss patterns can also be influenced by the type of hair

  • Caucasian hair can be finer and have a lower density in comparison to the other hair types. With FPHL, females with caucasian type hair may experience a more noticeable decrease in hair volume due to the naturally thinner strands
  • Afro hair is typically thicker and coarser, and may show a different appearance when affected by FPHL. The hair loss may not be as noticeable in the initial stages, but may then become visible with the contrast of thickness against the scalp.
  • Asian hair is sometimes considered similar to caucasian hair in texture, but is generally thicker and straighter. The FHPL is considered similar to that of caucasian hair types, but the overall appearance may differ due to the thickness and styling.

 

Who experiences Female Pattern Hair Loss?

It is during the postpartum period and menopause that you may experience female pattern hair loss. Those with medical conditions affecting female hormones may also experience female pattern hair loss, Polycystic Ovarian Syndrome being an example.

Studies show around 40% of women will experience hair loss after the menopause. Two thirds of these women will experience this all over the scalp, and for the remainder, hair loss is experienced at the front or over the temples only. Hair loss may start during the perimenopause or it begin years after.

Postpartum shedding, or female pattern hair loss, typically peaks four months after giving birth and 50% of new Mothers will experience it.

Why does it happen?

It is important to remember that female pattern hair loss is very common and increases in likelihood with age. It is not specific to any ethnicity, anyone can be affected. It can happen at any age, but it is most likely to occur when you experience a hormonal shift:

Postpartum

During pregnancy, elevated levels of estrogen and progesterone cause our hair to remain in the growth phase. After we give birth, the level of these hormones drop, causing more hair to enter the resting phase. Not long after, all of this hair will shed and can leave signs of female pattern hair loss behind.

Postpartum hair loss is temporary and your hair should return to normal within a few months.

Menopause

Through the perimenopause, menopause and post menopause, estrogen levels decline. Estrogen is a ‘hair-friendly hormone’ that allows our hair to stay in the growth phase a little longer and maintains hair thickness. The decrease in estrogen and hormone imbalance can result in hair becoming finer and even more susceptible to shedding.

Unfortunately, we cannot ignore aging. Menopause signifies the next stage in life (which we think should be celebrated!) and with our years of wisdom (provided you are going into menopause naturally) aging may begin to show in your hair, not just your skin laxity. After the age of 40, hair follicles begin to shrink and become thinner. The total number of follicles go down too.

PCOS

With PCOS, the cysts on the ovaries and infamous hormonal disturbances can impact hair health. One of the culprits is elevated androgens, such as testosterone, in the body. High androgen levels cause hair follicles to shrink, resulting in the production of thinner and shorter hairs. This can lead to hair thinning and the pattern of hair loss can look more like the male-pattern rather than female, which can be troubling.

{special highlight bit} When comparing women of the same age, those with PCOS are more likely to experience female pattern hair loss than women who do not have PCOS.

Hormones alone are not the cause, we also must consider genetics, family history, any medical conditions, medications and lifestyle factors like stress-levels and your nutrition

Poor nutrition

Poor nutrition, whether due to under-eating or insufficient nutrient intake can have a devastating impact on hair health. When the body doesn’t receive the nutrition that is required, it will prioritise vital functions over hair growth and health. This will lead to experiencing thinner hair, poor hair quality and loss of hair.

We see it often, the importance of a healthy, balanced diet flies under the radar for hair health. Protein deficiency, a lack of vitamins such as biotin, vitamin D and iron can disrupt the hair growth cycle in particular and malnutrition will eventually lead to hormone disruption and exacerbate hair loss.

Remember, nourishing your body is not only essential for overall health but also for maintaining vibrant and healthy hair.

 

What can I do about it?

The good news is, there are many things we can do to help improve female pattern hair loss. Most of these recommendations are lifestyle changes, or extra steps in your beauty regime that you can implement yourself:

  • Avoid wearing your hair up in a pony tail, especially if it is a high ponytail or a very tight one. Wearing your hair like this can put too much tension on the follicles and lead to damaging the roots as well as pulling your hair out.
  • Try to limit the damage you do to your hair. If you can, reduce any bleaching or colouring and turn the heat on any styling devices down. To go one step further, reducing the amount of times you put heat on your hair is a bonus!
  • A healthy, balanced diet is the most under rated way to treat hair loss and is something here at Blossom Wellness that we highly advocate! Think one portion of red meat a week if you can, two portions of oily fish per week, eating a variety of vegetables fruits, drinking enough water and certainly not neglecting your healthy fats and carbohydrates.
    We would recommend a nutrition review [clickable link] with Founder, Louise.
  • Speak to your Doctor about any potential deficiencies. In particular, iron and vitamin D. You may be able to get a blood test to establish these.
  • Hormone Replacement Therapy will boost your level of estrogen, often resulting in hair loss slowing down or completely stopping. This must be discussed in depth with your Doctor, as this isn’t a guarantee and may not be suitable for everyone.
  • Managing your stress levels with overhauling your life (getting rid of anything that could be causing you unnecessary stress), implementing daily meditations or breath work.
  • Minoxidil is a medication that is available on prescription from your Doctor, which is used to treat hair loss. It is important to have a consultation with your Doctor to discuss whether this may be an option for you and any other treatments available to you.
  • The effectiveness of supplements for hair loss is up for debate. However, some women find supplements really helpful when getting a balanced diet and positively impacting their hair. A popular supplement for strengthening hair is Biotin.
  • Discuss hairstyles with your hairdresser. Opt for a style that gives the illusion of thicker hair, and be sure to be very gentle when brushing your locks!
What Louise says: “Female pattern hair loss can be an incredibly challenging journey, affecting not only your appearance but also your confidence and how you view yourself. Experiencing female pattern hair loss is often confusing and an isolating experience, as many women struggle to identify the cause behind their thinning hair or hair loss, and it isn’t something that is talked about very often. I encourage you to change that! According to the North American Hair Research Society, by the age of 50, 50% of women experience hair loss and hair thinning. We understand the emotional toll and sometimes traumatic experience that female pattern hair loss can force upon us. We’re here to provide guidance, support and solutions in the form of lifestyle changes to help you regain not only some of your hair or improve hair quality, but also your confidence and peace of mind.”

Frequently Asked Questions

Read more about this topic

What is female pattern hair loss?
Female pattern hair loss (AKA androgenic alopecia) is a condition in females, characterised by thinning hair or hair loss. Typically, female pattern hair loss is starts with a widening of the parting in the hair or reduced hair density at the top of the head. It is hormone, genetic and lifestyle factors that play a role in the development of female pattern hair loss.
What are the signs and symptoms of female pattern hair loss?
Female pattern hair loss typically presents with gradual thinning of the hair on the top of the head. Signs include a widening hair parting, reduced hair density and increased visibility of the skin on the scalp. Female pattern hair loss doesn’t result in complete baldness but it can affect self-esteem and confidence.
How does female pattern hair loss differ from male pattern baldness?
Female pattern hair loss and male pattern baldness do share similarities, but there are some key differences. In female pattern hair loss, hair thinning is more dispersed across the scalp area and affecting the parting line. We sometimes see thinning of the hair on the sides of the scalp too. Male pattern baldness on the other hand, often results in a receding hairline and balding at the crown, creating a distinct pattern. Female pattern hair loss is typically a result of hormone imbalance, whereas male pattern baldness is connected to DHT (Dihydrotestosterone) and genetics.
What causes female pattern hair loss?
Female pattern hair loss is typically caused by a hormone changes or hormonal imbalance. It is linked to the presence of androgens, specifically DHT (Dihydrotestosterone), which can minimise the hair hollicles and shorten the hair growth phase in females. Genetics play role in determining your susceptibility to female pattern hair loss, and we must also consider lifestyle factors like poor nutrition, chronic stress, and medical conditions.
Are there any effective treatments for female pattern hair loss?
Yes, there are treatments that can be effective for female pattern hair loss. The first thing that we recommend, is to look at your current lifestyle. Are you eating a healthy balanced diet? Are you drinking enough water? Sleeping for 7-8hours daily? Could you do anything that would decrease your stress levels? If you have addressed your lifestyle, then the next step is to speak to your GP or healthcare provider. You may be able to access medical treatments such as Minoxidil or medications that block the affect of the androgens that are causing your hair to become thinner and weaker.
Can lifestyle factors contribute to hair loss in women?
Absolutely! One of the biggest contributors to hair loss in women are lifestyle factors. Chronic stress, poor nutrition, yo-yo dieting or crash diets, extreme weight loss and chronic lack of sleep can disrupt the hair growth cycle and lead to temporary hair shedding. All of these will impact your hair quality also (this isn’t addressing how we actually treat our hair!). Additionally, smoking and excessive alcohol consumption can negatively impact hair health. Maintaining a healthy lifestyle can improve the appearance of female hair loss and potentially help prevent it from worsening.
How can I cope with female pattern hair loss?
Coping with female pattern hair loss can be emotionally challenging. We recommend seeking support from someone you trust. Once you are addressing your lifestyle factors, it might be an idea to look into hairstyles that make hair loss less noticeable, or invest in hair extensions and products that can improve the appearance of the hair loss and boost your confidence! (SOMETHING ABOUT JOINING THE FACEBOOK GROUP??)
Is female pattern hair loss reversible?
Typically, female pattern hair loss is not reversible when it comes to restoring a full head of hair to its original state. However, there are treatments that can slow down hair thinning and encourage retention of your current hair. By looking at your lifestyle and overall health, you may be able slow down thinning, improve your hair quality and in some cases promote some regrowth. The earlier you can get to addressing female pattern hair loss, the better.
Can stress or hormonal changes trigger female pattern hair loss?
Yes, both stress and hormonal changes can trigger or exacerbate female pattern hair loss. These are example of the lifestyle factors we encourage you to address. High-stress levels can disrupt the hair growth cycle. Hormonal changes, especially fluctuations in androgens and DHT can play a role. Conditions like Polycystic Ovary Syndrome (PCOS) can lead to hormonal imbalances and contribute to hair thinning. Managing stress and looking into any potential hormone issues with medical guidance can begin to address and imrpove female pattern hair loss.
When should I seek medical advice for female pattern hair loss?
It is important to make sure you have addressed lifestyle factors like your nutrition, stress levels and sleep before you seek medical advice. We recommend to seek medical advice when you notice significant hair thinning, shedding or changes in your hairline. If female pattern hair loss is impacting your self-esteem, emotional well-being or quality of life, consulting medical professional is very important. You need to get the support that you deserve!

Additionally, if you suspect an underlying medical condition like Polycystic Ovary Syndrome may be contributing to your hair loss, it is essential to seek diagnosis and approporiate treatment. Early interventuon and treatment will lead to better outcomes.

References

Research further

References
Jiang VS, Hawkins SD, McMichael A. Female pattern hair loss and polycystic ovarian syndrome: more than just hirsutism. Curr Opin Endocrinol Diabetes Obes. 2022 Dec 1;29(6):535-540. doi: 10.1097/MED.0000000000000777. Epub 2022 Oct 13. PMID: 36226726. Prasad S, De Souza B, Burns LJ, Lippincott M, Senna MM. Polycystic ovary syndrome in patients with hair thinning. J Am Acad Dermatol. 2020 Jul;83(1):260-261. doi: 10.1016/j.jaad.2020.01.075. Epub 2020 May 20. PMID: 32444272; PMCID: PMC8291365.
https://www.contemporaryobgyn.net/view/patients-guide-management-hair-loss-polycystic-ovary-syndrome

Carmina E, Azziz R, Bergfeld W, Escobar-Morreale HF, Futterweit W, Huddleston H, Lobo R, Olsen E. Female Pattern Hair Loss and Androgen Excess: A Report From the Multidisciplinary Androgen Excess and PCOS Committee. J Clin Endocrinol Metab. 2019 Jul 1;104(7):2875-2891. doi: 10.1210/jc.2018-02548. PMID: 30785992.
https://www.contemporaryobgyn.net/view/patients-guide-management-hair-loss-polycystic-ovary-syndrome
https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/
https://www.harleystreethairtransplant.co.uk/the-ludwig-scale/
Photo Credits
@oliviamcveigh (Instagram) @sofiadesevilla (TikTok)

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