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Female Hair Loss
Over the past fifteen years there has been a large
increase in the number of women suffering from hair
loss, particularly between the ages of twenty-five to
forty.
The most common causes of hair loss in women are hormonally
related. Hormonal changes occur during and following
childbirth, with the use of the contraceptive pill,
anemia and menopause.
Treating and diagnosing Female hair loss is not as simple
and straight-forward as male pattern baldness. The good
news is that a large percent of women’s hair loss
is completely reversible. The key is to find out what
the reason is, and to then evaluate your options in
dealing with it.
At Harmonix, our diagnosis and treatments involve
responsible informed physicians and trichologists who
run a series of tests to ensure we uncover and correct
the problem instead of just treating the symptoms.
The Ludwig Scale - for Women's
Hair Loss.
Women have a pattern of hair loss called
Female Pattern Loss. This loss does not occur in the
same pattern as men but appears as a diffuse thinning
throughout the scalp. There is a chart designed to classify
Female Pattern loss called the Ludwig Scale. There are
however always exceptions and in some cases men may
suffer from a diffuse type thinning and women may experience
a similar hair loss pattern to men.
Usually called Female Androgenetic hair loss
is caused by both parents carrying the dominant gene
for hair loss and both passing it on to their daughter.
If only one of your parents passes this on, hair loss
is not caused as it would be in men. This is due to
the higher levels of Estrogenic or female hormones in
women.
Female balding occurs usually more slowly than in men,
with the hair on the top and front of the scalp gradually
becoming finer and weaker, the shaft diameter is reduced.
In more advanced or severe cases, the crown area is
also affected as is the hair growing above the ears.
The levels of the male hormone testosterone are raised
and this may cause various other symptoms including
oily skin, acne Hirsuitism (excessive hair growth on
the face and body in a masculine pattern). Menstrual
disturbances and lowered fertility may also accompany
this problem.
Normally, due to the higher levels of female hormones
Estrogens, the growth cycle of hair is slower in women
than in men. This means that generally each hair grows
for a longer period of time before being replaced. Women
therefore are usually able to grow their hair longer
than men unless the level of androgens interferes with
this process.
Female hormone levels are usually highest between the
age of puberty and about twenty-five. After this they
decrease slightly, speeding up the growth cycle giving
a slightly higher percentage of resting or catagen hairs.
In other words the hair never appears to grow quite
so quickly as it did during the teens and early twenties.
This has nothing to do with hair loss and is just a
natural change in the cycle.
It is known that chronic or acute stress has the effect
of lowering the production of estrogens and while testosterone
levels may not increase, as it is a powerful hormone
it may become more active affecting genetically targeted
hair follicles which would have been protected by higher
estrogenic hormone levels.
Various theories have been put forward as to why the
incidence of hair loss should be increasing in women.
The most likely reason is that as in male hair loss,
stress is a major factor. We do live in an increasingly
stressful world and for women in particular this has
its adverse effects. The female role has changed much
over the past two decades and now women have taken their
rightful place in industry, commerce and the professions,
bringing with it the increased levels of stress that
comes with management, responsibility and the decision
making processes. The incidence of heart disease, stomach
ulcers, high blood pressure, etc. which used to be the
prerogative of the male executive are now increasing
rapidly in women, particularly those with high pressure
jobs.
Polycystic Ovary Syndrome
The disorder sometimes referred to as Stein-Leventhal
Syndrome causes the ovaries, which usually produce estrogens,
to malfunction causing the metabolism of testosterone
to take place. Symptoms are hair loss from the scalp
and may also include stopping of periods, weight gain,
infertility, oily skin, acne and hair growth on the
face and body (hirsuitism). Hormone therapy and minor
surgery are usually successful in solving all the problems
that may occur.
Adrenal Tumor
A tumor of the adrenal gland which normally produces
adrenaline, a stimulant hormone, as its man secretion
can cause conversion of hormones produced and a disturbance
in their biosynthesis or chemical production to form
testosterone which will cause similar effects as for
Polycystic Ovary Syndrome.
It must be realized then that if your hair loss problem
is severe, that careful medical diagnosis is essential
to find the cause or site of the excessive production
of testosterone before treatment is given.
Fortunately in most cases the results are very good
but may take time to achieve. Treatments by Trichologists
are always recommended following medical check-up to
ensure re-growth of hair.
Hair Loss Following Pregnancy
During early pregnancy estrogenic hormone levels increase.
This slows down the normal cycle of hair growth, resulting
in only about five per cent of the normal hair fall
and replacement to occur. Hairs that would normally
stop growing, continue to grow beyond their normal life
cycle. This causes the hair in many cases to appear
to grow thicker as more hairs are in active growth than
usual. The hair on the eyebrows and eyelashes may also
thicken.
Assuming the expectant mother to be healthy, this
continues until the baby is born. Following the birth
of the baby, hormone levels change very rapidly often
causing the so-called ‘three day blues’
or depression. At this time those hairs, which were
growing beyond their normal lifespan, revert to telogen
hairs, which begin to fall at any time after one month,
but usually when the baby is about three months old.
Occasionally this may take place very rapidly so that
hair may fall out by the handful and can be very distressing,
particularly to a tired mother.
More usually the hair falls over a period of a month
or two and the hair loss gradually decreases. In some
cases, particularly when breastfeeding, the milk producing
hormone prolactin will delay the hair loss.
The important thing to know and remember is that as
fast as the old hairs are being shed, new anogen hairs
are growing so that at scalp level the number of hairs
rarely decreases. There will, however, be a large number
of short new hairs growing and less long hair. Under
normal circumstances the hair is all growing back by
the time the baby is a year old. Patience and treatment
is the normal answer.
Only about one in a thousand women find that their hair
does not grow back after childbirth and this is usually
due to general health problems, stress, poor circulation
or anemia (lack of iron). All problems that are usually
easy to correct. Again treatment is highly successful.
Miscarriage or Abortion
These may cause slight hair changes as described for
childbirth and hair loss is more noticeable if they
occur following the first three months of pregnancy.
Immediate regular treatment will help to stop hair loss
and speed complete recovery of hair growth.
The Contraceptive Pill
It is rare for contraceptive pills to cause any problem
with hair growth, they may however give rise to an increase
in oiliness in some women. Occasionally the pill prescribed
may not suit the hormonal balance of some women but
the symptoms are usually discomfort, water retention,
headaches, etc. Not hair loss. Sometimes a different
combination of hormones will be more acceptable.
When commencing to take the pill, hair may fall at a
slightly increased rate for the first three months or
it may grow thicker depending upon the individual reaction.
Ceasing to take the pill frequently gives rise to the
same reaction as that occurring after normal childbirth,
although usually in a mild form. Hair shedding will
increase slightly about three months after cessation
as a new growth cycle of hair begins. Regular treatment
will help to establish new growth cycle more rapidly.
Very rarely contraceptives with a high level of Progestins
may cause diffuse hair loss together with acne and an
increase in body hair. If these symptoms occur AFTER
starting to take the pill, a change to a pill based
on ethinoestradiol may be needed. Although rare, it
is sensible to be aware of any gradual changes. Following
a change of pill, treatment will work rapidly.
Anemia
Low blood pressure, poor circulation, lack of iron and
low ferritin levels to produce hemoglobin which is the
oxygen carrying component of blood may often lead to
diffuse thinning of hair from all parts of the scalp.
The hair may become lighter and some of the hairs finer
in texture. The hair often becomes more brittle and
broken hairs may be seen all through the hair at different
lengths. A blood test followed by iron supplements in
the diet will normally solve the problem within a couple
of months. If the scalp circulation is very poor or
the scalp muscles too tense, regular manipulative and
vibratory massage of the scalp will aid re-growth of
hair.
Low dosage iron supplements frequently improve density
of hair growth even where iron deficiency anemia has
not been diagnosed.
Hair Changes at the Menopause
The hair may gradually become slightly thinner and finer
with advancing age. General health, fitness and diet
are obviously important factors as well as maintaining
a good scalp circulation. Occasionally if genetically
at risk or hair has had a previous tendency to thin,
the loss of hair may become visible and noticeable.
E.H.T. (extended hormone therapy) is becoming more popular
for a variety of reasons including prevention of Osteoporosis
(brittle bones due to calcium loss), memory retention,
improved skin elasticity and continued interest in sex.
H.R.T. has also been shown to be highly effective in
maintaining or improving hair growth in middle aged
women. Just look at the film stars who still look great
in their 60’s! The use of extended hormone therapy
must be recommended and prescribed by a Doctor as it
does have some adverse side effects in a few women.
It is rather like taking a very low dose contraceptive
pill, although it can be administered by implant under
the skin or even by a sticking plaster impregnated with
the hormones.
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