Medical causes of female hair loss

Apart from genetics, female hair loss can stem from a variety of
medical causes. This section looks at those causes, from the gen-
eral to the more specific, including postpartum and menopausal
hair loss.
Underlying medical conditions
In women, many medical conditions may cause hair loss, including
the following:
 Thyroid disease
 Anemia
 Iron deficiency
 Weight loss induced by severe dieting or eating disorders
 Medication use (particularly oral contraceptives, beta-blockers,
vitamin A, thyroid drugs, tranquilizers and sedatives, Coumadin,
and prednisone)
 A variety of autoimmune diseases
See Chapter 5 for a full discussion of medical problems that cause
hair loss.
As a woman experiencing hair loss, you should first be evaluated
by a dermatologist to make sure that no underlying skin conditions
are contributing to the hair loss. They may require a treatment dif-
ferent and may require a biopsy to rule out the presence of certain
skin diseases like diffuse alopecia areata. Your family doctor can
do the required blood tests for the various diseases that may be
present. Dermatologists are the best to hone in on a diagnosis.
Blood tests check the following common contributors to female
hair loss and can help rule out some identifiable medical
conditions:
 ANA (antinuclear antibody): Used to test for lupus or other
autoimmune diseases. This test is either positive or negative
and further testing may be required if the initial screening
tests are positive.
 Iron: Levels serum iron, TIBC (total iron binding capacity),
and ferritin deficiencies in iron.
 Estradiol: This sex hormone indicates the status of ovarian
output.
 FSH (follicle-stimulating hormone): This sex hormone indi-
cates the status of ovarian output. This hormone reflects the
status of a woman’s ability to ovulate.
 LH (luteinizing hormone): This is a sex hormone indicates
the status of ovarian outputa woman may be in her overall
aging process. When she ovulates, this hormone stimulates
the production of eggs.
 Free testosterone: May help the doctor understand a
woman’s ability to convert testosterone into estrogen. Most
testosterone is bound to proteins in the blood and the free
testosterone is easily converted into estrogen.
 SHBG (sex hormone binding globulin): Level indicates the
status of male hormones.
 TSH (thyroid-stimulating hormone): Level indicates the pres-
ence of hyperthyroidism or hypothyroidism.
 Total testosterone: Largely bound to proteins in the blood.
It’s important to note that even after a medical condition has been
corrected, your hair loss may still persist perhaps because of a
“switch” in your genetic makeup that’s turned on when the medical
insult occurs. After the hair loss starts, it may be difficult to turn
off this switch. The hope is that your hair loss will slow down after
your medical condition is treated or cured and any deficiency of
your overall hormone balance is corrected.
Baby blues: Postpartum hair loss
Pregnancy alters a woman’s overall hormone configuration in
many different ways. When hormones change, hair becomes a
target organ for change in some (but not all) women because the
rapid growth of the hair cells reflects changes in the overall hor-
monal environment in the woman’s body.
When you’re pregnant, your production of the sex hormone estro-
gen increases, which prolongs the growth (anagen) phase of the
hair cycle. During pregnancy, many women are delighted to dis-
cover that their hair is thicker and more lush. After the baby is
born, however, estrogen levels drop and more hair lapses into the
resting (telogen) phase. Consequently, your growing hair may fall
out, and because the resting cycle lasts two to six months, it may
take time to see the hair return to its growth phase.
Because hair grows at about
1
⁄2 inch per month and doesn’t start
growing again until the rest cycle is complete, it can take up to a
year for you to get your “old” hair back. In that period, you may
think you’re going bald; don’t worry, you aren’t. In nursing moms,
the resting period can take longer than a year, and it may take
more than a year for hair growth to return to previous levels.
Anemia and hypothyroidism also can contribute to postpartum
hair loss. You can find out more about these medical conditions
and others in Chapter 9.
Menopause-related hair loss
Over 50 percent of women going through the hormone fluctuations
associated with menopause experience significant hair loss. The
drop in estrogen levels in postmenopausal women may put the
hair in a prolonged resting phase; this phase is particularly impor-
tant for those women who have inherited female genetic hair loss.
Unfortunately, doctors don’t really understand the mechanisms by
which the withdrawal of estrogen causes hair loss in women, but
they know that it occurs. Women who lose estrogen support have
many changes in their bodies, of which hair is only one. There are
books written on the use of hormone supplements for managing
menopausal changes in the body, and this book is not meant to
deal with these complex issues.