Female Hair Loss (Female Pattern Hair Loss, FPHL) may occur at any age and one of the main causes is the Endocrine Androgenetic Alopecia. Female body produces a small amount of androgen agents important for the skeletal and connective tissues but also for cognitive and ideational brain function and ideational, sexuality etc…
When androgens increases, however, as may happen in Polycystic Ovarian Disease or in Post-Menopause Syndromes or in certain diseases of the Adrenal Gland, Androgenic Alopecia may occur.
For this clinical problem, Endocrinologic Gynecologist’s most used strategy is to increase the Sex Hormon Binding Globulin (SHBG). SHBG is a blood protein produced by the Liver and devoted to carries the sex hormones: the increase of this protein in fact makes more androgen linked to them and less “available” for peripheral action. Another medical strategy is to use substances that compete for androgen cellular receptors.
In recent years, especially dermatologists, they found very helpful the use of MINOXIDIL also in female Androgenetic Alopecia. Minoxidil is a drug originally used to treat high blood pressure and than to treat male alopecia. Applied on the scalp can help female to in combating hair loss. Another drug recently used by dermatologists and aesthetic physicians is the SERENOA (Serenoa Repens), a plant derivative with antiandrogenic capacity and substantially free of side effects.
An initial therapeutic response in Androgenetic Alopecia and Female Hair Loss often takes 12 or even 24 months; and this is a very important aspect to take into consideration and to make known to the patients.
All of these strategies, however, should take into account age and in particular the reproductive function due to risk of fetus teratogenic effects (malformations). Other parameter to consider is the stage and severity of the disease: in fact, the action of the therapeutic strategy may be structured in different ways.
The results of an endocrinological intervention against Androgenic Alopecia are really exciting and, if done early, it can avoid a situation that is really unaesthetic.
Female Hair Loss is often attributed to stress factors, seasonality and nutritional deficiencies; this often leads to
a significant consultation delay with medical specialists. Even in some special but frequent situations such as post-partum period, in which so many women have hair loss, it is possible to intervene with substances that do not have contraindications to breastfeeding.
Finally, I would like to focus on that kind Alopecia that occur in Menopause and in Post-Menopause. In these cases, should not be overlooked the use either of estrogen either of anti-androgens and Minoxil (or Serenoa). Early pharmacological intervention may prevent thinning hair (typically of the occipital area) that would otherwise be manageable only using aesthetic techniques. My experience has led me to confirm that even during a cosmetic surgery, endocrine therapy support can be extremely helpful.