Hair Loss Hair Loss Treatment

Medical Treatments for Female Hair Loss

Summary & Participants

In a world where female hair loss is almost taboo, finding the right treatment can be confusing. Do the products that work for men work for women, too? Join our panel of specialists as they discuss the treatment options for women.

Medically Reviewed On: June 19, 2008

Webcast Transcript

NEIL SADICK, MD:  An androgen is a hormone, usually a masculinizing type of hormone, that is most commonly elevated in men compared to women, but is also present in women, and it's felt to play a role in terms of hair loss.  An increased amount of androgen or an increased sensitivity of receptors where androgens act are felt to play a major role in androgenetic hair loss, both in men and women, and there is a class of drugs that tends to inhibit these hormones and their receptors.  I've found this to be the most successful second option if a conservative route such as 2% minoxidil is not effective in women with diffuse hair loss.

DAVID R. MARKS, MD:  And spironolactone is a pill?

NEIL SADICK, MD:  Spironolactone is a pill.  It's actually a water pill or diuretic, but another major action of spironolactone is, again, to block these androgen receptors that decrease the amount of hormone activity in women.

DAVID R. MARKS, MD:  How long does it take to see an effect on hair?

NEIL SADICK, MD:  We usually see an effect when it's positive within a period of three to six months.  Women who take this drug do need to be monitored.  Because it is a water pill, they can lose potassium, so we need to monitor their electrolytes at least at three-month intervals.  It can also occasionally cause breast tenderness, and in women who are premenopausal, we usually use hormone replacement, as well, to try and counteract some of these effects.

DAVID R. MARKS, MD:  That's what I was going to bring up.  Hormone replacement, or maybe oral contraceptives -- is there any role for them in the treatment of hair loss?

MICHAEL REED, MD: An estrogen-dominant type of oral contraceptive may be helpful, at least to keep hair from coming out excessively and to prevent further thinning.  On some people it may grow back a little bit, but by itself it's probably not sufficient.  But it's definitely useful.

NEIL SADICK, MD:  It's really interesting that some women that are on oral contraceptives or women who are postmenopausal or who are on hormone replacement, a small percentage of them will notice an improvement in their hair loss, but in my experience, a larger majority of them will have actually a worsening of their hair loss when they're on hormone replacement, even if it's on an estrogenic or a high-estrogen type of compound.

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