Female pattern baldness (androgenetic alopecia) is the most common cause of hair loss in women, but there are many other potential causes. Some effective treatment options are available.

Hair loss regularly affects women and people of other genders. You may experience any one of several types of hair loss, such as hair thinning, a widening part, or patchy hair loss.

Several reasons can explain why women experience hair loss, including:

  • genetics
  • health conditions
  • hormonal changes
  • stress

Treatment options for hair loss typically depend on the cause. They can also vary according to the pattern and location of hair loss. While most causes of hair loss are treatable, some may not be.

Language matters

We use the term “women” in this article to refer to those assigned female at birth, but we acknowledge that sex and gender exist on a spectrum. The information in this article will also apply to you if you were assigned female at birth and have never had hormone therapy (HT). Trans women and trans men who have used HT may have additional risk factors for hair loss not covered here.

Hair loss may present in different ways depending on the cause. You may notice sudden hair loss or a gradual thinning over time.

Key signs and symptoms of hair loss include:

  • Overall thinning: Gradual thinning on the top of the head is the most common type of hair loss. Women may notice that their part broadens.
  • Bald spots: Bald spots may be circular or patchy areas on your scalp with thinning or no hair. Your skin may feel itchy or painful immediately before the hair falls out.
  • Handfuls of hair: You may experience sudden hair loss, particularly after emotional or physical trauma. Your hair may come out in clumps while washing or brushing, leading to overall thinning.
  • Full loss: Medical treatments like chemotherapy may cause sudden and dramatic hair loss.

It can be helpful to keep a hair diary to track changes you notice or symptoms you experience. Then, use this diary to facilitate a discussion with your doctor.

Alopecia

Female-pattern baldness is the leading cause of hair loss in women. The medical term is androgenetic alopecia (alopecia meaning “hair loss”).

Androgenic alopecia causes the typical hair growth cycle to shorten. As a result, hair doesn’t grow as long or thick as it normally would.

This pattern of hair loss may appear as an overall thinning or a widening of your hair part. It occurs slowly over several months or years.

Androgenetic alopecia can occur at any age after puberty, but it’s more common in postmenopausal women. Advancing age and a family history of the condition are two primary risk factors.

Other types of alopecia include:

  • alopecia areata
  • cicatricial alopecia
  • traumatic alopecia
  • anagen effluvium (sometimes called chemotherapy-induced alopecia)

Telogen effluvium

Telogen effluvium (TE) is typically temporary. According to the American Academy of Dermatology (AAD), TE isn’t defined as “hair loss” but rather as excessive hair shedding.

Stress causes many hairs in the active hair growth (anagen) phase to abruptly enter the resting (telogen) phase.

When the hairs reenter the growth phase, the hairs suspended in the resting phase are suddenly released, causing shedding.

You can sometimes identify TE by looking at the strand. Telogen hairs have a bulb of keratin at the root.

TE is generally caused by stress or a shock to the body. For example, you may lose hair in the months after giving birth. But there are many other possible triggers, such as

TE is typically reversible and often resolves 6 to 8 months after your body readjusts or the trigger is gone.

Chronic health conditions

Chronic health conditions that may lead to hair loss include:

Menopause and hormone imbalances

Hormonal changes of any kind, particularly decreasing estrogen levels, can temporarily disrupt the hair life cycle.

Women may experience hair loss during menopause due to slowed production of the hormones estrogen and progesterone.

Menopause can also lead to uncomfortable symptoms such as night sweats, weight gain, and vaginal dryness, which may raise your overall stress levels. This can also contribute to hair thinning or loss.

Some women may even notice hair growth changes after going off hormonal birth control pills.

Hair loss can affect anyone. But some factors may make a woman more likely to experience hair loss:

  • Age: Hair loss becomes more common as you age. With age, hair grows more slowly, and some follicles stop producing new hairs.
  • Family history: If you have an immediate family member (such as a parent or sibling) who experienced hair loss, then you’re more likely to have hair loss.
  • High stress levels: Stress and anxiety may contribute to hair loss.
  • Medical conditions: Certain health conditions may increase your risk of hair loss.

Hair loss caused by stress or hormonal changes, like pregnancy or menopause, may not require any treatment. Instead, the loss will likely stop after your body adjusts.

Any medical conditions that lead to hair loss should be treated directly to address the condition, not just its symptoms.

That said, a number of possible medications and treatments are available for female-pattern baldness and other alopecias.

Minoxidil

Minoxidil is an over-the-counter (OTC) medication available in liquid and foam forms for topical use (at 2% and 5%) and oral capsules.

In a 2020 clinical trial comparing the effectiveness of a low dose oral formulation (1 milligram [mg]) to the 5% formulation, both were associated with increased hairy density after 6 months of use:

  • The oral medication increased hair density by 12%.
  • The topical solution increased hair density by 7.2%.

People tend to show hair regrowth within 4 to 8 months. Regrowth continues for over a year, after which it stabilizes.

You’ll typically need to use minoxidil long-term to prevent hair loss and promote growth. When you stop, hair loss may begin again within 12 to 24 weeks.

This hair loss treatment is generally safe and well-tolerated in low doses for various causes of hair loss. But you should speak with your doctor first before trying it. You’ll need a prescription for oral minoxidil.

Spironolactone

Spironolactone (Aldalactone) treats hair loss by acting on hormones. Specifically, it binds to androgen receptors and decreases your body’s processing of testosterone.

A 2020 study tracked 79 women who had been taking spironolactone daily (doses ranged from 25 to 200 mg) for at least 6 months.

Twenty-nine of the 45 participants who used it for more than 6 months saw some improvement after 1 year. Those who began the trial with more pronounced hair loss benefitted most from the medication.

However, not all researchers agree that spironolactone works for hair loss. The Food and Drug Administration (FDA) hasn’t endorsed it as a treatment for androgenic alopecia.

Nevertheless, the medication has still been used off-label. But you’ll need a prescription from your doctor first.

More research is needed before definitive claims can be made regarding its effectiveness.

Corticosteroids

If you have hair loss due to alopecia areata, you may consider treatment with corticosteroids, which help reduce inflammation. You can either apply them to your scalp or have them injected into the affected area.

People with alopecia areata may also benefit from immunosuppressive medications like methotrexate. It’s typically combined with low dose corticosteroids.

While a very low percentage of patients who take Methotrexate for autoimmune disorders may experience hair loss, this isn’t a common side effect of the medication.

Surgery

In hair transplant surgery, pieces of your scalp tissue with attached hair are typically taken from one area of your scalp and moved to areas of baldness.

This technique is touted as being a dependable approach to addressing alopecia. But it’s not without risks, including infection or shock that may cause hair to fall out of the transplanted areas.

Insurance plans typically don’t cover hair transplants, and the cost (often thousands of dollars) may be a barrier.

Finasteride

Finasteride (Propecia, Proscar) is FDA approved to treat hair loss in men but not women. Doctors may sometimes prescribe it off-label to women who don’t plan on having children in the future.

Finasteride inhibits 5 alpha-reductase, blocking the conversion of testosterone to dihydrotestosterone (DHT), the androgen responsible for male pattern baldness.

Other treatments

Doctors may sometimes prescribe other treatments off-label to reduce the incidence of hair loss in women:

JAK inhibitors are a newer treatment under intense study for alopecia areata. While they’re FDA approved for treating certain skin conditions, more research is needed on their effect on hair regrowth.

Your hair falls out naturally all the time. It’s expected to lose between 50 and 100 hairs a day.

That said, you should reach out to a doctor if you notice:

  • hair falling out in clumps (may be evident in your brush, on your pillowcase, or in the shower drain)
  • hair that doesn’t seem to be growing as fast as it once did
  • thinning hair
  • a widening part
  • patchy hair loss
  • other symptoms like fever, pain, or fatigue

The most common cause of hair loss in women is female-patterned baldness (androgenetic alopecia), but several other causes exist.

OTC medications may help reduce hair loss and promote growth. Other types of hair loss may involve treating the underlying cause.

Speak with a doctor about any troubling hair loss, shedding, or thinning you may be experiencing. Your doctor can help determine the cause of your symptoms and put together a treatment plan.