While there are many theories about balding and why it occurs, one question many men have is, does testosterone cause hair loss? Hair loss can be a complicated issue for men; typically, the chances of experiencing some hair loss increase as you age. It can be frustrating and impact how you see yourself and your confidence level.
For many men with low testosterone, the symptoms can be significant and have a negative effect on their lives. While testosterone replacement therapy can be an option, many men are concerned with the possibility of hair loss. However, it's not necessarily testosterone that's the issue. Hair loss is usually caused by a genetic sensitivity to Dihydrotestosterone (DHT).
The relationship between testosterone and hair loss is complex and often confusing because testosterone is responsible for many vital bodily roles. It regulates sex drive, muscle mass, bone density, strength, distribution of fat, the development of the sex organs and sperm, mental health, motivation, focus and a variety of other things. But could it be responsible for balding?
What Causes Hair Loss in Men?
Hair loss, otherwise known as male pattern baldness (androgenic alopecia), is believed to be caused by three main factors: age, genetic factors and hormonal imbalances. (1)
- Age. Typically, the chances of going bald rise as you age. For some men, it can begin as early as their 20s, with about half of men experiencing hair loss by age 50.
- Genetics. Some men are genetically predisposed to male pattern baldness due to the sensitivity of the alpha-reductase (AR) gene on their X chromosome.
- Hormones. Androgens are sex hormones responsible for puberty and developing physically including hair growth. Dihydrotestosterone (DHT) is a type of androgen thought to be linked to shrinking hair follicles.
Does Testosterone Cause Hair Loss? No, it's DHT.
The connection between DHT and hair loss (androgenic alopecia) is down to the fact that DHT miniaturizes the hair follicles. However, sensitivity to the receptors is a genetic trait rather than one caused by DHT. You may have optimal testosterone levels and experience no hair loss, but if you have a genetic DHT sensitivity, you may experience some thinning and male-pattern baldness. Notably, if you are DHT sensitive, any hair loss would have happened at some point down the road anyway.
While plenty of theories suggest testosterone causes hair loss, in reality, the connection is between DHT, a hormone derived from testosterone and due to a genetic predisposition.
The Role of DHT
DHT are the androgen hormones that develop the male sex characteristic as they go through puberty, which include:
- Body and facial hair
- Muscle mass
- A deep voice
- Fat distribution
- Sex organs
As men age, the benefits of testosterone and DHT continue as they help to maintain muscle mass and fertility. (2) About 10% of testosterone is converted to DHT with assistance from the enzyme 5-alpha reductase (AR).
DHT links to receptors on the hair follicles on the scalp, which causes them to shrink, making them unable to grow hair. However, DHT doesn't affect everyone the same way. Since male pattern baldness is genetic, you don't have to look any further than your father and grandfather to see whether or not you may experience hair loss.
How Are DHT and Balding Connected?
According to research, (3) the growth of the hair follicles occurs in cycles that include rapid growth with periods of inactivity and regression. 3 phases of hair growth include:
- Anagen. This is a period of growth where the hair follicles work to produce hair fibers.
- Catagen. The period is a transitional time when the hair follicles begin to regress.
- Telogen. The resting phase of the cycle is when the hair follicles become dormant, and no growth occurs.
How these changes occur isn't fully understood, but the cycles can last for about 2 to 6 years. (4) Once the cycles are complete, the follicle produces new hair, and the cycle starts all over again.
When androgen levels are high, including DHT, hair follicles shrink and can reduce each cycle's time, resulting in thinning hair. Because of the variations in each person's androgen receptor (AR) gene, some people have a stronger reaction to the effects of DHT, making it more difficult to grow hair and increasing the likelihood of experiencing male pattern baldness.
DHT is an Essential Hormone
Many men fear DHT and believe it is simply going to make them bald. In reality, DHT is an essential hormone. It is required to maintain sexual, prostate, and bone health, protect cognitive function, and even help build muscle. Additional benefits include improved blood sugar management, cardiovascular maintenance, reduced stroke risk, and reduced depression. Studies also show DHT improves the signs and symptoms of aging.
Yes, there are potential downsides to too much DHT for some who are genetically sensitive to DHT, but its benefits far outweigh the issues it can cause.
Can Male Pattern Baldness be Prevented?
Hair loss can happen for various reasons and can happen slowly over time or quickly, depending on the cause. But male pattern baldness is considered heredity, and although lifestyle factors may have an impact, there's no known way to prevent it.
However, there may be ways to help keep hair healthy, which can promote hair growth. (5) They include:
- Taking your vitamins. Vitamins and minerals are vital for the body to function properly and help maintain healthy skin, muscle tissue and hair. Be sure to include enough iron, zinc, and vitamins A, B, C, D and E.
- Include enough protein. It's essential to include the appropriate amount of protein in your diet. A diet that includes whole foods and clean protein can be beneficial for healthy hair.
- Reduce stress. Stress can cause increased activity in your androgens, increasing chances of male pattern baldness.
- Haircare and lifestyle changes. Taking good care of your hair and scalp can also help minimize hair loss. Use gentle shampoos and conditioners, avoid excessive heat styling or harsh chemical treatments, and be mindful of tight hairstyles that can pull on the hair. Additionally, maintaining a healthy lifestyle with a balanced diet can help maintain a healthy head of hair.
Testosterone and Hair Loss
When testosterone levels drop, you can experience several symptoms that interfere with everyday life and negatively affect your health. Some symptoms include:
- Fatigue
- Erectile dysfunction
- Loss of muscle mass
- Increased fat
- Irritability
- Brain fog
- Lack of concentration
- Sleep problems
Testosterone replacement therapy can help to reduce and eliminate the symptoms, allowing you to feel like yourself again. But some men worry that it will cause hair loss. According to research (6), taking it may increase risks since testosterone replacement therapy increases testosterone levels. The thing is, it's not the testosterone but the DHT that can cause hair loss.
We optimize your hormones to similar levels to your early 20s when your testosterone would have been pretty high-your hair didn't fall out then due to DHT conversion, so why would it now?
What Medications Can Stop Hair Loss?
Several medications can help prevent or reduce hair loss. These are some common options:
Finasteride For Hair loss
Finasteride is a medication to help treat male pattern hair loss (androgenetic alopecia) and benign prostatic hyperplasia (BHP). This medication blocks the action of an enzyme called 5-alpha-reductaseIt. It inhibits the conversion of testosterone into dihydrotestosterone (DHT), a hormone that can contribute to hair loss in some individuals.
Finasteride summary
- Prescribed at 1 to 5mg
- Taken once daily
- Inhibits Type II male pattern baldness
- Stopped progression of hair loss in 86% of men (in clinical trials)
Minoxidil For Hair loss
Minoxidil is an over-the-counter medication available in a topical form and applied directly to the scalp promoting hair growth and slowing down hair loss. This medication is available in different strengths, and again, it's best to consult with a healthcare professional to determine the most appropriate dosage for your situation.
Minoxidil summary
- First FDA-approved drug for the treatment of male pattern baldness
- It may stimulate dormant hair follicles by extending the anagen phase
- More effective in women than in men
- 2% strength approved for usage
Dutasteride for hair loss
Dutasteride is another medication for treating hair loss. Like Finasteride, Dutasteride is a medication that inhibits the conversion of testosterone into dihydrotestosterone (DHT). Reducing DHT levels can help slow down hair loss and promote hair regrowth.
Regulatory agencies do not typically approve Dutasteride for treating hair loss, but it has been used off-label for this purpose. However, it's important to note that Dutasteride is a stronger medication than Finasteride and is associated with a higher risk of side effects.
Dutasteride summary
- Prescribed at 0.5 mg
- Taken 2x per week
- More effective than Finasteride at inhibiting Type I and II male pattern baldness
- Appropriate for men and women
- Women must avoid Dutasteride if they are planning on getting pregnant
Conclusion: Does Testosterone Cause Hair Loss
Since testosterone levels begin to decline as we age and the symptoms can impact every area of your life, testosterone replacement therapy can be beneficial, as it helps to reduce symptoms and make you feel like a younger version of yourself. But claims that testosterone causes hair loss are a little off the mark. It's DHT sensitivity that's the issue.
But for many men, hair loss is a concern. Since a boost in testosterone may also increase DHT levels, there could be damage to the hair follicle, accelerating the chances of hair loss. However, we optimize your hormones to similar levels to your early 20s when your testosterone would have been pretty high-your hair didn't fall out then due to DHT conversion, so why would it now?
Energy flagging, running on empty?
IT COULD BE YOUR HORMONES
