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Is It Female Pattern Baldness—or Normal Hair Loss?

By Sheryl Kraft

Created: 09/01/2015
Last Updated: 11/11/2019

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As we get older, our slowing metabolisms can make it harder and harder to stay thin. But the one thing that seems to get thinner without much effort is something we wish didn't: our hair.

Ironic, isn't it?

Lately, I've noticed long strands of my hair scattered around my bathroom. And I wonder if I'm losing more hair than normal—or if it's just standing out more because the floor in my bathroom is white. When I wash my hair, there's lots of it in the drain.

It's a bit disarming when that happens, but the reassuring news is that it's normal to shed somewhere between 50 and 100 hairs a day. On days you wash your hair, that number can climb up to 250 strands lost.

But what if there's more shedding than that? You may find your hair sheds more a few months after a stressful event. It's not uncommon to find you're losing more hair about two months after giving birth. It can also occur after undergoing surgery, suffering severe emotional stress, losing 20 pounds or more or having an illness (especially if you've had a high fever).

That's temporary. Eventually, your body readjusts and, along with that, the shedding slows and the hair on your head fills in, regaining its normal fullness.

But real hair loss—or female pattern baldness (the most common type of hair loss among women)—is different. The evidence is much more apparent than some random strands falling out.

What happens with female pattern baldness is that over time the hair follicle shrinks and eventually stops growing new hair. The part in your hair may get wider or your ponytail may lose its bulk. Maybe there's an unusually large amount of hair on your pillow when you wake. Or there's a lot in the comb or brush, even though you brushed softly and without tugging. This type of hair loss usually begins in midlife but can begin earlier.

Why does it happen? Although the reasons are not well understood, it may be related to such things as aging, changes in hormone levels (specifically the male hormone androgen) or a family history of male or female pattern baldness.

Diagnosis is usually based on your medical history, ruling out other causes of hair loss (like thyroid problems or recent surgery) and the actual appearance and pattern of the hair loss. Sadly, there's no way to prevent it.

Unlike some men who embrace their bald heads, with the attitude that "bald is the new sexy," hair loss in women is generally not welcomed kindly. Though it rarely  progresses to total or near total baldness in women, it can be quite disconcerting and affect self-esteem.

Although hair loss in female pattern baldness is permanent if not treated, it can be treated. You won't regain the hair that you lost, but it's possible for you to grow some new hair. 

The only medication approved by the FDA to treat female pattern baldness is minoxidil (commonly known as Rogaine), which, like many drugs, was discovered by chance. Originally used to treat high blood pressure (in pill form), patients and health care providers noticed a side effect: hair growth. It may not restore the luster of yesteryear, but it can help.

Like so many treatments, there are some caveats:

  • It's best to start at the first sign of hair loss.
  • There may be a temporary increase in hair loss for the first two to eight weeks, which stops when your hair begins to regrow.
  • It may irritate your scalp.
  • You need to use it continuously for one year before knowing how well it will work for you. It may help hair growth in one in four or five women; in most women it may slow or stop hair loss.
  • You must use it every day. If you stop, the hairs that grew during its use will fall out within three to four months.

If minoxidil doesn't work, there are other medications—approved by the FDA to treat other conditions but not female pattern hair loss—that doctors may prescribe. Among them:

  • Spironolactone (a diuretic)
  • Cimetidine
  • Birth control pills
  • Ketoconazole
  • Finasteride
  • Flutamide
  • Ordutasteride

The FDA has approved lasers, which emit a low level of laser light to treat hair loss at home. Available in the form of combs, helmets and other devices, they may help stimulate new hair growth and have been shown by some studies to be effective.  

If you seek other nonmedical solutions—which are often less expensive and the safest way to deal with the issue—look into hair weaving, hairpieces or a change in your hairstyle to help hide the evidence. Other treatments being studied or used, but not proven effective, include:

  • Platelet-rich plasma therapy
  • Supplements, like biotin and folic acid
  • Combination of specific omega-3 fatty acids, omega-6 fatty acids and antioxidants

Read more:
7 Foods for Healthy Hair
How to Maintain Beautiful Hair as You Age (Courtesy of the Late, Great Whitney Houston)
Shaving Face: The Truth About Facial Hair

Comments

I know I have a lot of hair. A lot. I say when it gets too long it's Don King-ish. But the other day I was in the bathroom somewhere in Manhattan and while quickly glancing at the mirror I saw an open spot on my hairline and I nearly jumped out of my skin. A quick comb-out and some water repaired it. Phew.

It's one thing for men to lose their hair, but when women's hair gets thin it's quite another. Thanks for another informative article that is important for women, Sheryl.

My fine hair has always been thin on top... Maybe thinner now. Interesting info.

Thank you for the information, Sheryl. Thank goodness there is a long line of hairy people in my family! One less thing to worry about!

Makes you not want to wash your hair, doesn't it? Thanks for the good advice.

Very interesting. It's so important to know the difference between normal again and something else—because either way perhaps there are remedies than can be tried to restore what can be safely restored.

I have always had overly thick hair that grows extremely fast. I have been so freaked out over the last year to see all the hair on my pillow in the morning and my shower drain clogged with hair.
My stylist and my doctor suggested antioxidants,Omega 3's and a gentler hair dye.
Good thing wigs are so popular. I may have to get a few.

Thank you for this important info that's probably hard for a lot of women to think about or talk about. I have pretty thick hair, but have noticed some thinning above my forehead. Am keeping an eye on it.

I've seen it happen to friends and it breaks my heart. So much of our society is hair based. It sounds crazy but it's true. My hair has gotten ridiculously thinner. I cut is differently and treat it with the utmost of respect and care. No balding as yet, and I hope to never see it. But if it does happen, I will be sporting some pretty fantastic wigs (depending on my mood).

I know many friends who are experiencing hair loss and wondering what if anything they can do. This post has been very instructive and I will share.

Wonderful research of where to turn for those who are at their wits end.

I've been losing hair like crazy for years. Fortunately I had very thick hair to begin with. I was just mentioning this to my husband the other day. Will certainly research more of your suggestions. Thank you!

I know a lot of women who suffer from this. It's not just a man's issue for sure. Some great info here!

Interesting and lots of solid information as usual from you, Sheryl. It's not a problem with me (as yet, anyway) but I am glad to know that treatments with biotin and omega threes are being studied.

I've always thought my hair was my best physical asset. My dad and brother went bald early, but so far, no baldness for women in the family.

This was really interesting. I feel fortunate to have hair that is thick and, so far, has not started to fall out, even after stressful situations.

Happy to say I also have an abundance of hair (so far). I've known women with thinning hair (even young-ish women). I'm sure it's tough.

I started experiencing hair loss when I moved from one country to another. I obviously freaked out. I was told to use medicated shampoos with minoxidil. but when I read the side effects of it, I refrained from using it. Then a friend recommended a new shampoo which is natural, without sulphates. Now myhair has stopped falling and it feels better than what it was before....

Very informative post on a problem that plagues so many women.

Thanks so much for sharing this article it was really informative and interesting!

Oh my gosh this makes me feel so much better! It’s so nice to know that I’m not the only woman out there suffering from hair thinning and hair loss - it makes me feel so much better to read this! Honestly since my hair started thinning a few months ago I’ve been so panicked and confused as to why it was happening. I’m quite vain and I’ve always loved my hair so I’ve been really worried about keeping my curly locks! My friend actually recommended getting a wig made. Apparently you can have small pieces and extensions to cover up certain thinning parts of your hair without losing all your hair (and I’m definitely leaning towards this option). My friend sent me a link (bless her she knows how upset Ive been) to this company http://www.optimahair.co.uk/, has anyone else used them? They look good but I don’t know that much about it if I’m honest so I’d appreciate any advice or recommendations people could give me! Also if there are any other products/options for women who are losing their hair Im genuinely all ears - Id love to hear more about other people's experiences!

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