Hair loss in women is a complex issue and so it requires a complex solution. What are the main causes for hair loss in women?
On this page we explore the causes of hair loss in women. Unexpected episodes, whether sudden or gradual are more common these days than it's ever been.
The following is written by Bambi Staveley RN, author of HAIR LOSS IN WOMEN – Understand why this is happening to you and learn how to turn your hair loss back on.
She has suffered hair loss herself for over a decade. And she has spent that entire time researching the causes of hair loss in women. The result is that she now has all her hair back.
Nothing she recommends involves so-called magic potions, drops or oils. Once you have discovered your underlying causes and your triggers, you too can get your hair back.
It is unlikely your doctor has been able to help you as current medical training doesn’t cover even the basics of the causes of hair loss in women. Some dermatologists do have some knowledge, but most of their knowledge is based on male pattern hair loss/balding. This is not the same as female hair loss as the causes of hair loss in women are completely different!
Below are the most common causes of hair loss in women and we have also included some great solutions.
Your hair could be falling out because hair naturally thins out as we age and this often happens gradually. However, if it is really noticeable or if you suddenly notice your hair is falling out, then there is likely to be something else going on. While hair fall occurs most of all at two specific times in a woman's life - during/following menopause and following pregnancy, there are many more causes of hair loss in women.
HAIR LOSS IN WOMEN: MORE THAN ONE CAUSE
According to a recent review published in the International Journal of Women's Dermatology, Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review, hair loss in women is polygenic (can be influenced by more than one gene) and multifactorial (dependent on a number of factors) with the additional influence of environmental factors.
So we know there are a broad a range of causes from the obvious such as damaging it with peroxides and other chemicals, to hidden causes such as systemic inflammation and stress.
But since the cause of hair loss in women can be multifactorial there are literally dozens of combinations. You may have joined a Facebook group hoping to find the answer from other women, but the truth is, what is causing hair loss for one woman, may only be half the story for another.
And even worse, women are prescribing over the counter treatments to one another online! It is horrifying to see women telling other women to start taking supplements like iron or Vitamin D when they have absolutely no knowledge of the overall health of the other woman, nor any real idea what could be causing the other woman's hair loss.
Have you seen all the hype lately about rosemary oil? While it sounds tempting to buy a bottle of something you can put on to make hair grow, hair doesn't grow from a "fertilizer"! It takes months for a dormant follicle to rejuvenate and it all happens from the inside.
So let's get to understanding the many causes of hair loss in women and armed with this knowledge you can begin to work on getting your hair back.
CAUSES OF HAIR LOSS IN WOMEN - TRIGGER PLUS CONTRIBUTING FACTORS
There can be multiple underlying causes for female hair loss that go unnoticed for many years until a final ‘trigger’ initiates hair loss. These triggers will only lead to an onset of hair loss in susceptible individuals, and the effect of a trigger depends on whether that individual is genetically susceptible, or experiences other underlying causes. It’s complicated.
A common example of underlying cause and trigger is menopause which is sometimes combined with a poor diet or low nutrition. This can be caused by women in menopause taking on crash diets or ketogenic diets to eliminate their menopause weight gain. So menopause is not the direct cause of hair loss in all women during menopause, but when combined with other factors such as those I have covered below, it can certainly be one piece of the puzzle in identifying the cause of hair loss in women.
A common underlying cause and a well known contributing factor (and not a cause of female hair loss on its own - necessarily), is stress. Many women take on too much. Full time work often in very high stress professions, plus everything else expected of women from child-bearing, to child-raising, to extended family responsibilities perhaps with ageing parents, combined with home and other pressing life issues and even for some women, adding study to their list of obligations. Combine these factors with the popularity of birth control products and the resulting hormonal effects, excessive demands on our time and, for many, a tendency to rely on a poor quality, fast-food diet, it is little wonder we find women of all ages, with all kinds of new ailments as manifestations of stress: chronic weight gain, heart disease and, of course, hair loss.
So as you read through these causes, look for your underlying causes which will be your contributing factors. Try to identify your initial trigger and then look to see if there is a secondary factor, or two or three, that is at play.
OESTROGEN AND HAIR LOSS
You hear of women who take iron supplements and their hair grows back, then you hear of a woman who changed her shampoo and her hair grew back. You read about women using a scalp spray and claiming their hair grew back. But there are equally as many, if not more, for whom those solutions did nothing. This is due to both the trigger and the contributing factor (or factors) working together.
Both a sudden or even a gradual reduction in a woman’s oestrogen (estrogen) levels can contribute to hair loss in a woman. Sudden changes in oestrogen levels can be caused by changes to the pill (going on, or off, or changing brand), or to hormone replacement therapy (HRT) or other medications, and gradual hair loss can be caused by the gradual decline in a woman’s oestrogen levels as a result of ageing.
When female hair loss is sudden and really noticeable, for example excess hair in the drain when washing, noticing it falling out during the day, seeing it on your clothes or around the house, then this is called telogen effluvium (TE). I will cover TE specifically later.
The drop in oestrogen following childbirth, will right itself over time and so will hair growth. If there are no other underlying causes, then this kind of hair loss will resolve and there should be noticeable regrowth and hair thickening up within a year.
Although a change in hormone levels can cause hair loss or thinning in a woman during and after menopause, it is worth noting that following menopause, hair can be thinning out in one of three ways:
First, the natural growth cycle may be interrupted and/or slowed resulting in diffuse hair loss. This is generally caused by a change in hormone levels.
Secondly as we age, our hair strands can get narrower (called miniaturisation) and this gives the appearance of less hair, when in fact you may have the same number of hairs, they are just much finer. This is especially noticeable for women who had very thick dark colored hair.
And lastly, low estrogen is also known to make hair dry and therefore more susceptible to breakage.
HAIR LOSS DUE TO LOW IRON
Low iron is a common cause of hair loss in women. This can cause diffuse hair loss where more than normal amounts of hair are shed, resulting in an overall appearance of ‘thinning hair’. Often the first thing a woman notices with this type of hair loss is the increased visibility of the scalp through the hair, or a much thinner ponytail.
Hair thinning of this nature can happen relatively quickly, but for some it can also happen very slowly, even over a period of years. Although it has been observed in all age groups, iron deficiency is the most common cause of hair loss in pre- and post-menopausal women.
You are probably familiar with fatigue as a key symptom of low or deficient iron. The mechanism for this is that the serum iron, that is the iron circulating in your blood stream, carries oxygen around the body. All cells need oxygen, so reduced function and exhaustion comes with inadequate oxygenation.
Stored iron is known as ferritin. When the serum iron drops, the body starts to call on its stored iron - its ferritin supplies. By the time a blood test shows low serum iron levels, the body will have exhausted its iron reserves. This is why it can take a long time to right any iron deficiency, replenish iron stores and restart the hair growth cycle.
However, low serum iron alone is not an indicator of an iron deficiency, it can also be an indication of other forms of chronic disease. For this reason and for your general health and wellbeing do not take iron supplements without medical supervision.
POST-PARTUM HAIR LOSS
The hormonal changes in pregnancy are completely normal and required to grow a human being. One of the most profound changes is the increase in oestrogen levels that is sustained throughout pregnancy. One of the side effects of this increase is a cessation or a slowing down of the hair growth/loss cycle. Many pregnant women comment on their luscious, thick hair when pregnant, only to find following birth, when the oestrogen levels drop back to normal levels, that the hair moves into the shedding phase and falls out. This is a very common process and no need for concern.
However, in some women, especially those with naturally fine or thin hair, or for someone who has had a previous bout of TE, this post-pregnancy hair loss can be quite distressing. When a woman worries consistently about the negative impact of sudden and unexpected hair loss, hair loss can increase. This cycle of stress confirms that worry about hair loss can contribute to further hair loss.
Worrying about hair loss while nurturing a totally dependent infant, being sleep deprived and potentially skipping proper meals makes a woman’s body vulnerable to further hair loss and thinning. It is a vicious cycle.
The good news is that most women find that their hair growth returns to normal after the postpartum phase, although this can take up to a year. Some women find that they go through this experience with all of their pregnancies, while others can be on their third or fourth pregnancy before experiencing it for the first time.
Sometimes, post-partum hair loss can become chronic (CTE) and continue on for longer than the average couple of months. If this is the case then there is something else going on. If this is you, a blood test is a good place to start to figure out your underlying causes. They have possibly been there for some time, but not until this post child birth shedding, was hair loss triggered.
POLYCYSTIC OVARIAN SYNDROME (PCOS)
Polycystic ovarian syndrome (PCOS) is a common underlying cause of hair loss in women that is not always otherwise evident or symptomatic. PCOS hair loss is caused by an excess of androgens – the same thing that causes men to lose their hair.
Many women with PCOS also have metabolic syndrome (a precursor to type 2 diabetes). Metablic syndrome is one of the underlying causes identified as having the potential to cause female hair loss on its own, without the added complication of PCOS.
If you’re taking any regular medications, you may not be in 100% tip top physical condition. Many illnesses or just being unwell can cause hair loss in some women and sometimes it can be the medication itself. Some medications that are known to trigger hair loss in some women include those for blood pressure management, acne, arthritis, gout, arrhythmias and psoriasis. This is not a complete list, so check your medication information thoroughly.
It is also important not to overlook any medications you may have been on long term where you have altered your dosage or recently stopped taking them altogether.
EXTREME WEIGHT CHANGES
Putting yourself on a restrictive diet can mean you miss out on some essential nutrients and that can cause thinning hair in women. Likewise, gaining a significant amount of weight quickly can also put your body out of whack and mean that you experience thinning hair.
If you have been on a ketogenic diet and notice sudden or unusual hair loss, then you need to have a clear understanding of your underlying causes. Not everyone on a keto diet loses their hair, so for those that do, there is something else going on. As I so often mention, the cause of hair loss in women is not simple, in fact it is complicated by the fact that there could be several underlying causes and the keto diet, is simply the trigger.
So please do your research, it is all laid out in the book HAIR LOSS IN WOMEN, so you can get started on rectifying your specific underlying condition.
Because hair is viewed by the body as non-essential, it is often the first thing the body stops assigning resources to, so it can begin to fall. Hair loss is a common symptom of a lot of illnesses e.g. autoimmune diseases, but what you may be surprised to learn is that hair loss in women can be caused by acute illnesses like gastroenteritis. These short but intense illnesses can put enough temporary stress on the body which can lead to hair loss in women usually around three months later. The good news is that this type of hair loss can usually right itself without intervention.
COVID-19 AND HAIR LOSS
Covid-19 has now become one of the leading causes of hair loss in women across the world. So don’t be surprised if this is you. You are not alone. However, not everyone who gets Covid-19 will suffer hair loss. So what is going on?
The human body’s long term response to Covid-19 is only just becoming evident. Scientists are working overtime trying to determine what has been going on at the cellular level in patients who end up with long Covid. There are many theories and papers being written right now (2022) and I will update this page when there is something conclusive to report.
But I will say this:
Covid-19 seems to affect people with metabolic syndrome more than the rest of the population. Metabolic syndrome is a catchall phrase that refers to the dysfunction of the major intracellular processes that are required for a healthy body.
There has been a lot of warning around Covid deaths being more prevalent in the obese and those with diabetes. And this goes for long covid and longer term heart and health issues like hair loss too.
But being obese, or having diabetes is not the problem, it is the underlying cause of these diseases (metabolic dysfunction, oxidative stress, systemic inflammation) that are the real culprits.
And the main cause of these underlying conditions? Sugar and processed foods. But that’s the subject of another book!
So when hair loss is experienced following Covid, it is likely to be due to the underlying causes a women has, such as those mentioned earlier in relation to metabolic syndrome. Like all the other causes of hair loss in women, getting to the base of your underlying causes and conditions and righting it, is the best gift you can give to your hair and your future self.
It’s probably not much of a surprise that heated styling products like straighteners, curling irons and hair dryers can cause hair loss in women, but did you know that your hairspray, gel or even the type of shampoo you use could also be causing your thinning hair? Be careful not to overuse styling products or opt for natural products. Whilst you’re at it, be careful with your poor head! Simple things like tight ponytails and harsh brushing can also cause hair loss.
Opt for healthy kind to hair products like the Boost & Be range.
DIGESTION AND GUT ISSUES
It should be no surprise that a healthy gut is needed for an overall healthy body. It's all very well to be careful what you eat and to have a generally good diet, but if your gut is not healthy (eg IBS) and you are not able to absorb the nutrients in your food then your hair follicles are not getting fed.
What you eat goes through your intestinal system during which time your gut wall absorbs all the goodness out of your food, leaving just the waste.
If you have any kind of gut issue like chronic diarrhoea, IBS or if you are taking a medication that is affecting your gut health (some drugs can cause diarrhoea which can lead to malabsorption, antiobiotics can also mess with gut health) then it is worthwhile seeing your doctor about it. If your hair loss cause is an unhealthy gut, the good news is, once fixed hair loss can be reversed.
AN UNHEALTHY SCALP
An unhealthy scalp can cause inflammation which then makes it difficult for hair to grow. Some of the skin conditions that can lead to hair loss include seborrheic dermatitis (dandruff), psoriasis, and fungal infections such as ringworm. If you are a gardener, think of your scalp like the soil you put your plants in. Great soil = healthy plants. When the soil is dry, parched and lacking in nutrients, then nothing can grow. Our scalp is similar. Be careful with super hot water, use chemical free shampoos and conditioners like the Boost & Be range and try to avoid getting your scalp sunburnt.
Hair loss in women can become your Achilles heel. For many women one bout of hair loss that rights itself following pregnancy or an illness, reoccurs later when the same or another trigger hits.
If you are suffering sudden hair loss ask yourself what you were doing three months ago. Since hair goes through a three month cycle it is often the case that it was three months ago when your body was stressed that the damage was done.
Whilst some of these causes for hair loss in women may have their own solutions (e.g. changing the medications that are causing your hair loss), the best cure is to look at your underlying health and work on getting that right.
Read HAIR LOSS IN WOMEN to get a full understanding of all the possible causes and triggers so you can find yours and start on reversing it and getting your hair back.
FEMALE HAIR FIBRES - your new best friend
If your hair loss has caused a widening part or hair so thin you can see your scalp through it then there is something you can do about it. Some clever Aussie women have developed a product that you can simply shake in to cover up thinning hair instantly. No need to look like you have thinning hair. That product is Boost N Blend™ - an instant, easy to apply hair loss concealer designed by women, for women. The results speak for themselves. The photo on the right was taken just after a few shakes of Boost N Blend™
Join thousands of women in our Private Facebook Group talking about hair problems and issues common to us all. See before and after photos that have not been made public. This is a CLOSED group for women who want to talk about their hair thinning and the hair care issues we face every day. Particularly for women who have fine, thin or thinning hair. Simply hit "Join group" when you arrive at our Facebook page.