Does Testosterone Cause Hair Loss?

If you’ve been noticing a receding hairline or otherwise thinning hair every time you look in the mirror, you may be wondering what’s causing it — and what you can do about it. 

Changing hormone levels can sometimes be to blame, which may make you wonder: Does testosterone cause hair loss? The answer: It can, but there’s usually more to hair loss than how much testosterone is coursing through your body.

As it turns out, hormones — and specifically testosterone — play a role in a form of hair loss called male androgenetic alopecia (AGA), also known as male pattern baldness or androgenic alopecia. While many factors can influence hair growth and shedding, genetics and male sex hormones like testosterone play a key role in the development of AGA.

And if you started testosterone replacement therapy (TRT) to boost libido, build muscle mass, or for any other reason, you may be asking yourself if the potential side effects are worth it. Does TRT cause hair loss, and if so, can you keep the therapy going and also keep your hair?

In this article, we examine the link between testosterone and hair loss, and look into ways to prevent hair loss, especially when its related to genetics.

Hair growth and hair loss are ongoing processes affected by many factors. The hair growth cycle involves three distinct phases:

• Anagen. The anagen (growth) stage is when new hair fibers actively form within the hair follicles. This process can last several years. 

• Catagen. The catagen (transition) phase signals the end of active growth. It can last several weeks.

• Telogen. The resting period (telogen phase) is when hair follicles become dormant. At any given time, up to 15 percent of the hairs on your body — including facial hair, arm hair, and even chest hair — are in the telogen phase. This stage can last up to a year.

Shedding hair every day is normal — up to 200 strands, give or take. But shedding more than that may indicate an underlying problem in the hair growth cycle. Read on to learn what can cause it.

External and Environmental Causes of Hair Loss

Many factors can disrupt the hair growth cycle and lead to thinning hair and shedding. These includes:

• Poor nutrition

• Infection

• Medication reactions

• Stress

• Menopause (in females)

• Tight hairstyles 

But in the case of male pattern baldness, it’s mainly hormones and genetics at play.

Hormonal Causes of Hair Loss

Can low testosterone cause hair loss? As the primary male sex hormone, testosterone can impact everything from your energy level and mood to your sexual health, muscle mass, and beyond.

If you’re struggling with erectile dysfunction, for example, it’s not uncommon to consider if your testosterone levels are out of sorts. After all, there’s a link between low testosterone levels and issues like erectile dysfunction, low sex drive, and poor sexual health..

While low testosterone is more common in older men, conditions like diabetes, autoimmune disease, thyroid disease, and testicular cancer (or injury) can increase your risk at any age. 

The following also can cause a temporary dip in testosterone:

• Over-exercising 

• Poor nutrition

• Certain medications

• Insufficient sleep

The good news? It’s possible to increase testosterone. 

Healthcare professionals commonly treat low-T with TRT, also known as testosterone injections. TRT can also be administered through oral medications, patches, and gels. As with any treatment, TRT comes with potential side effects, and in some people, it may trigger hair loss and hair thinning.

High testosterone levels and testosterone injections don’t directly cause male pattern baldness.

One 2017 population study in northeastern Germany looked at the relationship between sex hormones and hair loss in men. It found no link between male sex hormones and male hair loss.

Researchers noted that this backs up previous research that suggests developing bald spots from male pattern baldness might have more to do with sensitivity to male hormones than the hormone levels themselves.

It turns out its often genetics that influence how sensitive your hair follicles are to circulating dihydrotestosterone (DHT). DHT is a byproduct of testosterone and one of the most potent androgens (male sex hormones).

As your body produces testosterone, a small amount of that hormone is converted to DHT by way of the 5-alpha reductase enzyme, which exists in small amounts throughout the body. 

Young males need DHT to ensure the healthy development of the genitals and prostate, along with secondary sex characteristics like voice, muscle mass, and body hair.

In adulthood, DHT doesn’t really have a significant purpose, and it can even lead to problems, like male pattern hair loss. In fact, researchers have found greater amounts DHT in balding scalps compared to non-balding ones. But not everyone’s hair follicles are ultra-sensitive to this sex hormone. 

The more testosterone you produce, the higher the levels of DHT in your body. DHT can attach to receptors in the scalp and gradually shrink hair follicles until they can no longer produce hair — a process known as follicular miniaturization.

But what ultimately influences whether DHT has drastic effects on your hair is how sensitive your body is to DHT, which is something that’s genetically predetermined. If you do have a genetic predisposition to DHT sensitivity, then too much of it can wreak havoc on your hairline.

While TRT has helped countless men overcome low-testosterone and its many potential complications, the Endocrine Society notes that the therapy should only be prescribed to guys diagnosed with hypogonadism, a condition in which the body produces abnormally low levels of testosterone. It shouldn’t be considered a shortcut to bigger muscles, improved athletic performance, a higher sex driver, or other expected changes associated with aging.

Like any powerful treatment, TRT carries some potentially serious side effects. Among them are a higher red blood cell count, sleep apnea, enlarged prostate and/or breasts, and acne. Some studies suggest that TRT could raise the risk of certain cancers (especially prostate cancer) as well as cardiovascular disease.

As for hair loss, there’s little research on TRT’s potential influence on hairlines and baldness. But it does appear that TRT may contribute to hair loss if you have a genetic sensitivity to DHT. A genetic test can determine whether you’re sensitive to DHT and may therefore experience some hair loss during therapy.

Taking testosterone doesn’t mean you’ll definitely experience hair loss. Though having an increased DHT sensitivity is genetically determined, there are a few steps you can take to treat and prevent hair loss. Ask a healthcare professional about the following treatment options:

• Finasteride. Finasteride is an FDA-approved treatment for AGA (at a dosage of 1 milligram per day). Healthcare professionals also prescribe finasteride tablets for benign prostatic hyperplasia (BPH), also known as an enlarged prostate. How does it work? It stops the body from converting testosterone into DHT — by about 70 percent.

• Minoxidil. Minoxidil (the generic name for Rogaine®) seems to stimulate hair growth by shortening the telogen phase and lengthening the growth phase. Evidence suggests that topical finasteride — whether in the form of minoxidil foam or minoxidil liquid solution — is as effective as oral finasteride. It may be better for a receding hairline than for other types of hair loss.

• Low-level laser light therapy (LLT). Unlike the lasers that remove body hair, LLT uses low-intensity light to stimulate cellular activity — including in hair follicles. In one 24-week study, 40 participants received daily treatments with a helmet-style LLT device or a sham device. After 24 weeks, those who received LLT therapy were found to have greater hair density and thickness.

• Hair transplants. According to the American Academy of Dermatology (AAD), you’re a good candidate for a hair transplant if you have enough healthy hair on your scalp and can still grow hair in areas where you’re experiencing thinning. These treatments, while often effective, are often prohibitive because hair transplants can be costly, and they generally aren’t covered by health insurance. 

Your lifestyle choices also can have an impact on hair health. While healthy habits won’t stop hair loss, they can make hair more resilient and less likely to shed.

• Get your vitamins. Proper nutrition is key to your body’s overall well-being, and that includes your hair. Many vitamin deficiencies can make your hair more vulnerable to breakage and shedding. Your healthcare provider may recommend supplements like biotin to address any deficiencies that might be causing your hair loss.

• Keep a lid on stress. In severe cases, stress can trigger temporary hair loss, known as telogen effluvium. The good news is that this type of hair loss is usually temporary, and you’ll see hair regrowth once the cause is addressed.

• Be gentle on your hair. Taking proper care of your follicles can help reduce the damage that may contribute to breakage and shedding. Regularly washing with a product formulated for your hair and skin type can help prevent hair dryness You’ll also want to keep chemical treatments and dyes to a minimum.

Testosterone can affect hair and male pattern baldness, but it’s not the only cause for a receding hairline. It’s worth remembering that:

• High testosterone levels don’t necessarily translate to hair loss. High testosterone isn’t a direct cause of male pattern baldness, but you can get a blood test to see if you have normal testosterone levels.

• High levels of testosterone won’t trigger hair growth either. If you’re wondering “does testosterone cause hair growth?," the answer is no. That said, correcting a hormone imbalance may help restore hair health. It’s important to talk to a healthcare professional about what you’re experiencing to get sound medical advice.

• Some people are more sensitive to DHT. Sensitivity to this potent byproduct of testosterone makes some folks more likely to experience hair loss in response to higher levels of testosterone.

• It’s genetic — but treatable. While you can’t do anything to change your genetically-predetermined sensitivity to DHT, treatments for male pattern hair loss are available and effective. 

To learn more about hair loss and hair loss treatments, start with a free consultation with a healthcare professional. They’ll be able to help you concoct a treatment plan that helps you regain your hair (or at least prevent further loss) — and your confidence, too