Testosterone and Hair Loss: What's the Link?

If you’ve been noticing more hair than usual circling the shower drain, you may be wondering if your hormones are to blame. But does testosterone cause hair loss?

As it turns out, hormones 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.

In this article, we look at the link between testosterone and hair loss, and explore ways to prevent genetic-related hair loss.

You probably don’t think much about how your hair grows, but it’s actually a complex and fascinating process. 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. This includes:

• Poor nutrition

• Infection

• Medication reactions

• Stress

• Menopause (in females)

• Tight hairstyles 

But in the case of male pattern baldness, hormones and genetics are at play.

Hormonal Causes of Hair Loss

Can low testosterone cause hair loss?

If you’re struggling with erectile dysfunction, it’s not uncommon to worry about your testosterone levels. After all, there’s a link between low testosterone levels and issues like erectile dysfunction, low sex drive, and poor sexual wellness.

Low testosterone is more common in older men. But 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

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

Healthcare professionals commonly treat low-T with testosterone replacement therapy (TRT), also known as testosterone injections. But 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 suggesting that 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 genetics influence how sensitive your hair follicles are to circulating dihydrotestosterone (DHT). DHT is a byproduct of testosterone and one of the most potent androgens (also known as male sex hormones).

Your body produces testosterone. As a byproduct of testosterone production, it converts a small amount of that testosterone to DHT by way of the 5-alpha reductase enzyme, which is found in small amounts in the body. 

In young males, the body needs 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 more 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.

Taking testosterone doesn’t mean you’ll definitely experience hair loss. Male pattern baldness isn’t about the amount of testosterone in your body but whether your hair follicles have a higher sensitivity to DHT.

Though this increased 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 transplant. 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. The only problem is that hair transplants can be costly, and they generally aren’t covered by health insurance. 

Your lifestyle choices also can have a real 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 could 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.

Dealing with male pattern baldness can be stressful. But how does testosterone factor into it? 

• 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 don’t 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 — talk to a healthcare professional for 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.

To learn more about hair loss and hair loss treatments, start with a free consultation with a healthcare professional. They can help you determine what might be right for you.