Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 1/27/2023
Do DHT blockers for women’s hair loss actually work? Here’s what you should know.
Pattern hair loss is most commonly an issue for men. One study on caucasian males showed that more than half of men were affected by androgenetic alopecia, or hormonal hair loss, by age 50.
However, many women also experience hair loss at certain points in life. While female hair loss can have a variety of causes, one particular type — female pattern hair loss — is similar in nature to the male pattern baldness that occurs in men.
If you’re experiencing women’s hair loss, you might have looked into using DHT blockers like finasteride to stop your hair loss and potentially help regrow your hair.
DHT blockers for women’s hair loss aren’t approved by the FDA (U.S. Food and Drug Administration). However, they may be used in certain situations as “off-label” medications for women with hair loss potentially caused by excessive levels of androgen hormones.
Below, we’ll explain how DHT-related hair loss can occur in women, as well as how it differs from other common causes of hair loss.
We’ll also cover the use of DHT blockers for women’s hair loss, along with what you need to know before using this type of medication to combat hair loss and protect your hair follicles from future damage.
DHT, or dihydrotestosterone, is a sex hormone produced within your body as a byproduct of testosterone.
Yes, you read that right: testosterone. Although testosterone is primarily known as the male sex hormone, both men and women produce it, albeit in very different amounts.
In men, a normal testosterone level is between 300 and 1,000 nanograms per deciliter (ng/dL) of blood. In women, a normal testosterone blood level is between 15 and 70 ng/dL.
Testosterone and its byproducts, such as DHT, are responsible for what clinicians usually refer to as masculine characteristics. These are typically male physical features like a deep voice, body hair growth, high muscle mass and male genitalia.
As a woman, testosterone is also essential for your health and well-being. Your ovaries produce a small amount of testosterone every day, which is critical for maintaining strong, healthy bones, producing blood cells and maintaining your sex drive and general sexual health.
So, what does this have to do with DHT, and what does DHT have to do with genetic hair loss in women?
DHT is produced as a byproduct of testosterone. In certain areas of the body, an enzyme called 5 alpha-reductase (5AR) converts testosterone into DHT.
DHT can attach to androgen receptors in your scalp and cause hair follicles to shrink. This process (referred to as “miniaturization”) causes a type of hair loss called androgenetic alopecia or female pattern baldness.
As your hair follicles shrink, they may no longer be able to produce new hairs. This can result in diffuse thinning that may develop around your part line and become more noticeable as you get older. However, it’s still unclear whether these effects are more common among men than women.
Some people refer to this hair loss pattern as a “Christmas tree,” as it tends to become wider at the front of your part line as it progresses while remaining narrow near the back of your scalp.
Since women have lower levels of testosterone than men, less DHT is produced within your body. As a result, pattern hair loss is both less common and generally less severe.
Other health conditions that can affect androgen levels and may be connected to diffuse hair loss in women include:
Polycystic ovary syndrome (PCOS)
Adrenal gland disorders
Certain types of medication might also increase your levels of testosterone and DHT, which may affect your hair growth cycle and general hair health.
In addition to causing hair loss, high levels of testosterone and DHT can have other effects on your health. For example, androgen hormones are linked to acne, meaning you may notice more breakouts if you have higher-than-normal testosterone or DHT levels.
If you’ve started to notice thinning, extra stray hairs on your pillow or an itchy scalp, it could be a signal that you’re starting to lose hair. However, hair loss in women can occur for various reasons, and high DHT levels (or sensitivity to DHT) isn’t the only one.
Other types of hair loss in women include:
Telogen effluvium. This is a form of temporary hair shedding that can develop due to numerous factors, such as ongoing stress, infections, illnesses that produce fever and nutritional deficiencies. It’s common for regrowth of hair to occur once the causative issue is treated.
Anagen effluvium. This is a form of hair shedding that occurs when you’re exposed to certain chemicals, such as medications used in cancer treatment. This type of hair loss is temporary, and long-term regrowth is common.
Alopecia areata. This is a type of autoimmune hair loss that occurs when your immune system attacks your hair follicles. It can cause small, round bald patches to develop on your scalp, face and other areas of the body.
Traction alopecia. This type of hair loss is caused by tension on your hair follicles due to tight hairstyles, such as braids, tight ponytails, heavy locks or cornrows. Over time, this damage to your hair follicles can cause scarring and permanent hair loss.
Scalp infections. Some scalp infections, such as tinea capitis (ringworm of the scalp), can lead to a dry scalp and hair shedding.
Our guide to the causes of sudden hair loss in women goes into more detail about these forms of hair loss, as well as common signs you may notice if you’re affected.
Since these forms of hair loss aren’t caused by DHT, medications that block DHT aren’t effective at stopping or reversing hair loss. For this reason, it’s important to talk to your healthcare provider first if you’re not sure what type of hair loss you have.
Currently, the FDA has only approved one DHT blocker for treating pattern hair loss, an oral medication called finasteride.
This medication works by inhibiting 5 alpha-reductase, the enzyme that converts testosterone to DHT within your body. Finasteride is effective at slowing down and stopping hair loss, and in some cases, it even leads to the growth of healthy hair.
However, finasteride is currently only approved by the FDA as a medication for pattern hair loss in men, not women. Most research on finasteride has focused on its benefits as a medication for male pattern baldness, not as a hair loss treatment option for women.
However, several studies have found that finasteride seems to slow female pattern hair loss and produce fuller hair in women affected by DHT-related hair follicle damage.
For example, a review published in the journal Drug Design, Development and Therapy in 2020 noted that case studies of oral finasteride in women showed increased hair density and reduced levels of hair shedding.
A small study published in the International Journal of Trichology in 2013 also found that the use of oral finasteride produced improvements in hair density among postmenopausal women affected by pattern hair loss. But we should note participants were given a 5-milligram dose versus the FDA’s approved 1-milligram dosage.
Still, when women’s hair loss is caused by DHT, finasteride appears to be effective at either slowing it down or reversing it.
Effectiveness is only one part of the equation when it comes to medications. The other is the safety of the medication.
Is oral finasteride safe for women with pattern hair loss? If so, is it necessarily safe for all women or only for some?
In the study of postmenopausal women mentioned above, the researchers concluded that finasteride was “effective and safe,” with libido reduction (a reduced sex drive) and increases in certain liver enzymes being the only reported side effects.
Put simply, current research suggests that finasteride helps improve hair density in women who’ve been through menopause. But while the side effects of this type of DHT blocker are relatively mild, the researchers noted that potential long-term effects are still a concern.
However, this doesn’t mean that finasteride is safe for women who are premenopausal. In fact, finasteride is linked to birth defects in pregnant females in animal studies, and it’s currently unknown if it’s excreted in human milk during breastfeeding.
Because of these risks, the FDA recommends that you shouldn’t even touch crushed or broken finasteride tablets if you think you could be pregnant or are breastfeeding.
These safety risks during pregnancy and nursing are likely linked to the key role that DHT plays in the development of male genitalia.
In other words, finasteride and other DHT blockers are a no-go if you’re premenopausal, plan to have children in the near future or are currently pregnant or breastfeeding.
Currently, the best way to use finasteride to treat women’s hair loss is to apply it topically. We offer a topical finasteride and minoxidil hair growth spray formulated to help women who’ve gone through menopause stimulate hair growth and maintain healthy hair.
This DHT-blocking spray is available following an online consultation with a healthcare provider who will let you know if a prescription is appropriate.
Though finasteride is the best-known DHT blocker currently available, there are several other options if you’re noticing the signs of hair loss in women and want to do something about it.
One is spironolactone, an antiandrogen medication that stops male sex hormones like testosterone from working within the body. Instead of limiting DHT specifically, spironolactone decreases testosterone levels, meaning less DHT is produced as a testosterone byproduct.
Although large-scale study data on spironolactone and hair loss is limited, small studies suggest it can significantly reduce hair loss. Some women even experience regrowth of lost hair after taking spironolactone for several months.
Interestingly, due to its effects on testosterone levels, spironolactone is also used as a treatment for hormonal acne breakouts.
Spironolactone is a once- or twice-daily pill that’s typically safe for use prior to menopause. However, it’s not considered safe for use during pregnancy and may cause temporary changes to your menstrual cycle.
Because of this, you’ll need to talk with a healthcare provider before you can use spironolactone to treat hair loss.
We offer oral spironolactone for women’s hair loss online, following an online consultation with a healthcare provider who’ll determine if a prescription is appropriate.
Another option for treating hair loss and stimulating hair growth is minoxidil, a topical medication you apply directly to your scalp.
Minoxidil doesn’t reduce DHT or affect your hormone levels. Instead, experts believe it works by moving your hair follicles into a state of active growth and increasing the supply of blood to your scalp.
Unlike finasteride and spironolactone, minoxidil is available over the counter. We offer a minoxidil solution in the form of liquid drops and minoxidil foam online as part of our range of treatments for women's hair loss.
DHT blockers such as finasteride haven’t been approved by the FDA as treatments for hair loss in women. However, topical finasteride can be used off-label to treat hair loss in women who’ve already been through menopause.
Before menopause, medications like spironolactone — which work by limiting all androgens, not just DHT — can also treat female pattern hair loss.
Because of the potential side effects of DHT blockers in women, it’s important to talk with your healthcare provider if you’re considering this type of medication to prevent hair loss or promote hair growth.
You can do this by taking part in a hair loss consultation online using our telehealth platform. If appropriate, you may be prescribed medication to help you stop hair loss and gain control over your hair health.
Want to find out more before you get started? Our guide to balding in women goes into greater detail about what causes female hair loss, as well as your options for successfully coping with hair thinning, shedding and other common hair-related issues.