Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 2/1/2021
Noticed your hair falling out? Whether you’ve spotted more hairs than normal on your pillow, in the shower drain catch or on your clothing, it’s easy to panic when you notice your hair thinning at a faster pace than normal.
Female pattern hair loss is the most common type of hair loss women experience.
Hair loss in women can occur for a variety of hair types and reasons. Sometimes, it’s triggered by changes in your hormone levels and a genetic sensitivity to certain hormones. In other cases, factors such as stress, thyroid issues , weight loss and even environmental factors can all have an effect on your hairline. You can even lose hair at any age, as female pattern baldness 20s isn't unusual.
As a woman, dealing with hair loss can be difficult. Luckily, it’s almost always treatable using a range of safe, effective medications. We’ve covered these treatment options, as well as the key reasons for female hair loss, below.
When most people hear the words “hair loss,” they think of balding men. However, hair loss can also be a significant problem for women. Female hair loss can occur for several reasons, from a genetic sensitivity to certain androgenic hormones to reactive factors.
We’ve listed the most common causes of female hair loss below, as well as the specific ways in which each cause can affect your hairline.
Hormones are the most common cause of hair loss for both women and men. In both sexes, the specific hormone responsible for hair loss is the same: dihydrotestosterone (known as “DHT”), a hormone that your body produces as a byproduct of testosterone.
Both men and women need testosterone. In men, the body has a large amount of testosterone and a fairly small amount of estrogenic hormones. In women, this ratio is reversed, with a small amount of testosterone and larger quantities of estrogen and progesterone hormones.
Testosterone is responsible for several functions in your body, from regulating your sex drive to keeping your bones and muscle tissue healthy and strong.
Your body uses testosterone as a precursor for several other hormones. One of these hormones is DHT. DHT affects your hairline by miniaturizing hair follicles, causing the hairs to stop growing as they normally would and eventually fall out.
This hair loss is called androgenic alopecia, or female-pattern hair loss (FPHL). Overall, it’s the most serious form of hair loss. Because androgenic alopecia can miniaturize your hair follicles, the hair that you lose is often gone permanently.
In women, hormonal hair loss produces different results from men. Instead of the horseshoe-like hair pattern or receding hairline common in men, women with hormonal hair loss usually notice a diffuse thinning pattern across the entire scalp.
In simple terms, you probably won’t get a receding hairline if you’re prone to female-pattern hair loss, but your hair might become noticeably thinner.
Luckily, androgenic alopecia is treatable. We’ve covered the most effective treatment options for hormonal hair loss further down the page, along with other products that can help you retain as much of your hair as possible.
If you've ever wondered, "what causes hair loss in older women", menopause may be the answer because menopause affects your production of several hormones, it can often trigger hormonal hair loss in women.
During menopause, your body’s production of estrogens and progestins can decline. Alongside this decline in female hormone production, your sensitivity to male hormones such as DHT can increase. If you’re genetically sensitive to DHT, this can affect your hairline and hair thickness.
Menopausal hair loss usually happens between the ages of 50 and 60, with most women prone to hair loss noticing a steady decline in their hair density. It can also occur in your 30s and 40s, depending on the specific age at which you begin to enter menopause. Like other female-pattern hair loss, menopausal hair loss is treatable.
You can read our guide to hair growth rate by age for more information.
Both hypothyroidism (under-active thyroid) and hyperthyroidism (overactive thyroid) can trigger hair loss. This is because your thyroid plays a role in the development of new strands of hair at the root, helping your body maintain a consistent supply of new hairs.
If your thyroid isn’t working as it should, the hairs you normally lose each day may not be fully replaced by new hair growth.
Thyroid issues not only cause you to lose hair, they can also cause your hair to become weak, dry and brittle. Most of the time, thyroid issues cause diffuse hair loss across your entire scalp, rather than localized hair loss around your hairline, temples or crown.
Your healthcare provider will normally treat an under-active or overactive thyroid by prescribing levothyroxine, or a combination or propylthiouracil, methimazole and/or beta blockers.
Unlike hormonal hair loss, hair loss caused by thyroid issues is usually temporary. After you’ve identified and treated the underlying issue, your hair will slowly regrow to its previous thickness and length.
If you’ve been working long hours in a stressful environment or spent the last few weeks dealing with a challenging event in your personal life, it’s possible that the stress you’ve felt could take a toll on your hair.
Hair loss caused by stress is called telogen effluvium. Unlike hormonal hair loss in women, it usually isn’t permanent. Telogen effluvium usually results in sudden thinning of your hair across your entire scalp, resulting in more hairs on your pillow, in the drain catch or on your hairbrush.
Like other forms of temporary hair loss, telogen effluvium affects your hairline by forcing hairs into the telogen phase, the final phase of your hair’s growth cycle. This can cause your hairs to fall out without replacement hairs growing in to replace them.
You’ll usually notice telogen effluvium hair loss two to three months after the stressful event or lifestyle change that triggered it.
Like other forms of hair loss in women caused by non-hormonal factors, stress-induced hair loss usually isn’t permanent. Through lifestyle changes and the use of medication, it’s usually possible to regrow most or all of the hair you’ve lost as a result of stress.
Although losing weight slowly and consistently usually won’t affect your hair, rapid weight loss can and often does cause some degree of hair thinning.
Like stress, rapid weight loss affects your hairline through telogen effluvium. When you reduce your intake of calories and micronutrients by a significant amount, it can stress your body and trigger temporary hair loss.
Diet-related hair loss is most common in people who use extremely restrictive diets to quickly lose weight. If you only eat a small calorie deficit or exercise more to lose weight gradually, it’s unlikely that you’ll experience any negative effects on your hairline.
Like stress-induced hair loss, hair loss you experience as a result of rapid dieting usually isn’t permanent. Over time, by adjusting your diet, changing your habits and using medications to promote healthy hair growth, it’s usually possible to restore your hair to its normal level.
So, can anemia cause hair loss? The short answer is yes. If your iron levels are low, it could result in damage to your hair.
Iron deficiency hair loss causes the same type of diffuse thinning as hormonal hair loss and telogen effluvium, making it easy to assume this type of hair loss is the result of a hormonal imbalance or stress.
Iron deficiencies can occur for numerous reasons, from a poor diet that’s lacking nutrients to a range of intestinal diseases. Many women experience iron loss during their period, making this form of hair loss quite common in premenopausal women.
The easiest way to find out whether or not your hair loss is caused by anemia is to talk to your healthcare provider about an iron test. Using a ferritin level blood test, your healthcare provider will be able to check the level of iron in your blood and determine if it’s within the optimal range.
If your iron levels are low, your healthcare provider might recommend changes to your diet or the use of an iron supplement. Over time, as your iron levels return to the normal range, you’ll grow back the hair your body shed as a result of its iron deficiency.
Just like male hair loss, female hair loss becomes more common with age. Studies show that only 12% of women between the ages of 20 and 29 show some degree of hair loss, from loss around the hairline or temples to diffuse, overall thinning.
On the other hand, women aged 80 and up have a more than 60% chance of experiencing some degree of hormonal hair loss. Because hormonal hair loss is partly caused by a genetic sensitivity to DHT, your risk of hair loss could be higher if your mother, siblings or other female relatives have hair loss.
If you’re concerned about hair loss, it’s important to take action quickly. Because hair loss is gradual and affected by DHT, acting quickly allows you to minimize hair loss and maintain as much of your hair as possible.
Whether your hair loss is caused by hormones or a factor such as diet, stress or weight loss, it is treatable.
The first step in treating hair loss is determining why it’s happening. If your hair looks and feels thinner than normal, the best approach is to talk to your healthcare provider about it. Your healthcare provider will be able to look at your hair and, based on your symptoms and health history, provide a diagnosis.
If your hair loss is hormonal, the most effective treatment options include spironolactone, saw palmetto and minoxidil. We’ve listed these hair loss treatments below:
Saw palmetto is an over-the-counter topical ingredient that works by stopping the conversion of testosterone to DHT. It works on a hormonal level, helping to reduce the amount of DHT that reaches your hair follicles and causes thinning.
You can find saw palmetto as an ingredient in some hair loss prevention shampoos. While the science on saw palmetto isn’t conclusive, there have been studies done with men that do show improvements in hair growth when people with hair loss use it as a supplement.
Minoxidil is a topical medication that works by stimulating blood flow to your hair, helping hair move into the growth phase of the hair cycle faster.
There is no direct link between minoxidil and your body’s DHT levels, meaning this medication isn’t hormonal. This means minoxidil doesn’t stop hormonal hair loss by itself; instead, it works by making your existing hair follicles grow new hairs faster.
Studies show that minoxidil works, especially over the course of three to six months. Right now, it’s also the only hair loss medication that’s approved for use in women by the FDA, making it a safe, widely used treatment.
Our guide to minoxidil for female hair loss goes into more detail on how minoxidil works, as well as the type of results you can expect after using it over the long term.
Spironolactone is an antiandrogen that works by reducing the levels of testosterone produced by your body. By lowering your testosterone levels, spironolactone can help to lower the levels of DHT in your scalp.
Although spironolactone is best known as an acne treatment, studies show that it also works well as a treatment for female hair loss.
Spironolactone is a prescription medication. It’s important to be aware that spironolactone is not appropriate for all women or types of hair loss, and side effects beyond its direct effects on your types of hairline or skin may occur. Speaking with a healthcare provider is the best way to find out if spiranolactone is right for you and your goals.
If your hair loss is caused by an iron deficiency, your healthcare provider might recommend changing your diet to include larger amounts of iron, protein and other nutrients that are important for optimal hair health.
You might also need to take an iron supplement, especially if you experience iron deficiency because of a heavy period.
Like medications, dietary changes usually don’t produce immediate results. Instead, you’ll notice an improvement in your hair’s strength, feel and thickness over a period of time as your body adjusts to the extra nutrients in your diet.
To speed up regrowth and restore your hair faster, your healthcare provider might recommend using minoxidil at the same time as you change your diet.
For hair loss caused by stress, the most effective treatment is often to change your lifestyle so that your overall stress levels are reduced.
Stress can occur for a variety of reasons. If your professional life involves long hours, difficult decisions and high-pressure working environments, changing the way you work (or switching from your current job to a new career) can often produce huge improvements.
Obviously, not everyone can make a radical career change, meaning that eliminating stress from work is usually a gradual, steady process.
Other ways to reduce stress include reducing your consumption of caffeine, nicotine and other stimulants, taking frequent breaks to clear your mind during the workday, exercising often and recording stressful events and triggers in a stress diary.
Sometimes, highly stressful events such as a death, breakup or the loss of your job can trigger hair loss. Since this stress is specific and usually very sudden, you’ll normally regrow your hair over the following months as you allow time for the stressful experience to pass.
Worried about your hair? Whether you’ve noticed a few extra strands of hair on your pillow or a significant increase in shedding, it’s important to take action quickly so that you can retain your existing hair and regrow any lost hair as effectively as possible.
You can also learn more about what to look for in a hair loss treatment in our guide to science-backed hair loss shampoo ingredients. Or you can explore an alternative treatment and see if there are benefits to red light therapy for hair loss.