The link between hair loss and testosterone is complex. It’s a common misconception that bald guys have high testosterone levels, but is this true?
According to the National Institutes of Health, male pattern baldness, also known as androgenic alopecia, affects an estimated 50 million men and 30 million women in the United States (NIH). Hair loss is caused by the shrinking of hair follicles, which has an influence on the growth cycle. New hairs get finer and finer until there is no hair left and the follicles go inactive. Hormones and certain genes are to blame for this hair loss.
Different forms of testosterone
Testosterone may be found in your body in a variety of ways. There is “free” testosterone in your body that is not attached to proteins. This is the most active type of testosterone in the body.
Albumin, a protein found in the blood, may also bind to testosterone. The majority of testosterone is linked to the protein sex hormone-binding globulin (SHBG) and is inactive. You may have a high level of free testosterone in your system if you have a low level of SHBG. An enzyme converts testosterone to dihydrotestosterone (DHT). DHT has five times the potency of testosterone. The body predominantly uses DHT in the prostate, skin, and hair follicles.
Shape of baldness
Male pattern baldness (MPB) takes on a particular form. The front hairline recedes, giving an M shape, especially on the sides. This is known as frontal baldness. The crown of the head, also called the vertex, is also bald. Eventually, the two sections come together to form a “U” shape. MPB can also affect chest hair, which thins with age. Surprisingly, hair in various parts of the body can react differently to hormone changes. For example, facial hair growth may improve while other regions of the body may become bald.
DHT: The hormone behind hair loss
An enzyme called 5-alpha reductase converts testosterone to dihydrotestosterone (DHT). It may also be created from DHEA, a hormone that is more prevalent in women. DHT may be found in the epidermis, hair follicles, and the prostate gland. Hair loss is caused by DHT’s activities and the susceptibility of hair follicles to DHT.
DHT also has an effect on the prostate. The prostate does not grow properly in the absence of DHT. A guy who consumes too much DHT may develop benign prostatic hypertrophy, commonly known as an enlarged prostate.
DHT and other conditions
There is some evidence that baldness is linked to prostate cancer and other disorders. According to Harvard Medical School, men with vertex baldness are 1.5 times more likely to acquire prostate cancer than those without bald areas. Men with vertex bald patches are also more than 23% more likely to have coronary artery disease. DHT levels are being studied to see if there is a relationship between them and metabolic syndrome, diabetes, and other health problems.
It’s your genes
The sensitivity of your hair follicles, not the amount of testosterone or DHT, causes baldness. Genetics determines this susceptibility. The AR gene is responsible for the production of the receptor on hair follicles that interacts with testosterone and DHT. If your receptors are very sensitive, even modest levels of DHT might readily trigger them, making hair loss more likely. Other genes may potentially be involved.
Age, stress, and other variables can all have an impact on whether or not you experience hair loss. However, genes play a key influence, and men with close male ancestors who have MPB are at a substantially higher risk of having the disease themselves.
Myths: Virility and hair loss
There are several fallacies concerning balding guys. One of them is that males with MPB are more virile and have greater testosterone levels. This isn’t always the case. Men with MPB may have lower testosterone levels in their blood, but greater amounts of the enzyme that transforms testosterone to DHT. You might also have genes that cause your hair follicles to be extremely susceptible to testosterone or DHT.
Hair loss in women
Androgenetic alopecia can cause hair loss in women as well. Although women have considerably lower testosterone levels than males, there is enough to induce androgenetic hair loss.
Women have a distinct pattern of hair loss. The top of the scalp thins in a “Christmas tree” pattern, while the front hairline does not recede. Female pattern hair loss (FPHL) is also caused by DHT’s activities on hair follicles.
Treatments for hair loss
Several treatments for MPB and FPHL include interfering with the activities of testosterone and DHT. Finasteride (Propecia) is a medication that works by inhibiting the 5-alpha reductase enzyme, which turns testosterone to DHT. It is harmful to use in pregnant women, and both men and women may have sexual negative effects from this medicine.
Another 5-alpha reductase inhibitor, dutasteride (Avodart), is being investigated as a possible therapy for MPB. It is now available for the treatment of an enlarged prostate.
Other non-testosterone or DHT-based therapy alternatives include:
- minoxidil (Rogaine)
- laser treatment
- surgical hair follicle transplant
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