Although widely considered a problem that occurs with men, research (1) now shows that more than 50% of women will report significant hair loss or thinning at some point in their lives. 

In contrast to men, whose hair loss is mainly due to hormones, including dihydrotestosterone (DHT) (2), hair loss in women can be triggered by more than 50 different medical as well as lifestyle factors, including hormonal imbalances, iron deficiency, or extreme stress.

Unlike men, where balding may be considered stylish and can be dealt with by simply opting for cosmetic shaving their heads, when women lose their hair- it is a frightening emergency.  Hair loss in women significantly affects not only a woman’s self-image but also affects their emotional well-being. They can feel anger, shame, low self-esteem and confidence, humiliation, sadness, even fear when hair loss occurs.

What Does Hair Loss in Women Look Like?

We know the causes for hair loss are different for men and women, and similarly, so are the patterns of hair loss. Men experience thinning from the forehead or the crown of the head while women tend to notice thinning on the top third to one half of the scalp with the maintenance of the hairline. They often complain that they see the part in their hair gradually becoming wider and more visible. Sometimes they will see more of their scalp than normal when their hair is pulled back.

varying stages of hair loss in women

You can often hear a woman experiencing hair loss saying: 

“My hair is shedding!”

“I have lost my hair volume–my “ponytail”

“My hair is thinning in the front.”

“I have a wide part that you can see.”

“I have tried all these crazy things and they didn’t work!”

But what causes female hair loss? 

There are many causes of hair loss in women, such as genetics, hormonal shifts, and lifestyle changes. Keep reading to find out the 9 most important triggers of hair loss in women and the types of hair loss they cause.

Genetics & Autoimmune Disorders

Although there are genetic and as well as many hormonal causes for female hair loss, the most common cause of hair loss in women is due to androgenic alopecia or AGA.

Androgenic Alopecia (AGA)

AGA (3) is a genetic cause of hair loss which is autosomal dominant with complete penetrance- meaning that some degree of hair loss will occur in all people carrying the gene for AGA. 

AGA occurs due to androgens (male hormones) and their effect on hair follicles sensitive to these male hormones. Androgens are present in both men and women but are only present in small amounts in women. Despite the small number of androgens in women,  hair follicles in women with AGA are sensitive to these males hormones- causing hair loss. AGA is more common in Caucasians.

Androgen levels in AGA can cause (R):

  • A shorter cycle of hair growth leading to hair loss
  • Growth of shorter, thinner hair strands causing hair to look thinner
  • Delays in new hair growth decreasing the replacement of lost hair with new hair.

Alopecia Areata

Alopecia areata (4) is an autoimmune disease, which occurs when the body’s own immune system mistakenly attacks healthy hair follicles and destroys them. In most cases, the damage is not permanent. 

However, the hair loss may be extensive if the onset is before puberty. When alopecia areata occurs, the missing patches usually grow back in 6 months to a year. 

In rare cases, people may lose all of the hair on their scalp and body, a condition called alopecia universalis.

Scarring Alopecia

Scarring alopecia (5) causes hair loss that is possibly permanent and irreversible. This hair loss is characterized by the destruction of hair follicles which are replaced by scar tissues. Scarring alopecia can be associated with other medical conditions, such as lupus.

Congenital Hypotrichosis

Congenital hypotrichosis (6) is a genetic condition or a defect that occurs when the embryo is developing. It is present at birth and people who suffer from this disease have no hair growth.

Hormonal Shifts

Low levels of thyroid hormones or thyroid hormone level imbalances within the body can cause a multitude of problems, including hair loss. Having healthy thyroid hormone levels is important for your hair as well as for your overall health.

During menopause, changing estrogen, progesterone, and testosterone levels can create imbalances where hair loss is accelerated and new hair growth is slowed.

Many women notice fuller hair during pregnancy due to hormonal changes that keep resting hairs from falling out as they normally would. After childbirth, when hormones suddenly shift, a sudden and sometimes alarming amount of hair may be lost all at one time. It may take up to 2 years for hair to return to normal without proper care and intervention.

Other hormonal causes of hair loss include hormonal shifts caused by birth control pills and Polycystic Ovarian Syndrome (PCOS)


Extreme stress, severe illness, major surgery or other dramatic events, can cause hair thinning or loss. This condition is known as telogen effluvium (7) and is characterized by hair follicles which stop growing and a sudden loss of hair. Luckily, the condition is totally reversible and hair growth is typically restored within 6 to 9 months.

Cancer Treatment

Anagen effluvium (8) is commonly associated with chemotherapy. Since chemotherapy targets your body’s rapidly dividing cancer cells, it also attacks the hair follicles in the growing (anagen) phase. Soon after chemotherapy begins approximately 90% or more of the hairs can fall out while hair is still in the anagen phase. Good news? Hair grows again as soon as the cancer treatment is over.

Hair Care & Styling

Certain hairstyles such as extensions, cornrows, or tight ponytails can irritate the scalp and cause hair loss in a condition called traction alopecia

Certain treatments such as hair dyes, chemical treatments, bad brushes, tight rollers, blow dryers, and flat irons can result in damage, breakage, and further hair loss. 

Removing the source of this irritation is critical because long-term use of these styles can cause scarring of the scalp and can lead to permanent hair loss.


This emotional/behavioral (9) condition causes a compulsive tendency to pull hair from the scalp, eyebrows, or eyelashes. Most of the hair-pulling tends to occur in selected areas causing patchy hair loss instead of diffuse hair loss. Hair loss due to this cause cannot be treated effectively until the psychological or emotional problems are addressed first.

Fungal Infections (Ringworm)

Ringworm (10) is a fungal infection that can affect the scalp, triggering a distinct pattern of hair loss that occurs in itchy, round patches. Bald areas can appear scaly and red. This condition is usually treated with antifungal medication. Family members should be checked when this condition occurs since the fungus is easily spread by direct contact.

Nutrition & Diet

Many women experiencing hair thinning or hair loss are often iron deficient. Replenishing the iron stores of balding patients increases their chances of hair growth in most cases, and stops hair loss in nearly every patient.

You may lose more than just weight with a crash diet. Many people noticed hair loss within 3-6 months after losing more than 15 pounds, especially in weight loss programs that don’t include proper nutrition and vitamin supplementation.


Birth control pills have a little known side effect in the form of a higher potential for hair loss in women with a family history of hair loss. Other medications linked to hair loss include blood thinners, aspirin, and medicines that treat high blood pressure, heart disease, arthritis, and depression.

Take Away Message

A variety of causes are behind female hair loss. Hormonal shifts, genetics, stress, diet, and medication are just a few of the triggers of hair loss in women. That is why it is important for women suffering from thinning or falling hair to undergo a comprehensive evaluation including medical and lifestyle evaluation to identify the chief complaint, determine root causes and rule out risk factors is undertaken. The Hair Loss program at Ruthie Harper MD evaluates ALL of the factors that lead to female hair loss and creates a customized and integrated approach that provides you with the most effective solution designed just for you

Please call our office if we can answer additional questions for you 512 343 9355.


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