Female pattern baldness (androgenetic alopecia) is the most common cause of hair loss in women, but there are many other potential causes. Various treatment options are available depending on the cause.

Women may experience different types of hair loss, including hair thinning, a widening part, or patchy hair loss (bald spots).

Several reasons can explain why women experience hair loss, including:

  • genetics
  • health conditions
  • hormonal changes
  • stress

Treatment options typically depend on the cause. They can also vary according to the pattern and location of hair loss. While most causes of hair loss are treatable, some may not be.

Language matters

We use the term “women” in this article to refer to those assigned female at birth, but we acknowledge that sex and gender exist on a spectrum.

The information in this article will also apply to you if you were assigned female at birth and have never had hormone therapy. Trans women and trans men who have had hormone therapy may have additional risk factors for hair loss not covered here.

Hair loss may present in different ways depending on the cause. You may notice sudden hair loss or a gradual thinning over time.

Key signs and symptoms of hair loss include:

  • Overall thinning: Gradual thinning on the top of the head is the most common type of hair loss. You may notice that your part gets wider.
  • Bald spots: Bald spots may be circular or patchy areas on your scalp with thinning or no hair. Your skin may feel itchy or painful immediately before the hair falls out.
  • Handfuls of hair: You may experience sudden hair loss, particularly after emotional or physical trauma. Your hair may come out in clumps while washing or brushing, leading to overall thinning.
  • Full loss: Medical treatments like chemotherapy may cause sudden and dramatic hair loss.

It can be helpful to keep a hair diary to track changes you notice or symptoms you experience. You can then use this diary to start a discussion with your doctor.

There are many causes of hair loss in women, including:

Androgenetic alopecia

Female-pattern baldness is the leading cause of hair loss in women. The medical term is androgenetic alopecia (alopecia meaning “hair loss”). It can also be called androgenic alopecia, but it’s the same condition.

Androgenetic alopecia causes the typical hair growth cycle to shorten. As a result, hair doesn’t grow as long or thick as it normally would.

This pattern of hair loss may appear as an overall thinning or a widening of your hair part. It occurs slowly over several months or years.

This condition can occur at any age after puberty, but it’s more common in postmenopausal women. Advancing age and a family history of the condition are two main risk factors.

Other types of alopecia include:

  • alopecia areata
  • cicatricial alopecia
  • traumatic alopecia
  • anagen effluvium (sometimes called chemotherapy-induced alopecia)

Telogen effluvium

Telogen effluvium (TE) is excessive hair shedding that leads to hair loss/alopecia. It is typically temporary.

Stress causes many hairs in the active hair growth (anagen) phase to abruptly enter the resting (telogen) phase.

When the hairs reenter the growth phase, the hairs suspended in the resting phase are suddenly released, causing shedding.

You can sometimes identify TE by looking at the strand. Telogen hairs have a bulb of keratin at the root.

TE is generally caused by stress or a shock to the body. For example, you may lose hair in the months after giving birth. But there are many other possible triggers, such as:

TE is typically reversible and often resolves 6 to 8 months after your body readjusts or the trigger is gone.

Chronic health conditions

Chronic health conditions that may lead to hair loss include:

Menopause and hormone imbalances

Hormonal changes of any kind, particularly decreasing estrogen levels, can temporarily disrupt the hair life cycle.

Women may experience hair loss during menopause due to slowed production of the hormones estrogen and progesterone.

Menopause can also lead to uncomfortable symptoms such as night sweats, weight gain, and vaginal dryness, which may raise your overall stress levels. This can also contribute to hair thinning or loss.

Some women may even notice hair growth changes after coming off hormonal birth control pills.

Hair loss can affect anyone. But some factors may make a woman more likely to experience hair loss:

  • Age: Hair loss becomes more common as you get older. With age, hair grows more slowly, and some follicles stop producing new hairs.
  • Family history: If you have an immediate family member (such as a parent or sibling) who experienced hair loss, then you’re more likely to have hair loss.
  • High stress levels: Stress and anxiety may also contribute to hair loss.
  • Medical conditions: Certain health conditions may increase your risk of hair loss.
  • Hair styles: Some hair styles, particularly tight ones, may contribute to hair loss over time.

Some hair loss caused by stress or hormonal changes, like pregnancy or menopause, may stop after your body adjusts, without treatment.

However, hair loss starting around menopause, like androgenetic alopecia, can worsen with time, so many women opt to treat it.

Any medical conditions that lead to hair loss should be treated directly to address the condition, not just its symptoms.

However, a number of possible medications and treatments are available to help treat the symptom of hair loss.

Minoxidil

Minoxidil is an over-the-counter (OTC) medication available in liquid and foam forms for topical use (at 2% and 5%) and oral capsules.

Only topical minoxidil is FDA approved for hair loss in women with androgenetic alopecia, not oral minoxidil or spironolactone, though dermatologists often use them.

A 2020 clinical trial showed that both low dose (1 milligram [mg]) oral formulation and the 5% topical formulation (1 milliliter [ml]) were associated with increased hair density after 6 months of use.

In the trial, oral minoxidil (1 mg) increased hair density by 12% and the 5% topical solution (1 ml) increased hair density by 7.2%.

Minoxidil is generally safe and well-tolerated in low doses for various causes of hair loss. But you should speak with your doctor first before trying it. You’ll need a prescription for oral minoxidil.

Spironolactone

Spironolactone (Aldalactone) treats hair loss by acting on hormones. Specifically, it binds to androgen receptors and decreases your body’s processing of testosterone.

A 2020 study looked at women who had been taking spironolactone daily (doses ranged from 25 to 200 mg).

Twenty-nine of the 45 participants who used it for more than 6 months saw the most improvement at 1 year or longer. Those who began the trial with more pronounced hair loss benefited most from the medication.

However, not all researchers agree that spironolactone works for hair loss. The Food and Drug Administration (FDA) has not approved it as a treatment for androgenetic alopecia.

Nevertheless, the medication is still used off-label. But you’ll need a prescription from your doctor first.

More research is needed before definitive claims can be made regarding its effectiveness.

Corticosteroids

If you have hair loss due to alopecia areata, your doctor may consider treating you with corticosteroids, which help reduce inflammation. You can either apply this medication to your scalp or have it injected into the affected area.

People with alopecia areata may also benefit from immunosuppressive medications like methotrexate. Methotrexate is typically given in combination with low dose corticosteroids.

While a very low percentage of patients who take methotrexate for autoimmune disorders experience hair loss, it isn’t a common side effect of the medication.

Surgery

In hair transplant surgery, pieces of your scalp tissue with attached hair are typically taken from one area of your scalp and moved to areas of baldness.

This technique is considered a dependable approach to addressing alopecia. But it’s not without risks, including infection or shock that may cause hair to fall out of the transplanted areas.

Insurance plans typically don’t cover hair transplants, and the cost (often thousands of dollars) may be a barrier.

Finasteride

Finasteride (Propecia, Proscar) is FDA approved to treat hair loss in men but not women. Doctors may sometimes prescribe it off-label to women who don’t plan on having children in the future.

Finasteride blocks 5 alpha-reductase, preventing testosterone from becoming dihydrotestosterone (DHT), the androgen responsible for male pattern baldness.

Other treatments

Doctors may sometimes prescribe other treatments off-label to reduce hair loss in women:

JAK inhibitors are a newer treatment approved to treat severe alopecia areata. They include Olumiant (baricitinib), Litfulo (ritlecitinib), and Leqselvi (deuruxolitinib).

Your hair falls out naturally all the time. It’s expected that most people lose between 50 and 100 hairs a day.

That said, reach out to a doctor or dermatologist if you notice:

  • hair falling out in clumps (may be evident in your brush, on your pillowcase, or in the shower drain)
  • hair that doesn’t seem to be growing as fast as it once did
  • sudden hair loss
  • thinning hair
  • a widening part
  • patchy hair loss or bald spots
  • other symptoms like fever, pain, or fatigue

The most common cause of hair loss in women is female-patterned baldness (androgenetic alopecia), but several other causes exist.

OTC medications may help reduce hair loss and promote growth. Other types of hair loss may involve treating the underlying cause.

Speak with a doctor about any troubling hair loss, shedding, or thinning you may be experiencing. Your doctor can help determine the cause of your symptoms and put together a treatment plan.