Mechanism of Genetic Hair Loss in Women

As with loss of hair in men, women genetic hair fall largely stems from a complex stew of genes, hormones and age. However, in female there are even more players. In addition to 5-a reductase, testosterone, and dihydrotestosterone (DHT); which are also found in men’s hair loss; also current in women are the enzyme aromatase and the women hormones estrone and estradiol. So let’s break down the process that leads to common hair shedding in women.

In both men and women, 5-a reductase reacts with testosterone to produce DHT, the hormone responsible for the shrinking and gradual disappearance of concerned hair follicles. This explains why both men and women lose their hair. But one of this reasons why women rarely have the conspicuous bald areas that men do is because women naturally have only half the amount of 5-a reductase compared to men.

Adding to this complexity, in women, the enzyme aromatase is responsible for the formation of the women hormones, estrone and estradiol, counteract the action of DHT. Female have higher levels of aromatase than men, especially at the frontal hairline. It is this existence of aromatase which may help explain why hair loss in women looks so different than in men, particularly with respect to the preservation of the frontal hairline. It may also explain why women have a poor response to the drug finasteride (Propecia), a medication widely used to treat hair loss in men that works by blocking the formation of DHT.

The following is a schematic graph of how the female hormones estrone and estradiol are produced and their relationship to DHT:

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