So far, more research is needed to determine the safety and efficiency of saw palmetto for women with female pattern baldness. Since 55% of women experience hair loss during their lifetime [1], it is normal to seek effective natural remedies and this plant extract can look promising. That is because it contains compounds that may be natural DHT blockers, and it has shown positive results in curbing male pattern baldness, likely through the same mechanism as popular hair loss treatments Finasteride and Dutasteride [2].
However, these medications are not recommended for premenopausal women because they can cause foetal malformations and hormonal imbalances [3]. It is unclear at this time whether this also applies to saw palmetto, but premenopausal women are generally advised against taking it, as a precaution [4]. That may be why no specific studies have been conducted to test the effectiveness of this plant extract on female pattern baldness.
If you are interested in the best hair loss treatments for women, there are safe and proven alternatives to saw palmetto that you can try. Some of the most effective ones include Minoxidil, rosemary oil for hair growth, derma rolling for hair growth or red light therapy for hair growth.
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Saw palmetto (Serenoa repens) is a species of dwarf palm tree often found in the West Indies Islands, but also the Southeastern U.S.A. Traditionally, the indigenous population prepared extracts of its fruit to use as natural remedies against infections, inflammation, pulmonary, digestive, urinary, sexual and reproductive issues [5][6]
Today, there is a special interest taken in saw palmetto extract for its promising effects against prostate enlargement and male lower urinary tract symptoms. Recent studies show that it could provide an effective alternative to conventional medication in mild-to-moderate forms of these conditions [7][8].
At this time, there is insufficient evidence to confidently say we understand how saw palmetto works against hair loss. However, it is hypothesised that some of its components (certain phytosterols and fatty acids) can inhibit the activity of an enzyme called 5- alpha-reductase [2][6]. This enzyme transforms some of your testosterone into a different androgen hormone called dihydrotestosterone (DHT).
If you are experiencing androgenetic alopecia, it means you have too much DHT in your blood, which binds to androgen receptors in your hair follicles. This causes them to shrink and produce smaller, finer hair until they stop producing any strands at all [9]. So what saw palmetto does is play a role in decreasing the amount of DHT that your body produces, thus curbing your hair shedding.
Some small clinical studies have shown that while saw palmetto isn’t as effective as Finasteride, it can reduce hair loss and increase hair density in patients with male pattern baldness. However, only very few saw palmetto clinical trials included female participants. The ones which did report promising results, but this is while using combinations of this plant extract and many other ingredients that could affect hair growth, such as curcumin, castor oil, phytosterols from pine extract, wheat germ oil, etc [10][11].
For example, one study performed on 40 women with hair thinning reports that a proprietary formula containing saw palmetto showed a 10.8% increase in hair count after 6 months of treatment. However, the formula they used contained 20 other ingredients besides saw palmetto [12][13].
The combination of active ingredients used in these clinical trials, along with their small sample sizes and various methodological flaws [14] make it difficult to assess the effect of saw palmetto on female pattern baldness.
There is presently only one available clinical trial which included female participants treated with only a standardised saw palmetto oil, with no other added substances. However, its sample was comprised of both men and women and the authors failed to specify the male-to-female ratio or any gendered differences in their results.
All that is revealed is that there were 80 participants in total (half of them representing the control group), with mild to moderate androgenetic alopecia. After 16 weeks of treatment, participants who received oral saw palmetto oil experienced a 29% improvement in hair shedding and a 5.17% increase in hair density, while those who received topical saw palmetto experienced 22.19% less hair loss and 7.61% greater hair density.
This saw palmetto data insufficiency is not surprising, considering that at this time, there is not enough evidence to prove the efficacy of 5-alpha-reductase inhibitors in general against female pattern hair loss [15][16]. While some of the existing data is encouraging, clinical trials with female participants are few and their findings can be contradictory.
So far, no specific studies have been performed to test the safety of saw palmetto on pre-menopausal, pregnant or breastfeeding women. The few clinical trials performed on female participants reported no side effects [17][12]. However, it must be kept in mind that in most cases, the women included in the samples were post-menopausal and/or the saw palmetto was used in small quantities, mixed with other ingredients.
Researchers warn that since it likely works by reducing the DHT levels in your blood, “this plant may cause irreversible damage to the fetus or lead to miscarriage” [6] and it is thus contraindicated to women who may become pregnant [4]. It is also believed that saw palmetto may make oral contraceptives less effective, increasing the risk of unplanned pregnancy [18].
Studies conducted on men show that this plant extract is normally safe, as patients experienced very few and minor side effects. These include abdominal pain, diarrhoea, nausea, fatigue, dizziness, headaches, decreased libido, or rhinitis [19][6]. The rates of these reported saw palmetto side effects were similar to those experienced by people in the placebo group.
It must be taken into consideration that the small sample sizes used in saw palmetto studies can be insufficient to fully explore its potential side effects in the general population.
If you are experiencing hair loss, there are several treatments which have been scientifically tested and have proven themselves safe and effective for women. Here are some of the best choices:
This is the most recommended hair loss treatment for women and it yields very good results in female pattern hair loss, but can also help treat other conditions, such as telogen effluvium or alopecia areata [20]. It works by dilating the blood vessels in your scalp, allowing increased blood flow to reach your hair follicles. The additional oxygen and nutrients can help your hair grow thicker and improve its density.
Choosing a good diluted rosemary oil blend can help reduce your hair loss and increase its density. That is why it is known as one of the best essential oils for hair growth. Research shows that it can be as effective as Minoxidil in treating androgenetic alopecia [21]. And since it is used topically on your scalp, there is no risk of systemic side effects.
Pumpkin seed oil is another excellent hair growth oil option. Studies performed on women with female pattern hair loss show that applying it topically can produce an increase in hair regrowth and a decrease in strand miniaturisation after only 3 months of constant use [22].
This form of low-level laser therapy involves using focused beams of red or near-infrared light to increase mitochondrial activity in your cells and increase the amount of energy that reaches your hair follicles. Research shows that this therapy can improve several types of alopecia, such as female pattern hair loss, telogen effluvium, alopecia areata and chemotherapy hair loss [23][24][25]. You can even get it comfortably in your own home, using a laser hair growth cap to regrow your hair.
One study shows this kind of device can produce a 51% increase in hair count for women with female pattern hair loss after only 17 weeks of daily 30-minute sessions [26].
Also known as microneedling, this therapy involves using a small tool covered in fine needles to create microscopic wounds in your scalp. While this is not painful, it triggers your body’s healing process, stimulating your follicles for hair growth [27]. Moreover, using Minoxidil and a derma roller together can enhance both their effects, as microneedling increases the absorption rate of topical Minoxidil [28].
However, the best way to make sure you are getting the right treatment for your specific hair loss problems is to book a consultation with a trichologist. They will examine your scalp and hair and perform all the necessary tests (e.g. a dermoscopy, a scalp biopsy or blood tests for hair loss) to determine the exact reason your hair is falling out. Then, they will make personalised recommendations based on your condition, needs and preferences.
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