Male pattern baldness, also known as androgenetic alopecia, affects approximately 85% of men by the age of 50 [1]. It can present as widespread thinning, balding around the crown, and a receding hairline, often drastically changing men’s appearance.
While the primary culprit behind this form of hair loss is the hormone dihydrotestosterone (DHT), emerging research suggests that oestrogen also may play a crucial role in the development and progression of male pattern baldness.
While oestrogen is not currently a viable treatment for male pattern baldness, this article aims to delve into the intricate relationship between oestrogen and hair loss, exploring the scientific evidence, potential mechanisms, and treatment implications.
Discussion around male hair loss mainly focuses on testosterone, the male sex hormone. However, for both men and women, the opposite sex hormone exists in small quantities in the body – small amounts of testosterone in women, and oestrogen in men. How this oestrogen interacts with the hair growth and hair loss process is still not understood, but research and theories are beginning to develop.
Many of these ideas are based on initial studies into female pattern baldness and hormones – the drop in oestrogen following menopause or childbirth, for example, commonly leads women to develop female pattern baldness.
However, unlike women, men do not suffer from significant increases or decreases in their male sex hormones across their lives. While ‘male menopause’, also known as andropause, is often mentioned in health discussions, this is not a significant hormonal change like female menopause.
Instead, men experience a steady, gradual decline in testosterone over their lives. By the time most men reach 40 years old, their testosterone will only decrease around 1% per year as they age (although this can vary according to individual physiology) [2].
While studies remain very limited, and many conclusions are theoretical only at this time, the female sex hormone is hypothesised to affect hair growth in two important ways:
The main cause of male pattern baldness and female pattern baldness is DHT or dihydrotestosterone. A derivative of testosterone, DHT binds to androgen receptors within hair follicles, causing them to shrink and stop growing hair.
While DHT exists within everyone, male pattern baldness comes down to your individual sensitivity to the DHT hormone, which in turn is decided by genetics.
Side note: It’s a myth that bald men are more virile because they have more testosterone, which causes the hair loss. Studies have shown that hair loss is caused by your sensitivity to DHT, not the amount of testosterone [3].
Oestrogen is known to have an inhibiting effect on the production of androgens, a group of hormones which includes testosterone and DHT [4]. By reducing the production of androgens, oestrogen can limit the amount of DHT produced, which, in theory, lessens how many hair follicles are affected.
This idea can be seen in practise through the correlation between female balding and hormonal cycles as women with lower oestrogen levels during menopause or postpartum are more likely to develop female pattern hair loss.
Research has also shown that oestrogen promotes hair growth by extending the anagen (growth) phase of the hair cycle, thus prolonging the period of active hair production [5]. This is why many women believe that they lose hair after giving birth, as the increased oestrogen has caused the hair to grow for longer than usual.
After childbirth, with the return to normal levels of oestrogen, the hair naturally shifts into the telogen (resting) phase and reverts to normal growth and shedding cycles.
Oestrogen also enhances the size and thickness of hair follicles, resulting in fuller and healthier hair. Oestrogen achieves these effects by modulating the expression of various genes and signalling pathways involved in hair follicle development and function [6]. However, this has only been observed through studies involving combined oral contraceptive drugs, which contain oestrogen and progestogen [7].
While it may seem counterintuitive, studies have found that oestrogen can exert both protective and detrimental effects on hair follicles in men. On one hand, oestrogen can antagonize the conversion of testosterone into DHT by inhibiting the production of androgens.
On the other hand, oestrogen’s influence on hair follicles can be complex. Some research suggests that high levels of oestrogen can have an inhibitory effect on hair growth, potentially contributing to hair loss. In men with conditions such as liver disease or obesity, which can lead to increased oestrogen levels, the risk of male pattern baldness may be heightened.
For men, too much oestrogen can have severe negative impacts. Men with a hormonal imbalance may suffer from infertility or erectile dysfunction. Therefore, oestrogen is not an effective treatment for male pattern baldness.
Several options exist for men who wish to treat or even reverse their male pattern baldness, depending on the severity of their condition.
Topical treatments include Finasteride and Minoxidil. Finasteride reduces hair loss by inhibiting 5-alpha reductase, the enzyme which converts testosterone into DHT. Minoxidil works as a vasodilator on the scalp, helping more nutrients reach the hair follicle.
Both are FDA-approved treatments for hair loss, and studies have shown their effectiveness. Considering the potential role of oestrogen in hair loss, future treatment approaches could explore combination therapies that simultaneously address DHT and oestrogen activity.
More intensive options include micropigmentation to tattoo over balding areas, or hair transplants in case of extensive balding. For more information, read our clinic reviews, or check out the before and after gallery.
Understanding the relationship between oestrogen and male pattern baldness opens up new possibilities for treatment interventions. However, research so far indicates that oestrogen is not an effective treatment for male pattern baldness as hormonal imbalances can have wide-ranging, negative effects on male physiology.
Instead, men looking for solutions to their hair loss or hair thinning should consider topical treatments like Finasteride, or non-hormonal options like Minoxidil. In cases of extensive or permanent balding, the best option to restore your appearance may be a hair transplant. For more individual advice, book a free consultation with us.
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