On average, a man’s production of testosterone decreases by about 1–2% each year [1] after around 30 years old. For some, low levels of testosterone can have a range of physical impacts, including low bone density, reduced muscle strength, erectile dysfunction and low sex drive.
As a result, many men turn to testosterone replacement therapy (TRT) to alleviate these symptoms. However, testosterone — and its metabolite, dihydrotestosterone (DHT) — are closely linked with male pattern hair loss [1]. So does TRT cause hair loss — and if so, how can you combat this?
Here’s everything you need to know about how TRT can affect your hair, and what to do if you’re experiencing hair loss following testosterone replacement therapy.
Testosterone replacement therapy is a treatment that involves increasing your testosterone levels as your body begins to produce less of its own. The hormone is administered via an injection, gel patch or oral pill, increasing your levels to counteract the side effects of decreased testosterone as you age.
Studies have shown that TRT has the ability to increase muscle strength, boost sperm count, and improve a man’s sexual function [2]. Most men who choose to go through TRT do so later in life when the effects of low testosterone are more noticeable.
Common symptoms of low testosterone in men include the following:
Testosterone is the hormone primarily responsible for a man’s sex drive, sperm production, body hair growth, facial hair, and muscle mass. While women also produce testosterone, men produce it in far larger quantities.
Testosterone can also affect your hair. Around 10% of the testosterone produced by the body metabolises and becomes DHT, which causes the majority of pattern hair loss in both men (in the form of male pattern baldness) and women (in the form of female pattern hair loss) [1, 3].
As a result, the higher your testosterone levels, the more DHT you produce. This is part of the theory behind the myth that masturbation causes hair loss. Since men produce more DHT than women, they’re at higher risk of experiencing male androgenetic alopecia (male pattern baldness).
DHT is produced when an enzyme in the body known as a 5-alpha reductase converts a small amount of testosterone into DHT. DHT conversion happens in various areas of the body including the hair follicles.
DHT can trigger hair loss in individuals who are genetically predisposed to androgenetic alopecia. Unfortunately, individuals with male androgenic alopecia (male pattern baldness) have hair follicles which are especially sensitive to DHT which binds to androgen receptors in the hair follicles. This in turn disrupts the normal hair growth cycle causing the hair follicle to spend less time in the anagen (growth) phase.
As testosterone replacement therapy increases testosterone levels, it may put you at greater risk of hair loss. However, some research suggests that it’s actually your hair follicles’ sensitivity to the hormone, rather than the amount of DHT itself, that causes hair loss [4]. So you shouldn’t let this potential risk stop you from getting the men’s hair loss treatment you need.
In women, research suggests testosterone therapy can actually enhance hair growth for those who are testosterone-deficient [5]. In men, this is unlikely to be the case, but the benefits of testosterone treatment may still outweigh the risks to your hair, so it’s important to consult with your doctor if you’re concerned.
It’s also difficult to tell how your hair will react to the testosterone therapy. DHT can metabolise further into other hormones, which may help you avoid losing hair. You should also remember that there are many effective hair loss treatments, so even if you do see greater hair loss, you may be able to slow the impact and/or restore your hair.
If you have started to lose your hair after TRT, or you just want to explore your hair restoration options, there are a few different treatments to consider.
Finasteride and Dutasteride are drugs that are designed to stop your body from converting testosterone to DHT. These drugs are known as 5α-reductase inhibitors and work by inhibiting the enzyme that stimulates metabolism — so these are often the best ways to prevent hair loss following TRT.
Research suggests Finasteride can reduce DHT production by 70-90%, while Dutasteride can reduce it by a huge 99% [6]. These drugs are available on prescription only, so speak to a trichologist to see if you’re eligible for these treatments.
Other hair loss drugs like Minoxidil are also proven to reduce hair thinning and hair loss, helping you extend the hair growth cycle of your existing hair.
Minoxidil works by acting as a vasodilator, winding the blood vessels in the scalp and improving blood flow. As a result, hair follicles receive more nutrients and oxygen which help to stimulate hair growth.
There are a variety of alternative treatments for hair loss available. These can include treatments such as:
It should be noted that these treatments for hair loss are particularly effective in the early stages of hair loss. If hair loss is advanced, surgical intervention in the form of a hair transplant is recommended to restore hair if it’s not too late for a hair transplant.
For advanced hair loss, you can also restore your hair with an FUT or FUE hair transplant. These procedures involve taking healthy hair follicles that are less susceptible to pattern hair loss from one area of the body (usually from somewhere on the scalp where there is no balding) and transplanting them into areas of hair loss and/or hair thinning.
FUT hair transplants involve surgically removing a strip of hair follicles, dissecting them into individual hair grafts then implanting them into areas of hair loss.
FUE hair transplants on the other hand, meticulously remove healthy hair follicles individually and then implant them into areas of hair loss.
It should be noted that both hair transplant techniques produce natural-looking results. Take a look at our gallery page to see for yourself the hair restoration results from each type of hair transplant technique.
If you are considering getting a hair transplant and want to know which technique is better for you, speak with a trichologist about your options.
If you’re concerned about hair loss following testosterone replacement therapy, our professional trichologists can help you restore your hair. We can assess your hair loss and provide prescriptions for finasteride and dutasteride if you’re eligible.
No matter what the cause of your hair loss is, our team can discuss your current state of hair loss with you to establish the best possible treatment plan. Book your free consultation at the Wimpole Clinic to find out more.
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