Does Testosterone Replacement Therapy (TRT) cause hair loss?

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. But testosterone — and its metabolite, dihydrotestosterone (DHT) — are closely linked with hair loss [1]. So can 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.

What is 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.

Is there a link between testosterone levels and hair loss?

Testosterone is the hormone primarily responsible for a man’s sex drive, sperm production, 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 and women [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. Because men produce more DHT than women, they’re at higher risk of experiencing pattern baldness.

Can TRT cause hair loss?

Because 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 body’s 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 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 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 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 restoration treatments, so even if you do see greater hair loss, you may be able to slow the impact and/or restore your hair.

How to manage hair loss after testosterone replacement therapy

If you have started to lose your hair after TRT, or you just want to explore your future options, there are a few different treatments to consider.

Finasteride and dutasteride are drugs that are designed to stop your body converting testosterone to DHT. They 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 (learn more about Minoxidil’s Uses, Results & Side Effects) are also proven to reduce hair loss, helping you extend the growth cycle of your existing hair. Alternative treatments like vitamin therapy, medicated shampoos, and laser therapy can also reduce hair loss, particularly in the early stages. For advanced hair loss, you can also restore your hair with an FUT or FUE hair transplant.

Book a consultation

If you’re concerned about hair loss following TRT treatment, 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, 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.

Sources:

1. What You Need to Know About DHT and Hair Loss
2. Testosterone Treatments: Why, When, and How?
3. Assessment of the usefulness of dihydrotestosterone in the diagnostics of patients with androgenetic alopecia
4. Sex Hormones and Hair Loss in Men From the General Population of Northeastern Germany
5. Improvement in scalp hair growth in androgen-deficient women treated with testosterone: a questionnaire study
6. Finasteride