Bernstein Medical Center for Hair Restoration - Androgens

Androgens

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Q: I have read several articles on the internet which suggest that resistance training can accelerate male pattern baldness. Is there any truth in this? –B.F., Altherton, CA

A: Anything that raises androgen levels in your body can potentially accelerate hair loss. That said, I suggest that you should exercise as you normally would. As long as you don’t take drugs to enhance your workout, the effects should be minimal.

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A study published in the British Journal of Dermatology suggests that subcutaneous placement of testosterone pellets may boost hair regrowth in some women. ((Glaser RL, Dimitrakakis C, Messenger AG. Improvement in scalp hair growth in androgen-deficient women treated with testosterone: a questionnaire study. Br J Dermatol. 2012 Feb;166(2):274-8.))

This retrospective analysis examined patients who had androgen deficiency. Of the 285 patients studied, 76 had some degree of hair loss prior to beginning treatment. At one year on testosterone replacement 63% reported an increase in hair regrowth on the scalp.

Traditionally, elevated levels of androgens, such as testosterone, are felt to be the primary cause for common hair loss in both men and women. This is due to the seemingly adverse effect of androgens on hair follicles. This has held true for most men with patterned hair loss in whom DHT-blockers, such as Propecia (finasteride) and Avodart (dutasteride), have proven to be a potent remedy.

Given this, it was surprising that none of the 285 women in the study who had been treated with testosterone reported any hair loss after one year. In fact, of the 76 women who initially reported hair loss before the study, 63% reported positive hair regrowth at one year.

The researchers noted that patients with a “significantly higher body mass index (BMI)” were in the subset of those who did not regrow any hair. This suggests that a higher dose might be needed in some patients. ((Kapp N1, Abitbol JL2, Mathé H2, Scherrer B2, Guillard H2, Gainer E2, Ulmann A2. Effect of body weight and BMI on the efficacy of levonorgestrel emergency contraception. Contraceotion. 2015 Feb;91(2):97-104. doi: 10.1016/j.contraception.2014.11.001. Epub 2014 Nov 8.)), ((Lopez LM, Grimes DA, Chen M, Otterness C, Westhoff C, Edelman A, Helmerhorst FM. Hormonal contraceptives for contraception in overweight or obese women. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD008452. DOI: 10.1002/14651858.CD008452.pub3)), ((Glasier A, Cameron ST, Blithe D, Scherrer B, Mathe H, Levy D, Gainer E, Ulmann A. Can we identify women at risk of pregnancy despite using emergency contraception? Data from randomized trials of ulipristal acetate and levonorgestrel. Contraception. 2011 Oct;84(4):363-7. doi: 10.1016/j.contraception.2011.02.009. Epub 2011 Apr 2.))

Summary

By correlating higher levels of testosterone with more hair growth and/or retention in women, the study bolsters the idea that hair loss in men and women is caused by different mechanisms. Though not conclusive, the study opens the idea that testosterone implantation can effectively treat hair loss in women.

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A study of Australian men between the ages of 40 and 69 suggests that men who were mostly bald by the age of 40 were more likely to develop prostate cancer in their 50s or 60s. The Melbourne Collaborative Cohort study of about 10,000 men showed that men who have high levels of testosterone may be more vulnerable to cancerous prostate tumors.

The team of scientists that conducted the long-term study, which was published in the journal Cancer Epidemiology, Biomarkers and Prevention, reported that both baldness and prostate cancer are age-related and androgen dependent conditions, so these findings are not surprising. The statement said, “We found that baldness at the age of 40 might be a marker of increased risk of prostate cancer.”

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Q: Dr. Bernstein, a lot of older women are taking testosterone to restore libido, but are they going to experience hair loss as a consequence?

A: They can. In women there is a delicate balance between the androgens, i.e. testosterone and estrogens. Estrogen is protective to some degree against hair loss in women, which is why most women don’t experience such severe hair loss as do men.

When a woman takes testosterone supplements it upsets that balance and can cause hair loss. However, hair loss in post-menopausal women is usually due to age related changes. Typically, the hair decreases in size in a genetically determined progression that seems not to be directly related to changes in the levels of hormones.

For more information, please see the Causes of Hair Loss in Women page on the Bernstein Medical – Center for Hair Restoration website.

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Q: Will the shock of a hair transplant make me lose my existing healthy hair and is it permanent? G.S. – Westport, C.T.

A: In general, only miniaturized hair (the hair that is affected by androgens and that has begun to decrease in diameter) is shed after a transplant. This hair would be lost in the near term anyway.

Existing healthy hair is unlikely to shed, but if it were shed, you could expect it to grow back.

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