Hormonal imbalance. Hair loss during menopause and perimenopause is common due to declining estrogen levels. As estrogen levels fall, the resulting imbalance between estrogen and testosterone can cause thinning hair on certain areas of the head that are sensitive to androgens, commonly referred to as male pattern baldness. The same imbalance can also contribute to unwanted hair growth on the chin and face.
I took your quiz. Sadly, the answers I gave were as of my early 20s, when my hairline started receding and had that ‘M shape’. I receded to Norwood 3, but mysteriously, the receding stopped there. The only explanation I can think of is that I gave up junk food and started eating more fresh fruit and veggies and started regular running and hiking. I lost a lot of weight and felt great. Until my early 50s, when suddenly my hair began to rapidly recede and I developed a bald spot in back. I panicked, thinking that I might have a serious medical condition, since I had not changed my good living habits. My doctor reassured me that I was still very healthy. Next stop: hair restoration specialist. He informed me that I had male pattern baldness and would eventually go completely bald on top. To my surprise and delight, my wife was thrilled that I was going bald and begged me to just let nature take its course. She confessed to me that she had always secretly wished that I would someday go bald and was delighted that her wish was finally coming true. Reluctantly, I agreed to just let myself go bald. Two things amaze me: First, how fast I went bald (less than two years to go completely bald on top). It was as if I was making up for lost time. Secondly, the sudden change in my attitude. Whereas I was panicked my wife would hate it, now thanks largely to her encouragement, I couldn’t go bald fast enough. It was a huge turn of for my wife and me. She still loves to sneak up behind me while I’m relaxing watching TV news or sports and kiss me on top of my bald head. I haven’t just adjusted to being bald. I really love being bald and wouldn’t ever try to regrow my hair. Not at my age. I’m in my 70s and it is quite normal for someone my age to be bald. The information you email to me I will pass on to my two sons, who, like me, face the likelyhood that they will eventually go bald. They are in their mid 30s and their hairlines are beginning to recede a little at their temples. I chose to go bald. They don’t have to. Oh, a third thing amazes me: that there are women out there who prefer bald men to men with a full head of hair. Thank God I am married to one of those women. 

Ever since I was around 13, I've had bad dandruff and a dry scalp, and thus, have created bad habits of scratching my scalp a lot. Recently, I've stopped, as I don't want to lose any more hair, I use Head and Shoulders, and a tar based shampoo, I also put coconut oil on my scalp now. I would like to know if dandruff, dry scalp, and itching can cause balding, and if so, is it temporary, the... READ MORE
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Senescent thinning was indistinguishable from androgenetic alopecia in older males. Inflammatory changes were not a significant feature. Biochemical analysis for androgen receptors, 5 -reductase type 1 and 2, and aromatase, in scalp biopsies from older males showed nearly a two fold decrease in levels compared to levels in young males with Androgenetic Alopecia.
According to psychologist Dr. Ana Fonseca, “For women, self-esteem and self-concept are the reflex of social influence, which can act as a source of conflict and misfit, with repercussions on body image and health. The relationship with the hair often includes anxiety about its general condition, if it’s thinning and falling out, or going gray. Hair is valued in connection with beauty and femininity, sexuality and attractiveness, so when losing it, people are affected negatively in their self-esteem and self-image. Hair loss threatens our vanity, how much we value ourselves and is usually seen as unattractive and often associated with being unwell or aging. It is recognized that there are also emotional factors associated with hair loss so it can mean psychological discomfort.”
Dietary supplements are not typically recommended.[30] There is only one small trial of saw palmetto which shows tentative benefit in those with mild to moderate androgenetic alopecia.[30] There is no evidence for biotin.[30] Evidence for most other produces is also insufficient.[37] There was no good evidence for gingko, aloe vera, ginseng, bergamot, hibiscus, or sorphora as of 2011.[37]

In men, finasteride (originally marketed as Proscar) is approved for hair loss associated with androgens. In one study, 62% of women also taking oral contraceptives containing the synthetic progestin drospirenone reported improvement. So it may be effective for female hair loss in the setting of increased androgen. But studies are limited and it is harmful to the male fetus so should not be used by women thinking about becoming pregnant or who are pregnant.

It’s good to know that hair loss is a hereditary thing. My husband’s father has hair that is thinning out quickly, so I imagine that my husband will have a similar problem in the future. If that’s the case, then I should probably look into some preventative treatments to help him out. After all, the last thing I want is for my husband to start balding at age 40!
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