I explained to Emily that The Iowa Writers’ Workshop wasn’t really in the business of handing out medical degrees, but that since my hair was also thinning, and since I was curious, and since I supposed we weren’t the only two women on the planet who wanted some answers, I’d do some research. This is what I came up with for how to handle hair loss during perimenopause.
Symptoms of hair loss include hair loss in patches usually in circular patterns, dandruff, skin lesions, and scarring. Alopecia areata (mild – medium level) usually shows in unusual hair loss areas, e.g., eyebrows, backside of the head or above the ears, areas the male pattern baldness usually does not affect. In male-pattern hair loss, loss and thinning begin at the temples and the crown and hair either thins out or falls out. Female-pattern hair loss occurs at the frontal and parietal.
Hair transplantation may help IF the woman has enough donor hair. So far the only way we do hair transplant is to take hair from one area of the scalp – usually at the back, near the nape of the neck, and move some of that hair to the thinning areas. Women however, don’t lose in the pattern as men do and have thick hair still in the back. While we may lose in a pattern--widening part--we also thin diffusely, over all our scalp. So hair transplant might not be right for everyone. Again, this is a discussion with a dermatologist and a hair transplant surgeon. But have realistic expectations of what it can and cannot accomplish. I go into this at length in my book.
Hi Will, my hairline has been receding since the age of 17. I’m 21 now and my hairline has receded worse, and I feel so bad at how I look that I barely communicate with people anymore 🙁 I want to know if excessive masturbation could have anything to do with my hairloss, but its supposedly a myth?! Is there any info you can share on this topic, Will?
In males over 60, androgen receptor and aromatase levels were low and comparable in scalp with and without thinning in both frontal and occipital regions. The 5a -reductase type 1 and 2 levels were only slightly higher in males with thinning hair in both frontal and occipital regions, but the differences were not significant. Histologic and hormonal findings suggest that senescent thinning is a diffuse process that is histologically similar to Androgenetic Alopecia, but hormonally different and may not be entirely androgen dependent. 

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As the name suggests, androgenetic alopecia involves the action of the hormones called androgens, which are essential for normal male sexual development and have other important functions in both sexes, including sex drive and regulation of hair growth. The condition may be inherited and involve several different genes. It can also result from an underlying endocrine condition, such as overproduction of androgen or an androgen-secreting tumor on the ovary, pituitary, or adrenal gland. In either case, the alopecia is likely related to increased androgen activity. But unlike androgenetic alopecia in men, in women the precise role of androgens is harder to determine. On the chance that an androgen-secreting tumor is involved, it's important to measure androgen levels in women with clear female pattern hair loss.

The directions say patients will see an improvement in hair growth in six weeks, but Dr. Mirmirani suggested trying it for six months before deciding whether it works or not. About a third of patients who use it see significant improvements, another third find it prevents hair loss from getting worse, and the remainder don’t see any effect, she said.
There's a chance you're genetically predisposed to hair thinning, which means you may see a progressive, gradual reduction in hair volume. "In these instances, certain hair follicles are sensitive to male hormones – and this sensitivity causes follicles to gradually shrink and produce slightly finer and shorter hairs with each passing hair growth cycle." Explains Anabel.
Although it’s generally only prescribed as a last resort for menopausal symptoms, hormone replacement therapy is a common and very effective hair loss treatment for some women — as long as they are menopausal or post-menopausal and are not at higher risk for adverse effects from HRT. It's most often prescribed for women who have androgenetic alopecia, also called pattern baldness. Hormone replacement therapy has a number of benefits for both general health and symptom management, but also a number of side effects — which range from unpleasant to dangerous.
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