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Ask the Medical Expert Archives 2000-2004

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Noticible Hair Loss
October 2000

Q. Beginning around June of this year, I began noticing that I was shedding a lot more hair than I had in the past. My hair went from dry to oily, I went from washing it two times per week to washing it daily, or every other day. I also noticed an increase in facial hair and oiliness of my face. Now, 2 months later, my hair is noticeably thinning - my scalp is now visible (it has never been before). I am a 45-year-old menopausal female and have had a complete hystorectomy/including ovaries. I have consulted my family physician regarding this condition and he told me that it was probably stress related. However, because I am presently on Estratest, I am concerned that I may have a significant hormone imbalance (possibly androgen excess, or not enough progesterone?) Is there any way that I can find out if this is the case and if so can my hair loss be stopped and/or reversed?

A. Your question raises several concerns. While hair loss in men is quite familiar and a subject of conversation, it is frequent among women as well. In women over age 60, around half will have some general thinning of the hair, but rarely the hair loss at the temples seen in men.

In your case, the hair loss is accompanied by other symptoms, oily skin and facial hair, that suggest excess androgens, the male hormones that are present to a lesser degree in women. This should be evaluated thoroughly by an endocrinologist who specializes in this area to determine the underlying cause, of which there are many possibilities. After this evaluation to determine the cause, various treatment possibilities can be determined.

MEDICAL REFERENCES (usually available through the library of your local hospital):

Norwood OT, Lehr B.
Female androgenetic alopecia: a separate entity.
Dermatol Surg. 2000 Jul;26(7):679-82.

Sawaya ME, Shapiro J.
Androgenetic alopecia. New approved and unapproved treatments.
Dermatol Clin. 2000 Jan;18(1):47-61, viii. Review.

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