Does Testosterone Replacement Therapy Cause Hair Loss?
Does Testosterone replacement therapy cause hair loss? That is a common question. Testosterone replacement therapy (TRT) is becoming more popular (it seems) every day. Testosterone replacement therapy in the year 2023 is a safe and time-tested treatment. Prospective patients are assessed before beginning TRT and regularly at least once yearly while under treatment. There are potential side effects of testosterone replacement therapy.
A common concern is hair loss. Poorly functioning hair follicles are the most common cause of hair loss. There is strong evidence that TRT is not a significant cause of hair loss condition.
What is Testosterone Replacement Therapy?
Testosterone replacement therapy is the subsequent treatment or replacement of a patient’s internal testosterone production with endogenous androgenic compounds. These can be an intramuscular injection, a gel patch, even an oral pill, or, most desirably, a small pellet inserted beneath the skin.
This time-tested medical treatment is used primarily to alleviate low testosterone symptoms (low T), like decreased sex drive, loss of muscle mass, reduced bone density, and memory loss (or brain fog).
The exact causes of low Testosterone vary with every patient. Most ordinary men (and women) will begin to experience a minor, gradual decline in their total serum testosterone production year-by-year after age thirty.
Men and women with low T due to lifestyle choices, aging, or an underlying medical condition may slowly lose hair before starting TRT. Because reversing these symptoms can take time, they may not notice their hair loss until after starting TRT.
Does Testosterone Replacement Therapy Cause Hair Loss?
Men and women can experience hair loss for many reasons. Some may continue to occur when beginning TRT, while others are likely unavoidable.
Genetics is the most common cause of hair loss in both men and women. This type of balding is difficult, if not entirely impossible, to avoid. Especially later in life when increasing stress levels and the expected effects of aging affect hair follicle function.
Another reason for hair loss is excess dihydrotestosterone (DHT), a byproduct of Testosterone that is a primary reason for hair loss. Healthy levels of DHT are vital to the proper function of the human body. Because of this, simply reducing DHT levels can negatively affect our health.
In theory, increased levels of DHT could negatively affect healthy hair follicles through their chemical interaction with those tissues.
What is Dihydrotestosterone (DHT)?
Dihydrotestosterone (DHT) is an androgenic hormone required to function correctly in several systems in both men and women. In most healthy people, DHT comes from Testosterone. Approximately 10% of that Testosterone will convert to DHT. This occurrence varies from person to person. Genetics and TRT may alter DHT’s conversion rate.
Some may infer that the elevated serum testosterone levels found in a patient’s body during their treatment with testosterone replacement therapy will convert into DHT. This conversion increases their risk of hair loss and similar direct effects of the androgenic hormone.
This result is due to an enzyme called 5alpha-reductase. It is responsible for converting Testosterone to DHT. This conversion can indirectly cause hair loss in patients undergoing TRT.
Can the Production of DHT be Avoided?
While most prescribing physicians and similar medical professionals do not usually prescribe DHT blockers with TRT, a patient can request it is added to their TRT regimen if hair loss is a significant risk factor for them. However, without DHT blockers, your genetics and lifestyle will determine if you have hair loss.
Who is at the Most Risk of Hair Loss with TRT?
The cause of hair loss is always on a case-by-case basis due to the variable factors that can contribute to hair loss. Specific populations are likelier to experience balding, placing them at a higher risk of hair loss.
Men are the most likely to experience hair loss from TRT because they have higher levels of DHT. Men are also more susceptible to hair follicle deactivation as a natural characteristic of aging.
It should also be no surprise, patients over 30 are at a higher risk of hair loss during TRT. Men over the age of 30 are also more likely to undergo TRT.
Besides these factors, patients with a family history of baldness, including androgenic alopecia, male or female pattern baldness, or other forms of alopecia, are more likely to experience hair loss, especially if both parents present the same condition.
In more specific cases, certain medications, endocrinological changes, conditions, or a traumatic or stressful life event can trigger episodes of hair loss. This type of hair loss is especially true when genetic and demographic conditions are combined.
Can You Reverse Hair Loss From TRT?
Whether your hair loss is reversible depends on the specific reasoning behind the hair loss. Genetic factors or certain diseases make reversing the baldness far more complicated than simply stopping the testosterone replacement therapy treatment.
While TRT may cause some level of hair loss, if the hair loss occurs due to factors unrelated to TRT, stopping the treatment will probably not affect the hair loss. However, if your TRT is the primary cause of your hair loss, altering the dosage or type of TRT may halt or even reverse your hair loss.
Does Testosterone Replacement Therapy Cause Hair Loss and Can It Be Prevented?
Hair loss from testosterone replacement therapy may be an individual risk. Still, it is often unpredictable due to its case-by-case occurrence. Certain medications and lifestyle choices can reduce the risk of hair loss during TRT. Using DHT blockers with TRT can prevent some conversion of 5alpha-reductase. Of course, every medication has its drawbacks and side effects.
Other methods include:
- Regular exercise.
- Improving blood flow to the scalp.
- Improving hair follicle health.
- Proper nutrition.
- Healthy amounts of sleep (at least 7-8 hours per night)
These factors are essential for good health as well as optimal health of skin and hair. Not sure if Low-t is a problem for you? Take our FREE Hormone Health Quiz (Men’s quiz, Women’s Quiz). Interested in TRT but worried about hair loss? Schedule a FREE in-person consultation with a BHRT Specialist.