Female hair loss is significantly less discussed than male hair loss, is frequently misunderstood, and is often undertreated. This guide covers the main causes, how they differ from male pattern loss, and what treatment options are available.
The most common cause of hair loss in women is androgenetic alopecia — female pattern hair loss. Unlike male pattern baldness, which presents as recession at the temples and crown, female pattern loss typically causes diffuse thinning across the top of the scalp while the hairline remains largely intact. The Ludwig classification describes three stages of increasing severity. The underlying mechanism — DHT-driven follicle miniaturisation — is similar to male pattern loss, though the hormonal context and the follicle sensitivity thresholds differ.
Iron deficiency is the most common nutritional cause of hair loss in women, reflecting the additional iron demand created by menstruation. Ferritin levels below 70 ng/mL are associated with increased shedding in women with androgenetic hair loss. Testing and correcting ferritin is an essential early step for any woman presenting with hair loss.
Thyroid dysfunction, polycystic ovary syndrome (PCOS), and post-partum hormonal changes are all important causes of hair loss specific to women. Each requires specific investigation and management. A GP consultation with a full hormonal profile — TSH, iron studies, hormonal panel including androgens — is the appropriate starting point.
Treatment for female androgenetic hair loss includes minoxidil (licensed for women at 2% and 5% topical formulations, and increasingly used as low-dose oral), anti-androgens (spironolactone, cyproterone acetate), and, for appropriate candidates, hair transplant surgery.
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