The popular myth that “women don’t bald” is just that – a myth. As much as 50% of women experience hair loss at some time in their lives. Loss from permanent female pattern balding as well as temporary androgynous causes occur in women, just as they do in men (see also Chapter 3 – Androgynous Causes). Most often, though, women’s loss is diffuse, rather than localized like men. Diffuse hair loss is not as obvious and rarely does the hair totally disappear from one area.
Experts use the Ludwig Classification System (described below) to diagnose genetic female pattern balding in women with hair loss. Generally, the loss occurs at the top of the head. The system shows each stage of this development—mild, moderate, and extensive:
Since most women don’t bald the way men do and because they pay closer attention to their hair, they’re more likely to notice early signs of thinning. Typically, loss is diffused evenly over the head. So, while they may notice hair in the drain, most often an early symptom is the see-through quality of the hair as they style it. Styling challenges, then, are more likely to be the first sign for women.
Also unlike men, hair loss in women often occurs when the woman’s female ancestors had problems with thinning hair. If a woman’s mother, sisters, aunts, or grandmothers have loss, the chances are that she will too. This happens in up to 50% of women and may be particularly evident in menopausal women.
Some underlying medical conditions cause symptoms that indicate hair loss in women. Some common illnesses that can be sign posts are thyroid disease, anaemia, iron deficiency, weight loss resulting from severe dieting or eating disorders, and autoimmune diseases (read more on this topic in Chapter 3 – Androgynous Causes).
In some women, genetic balding is related to male sex hormones such as testosterone and DHt as discussed in the section covering male hair loss. The loss of estrogens can cause female genetic loss as well as the presence of an enzyme called aromatese. A consultation with a dermatologist can determine if hair loss is due to a skin conditions. (See Hormonal section below for tests associated with hormones.)
Pregnancy, postpartum and menopausal women are at unique risk due to their conditions for hair loss. Consultations with certified professionals can assure that the minimum damage will occur during such stages and some conditions may even be reversed.