Primary causes of hair loss in women
Hair loss in women is multifactoral that means there is usually more than one cause. Some of the common causes include hormone changes during menopause1, peri-menopause, following childbirth, taking the contraceptive pill as well as illness, stress2, restricted protein and decreased nutrition (eg during strict dieting). Vitamin deficiency3 such as from low iron and vitamin B and D can also be a contributing factor for hair loss in women.
Several health conditions, including thyroid disease, iron deficiency anemia, and secondary syphilis, are also known to cause hair loss.
No matter what is worrying you or concerning you about your hair falling out, please be assured that you are not alone and you have come to the right place.
Why is my hair falling out?
Unexpected episodes of hair loss in women, whether sudden or gradual is more common these days than it's ever been.
This has been written by women for women. We are women who have also suffered from varying degrees of female hair loss due to unexpected factors so we have a lot to share with you. We have outlined the 10 most common causes of hair loss in women here and you will also find some great solutions.
Your hair could be falling out because hair naturally thins out as we age and this often happens gradually. However, if it is really noticeable or or if you suddenly notice your hair is falling out, then there is likely to be something else going on. While hair fall occurs most of all at two specific times in a woman's life - during/following menopause and following pregnancy, these are more "normal" or natural causes of hair fall/ hair loss. Read more about these specific causes at the links below:
However, for about 1 in 4 women suffering hair loss there are clearly other causes too. So here we list some of the most common causes of hair loss in women and some suggested solutions.
But first, let's understand the mechanics of hair loss in a female (it is different for men).
FEMALE HAIR LOSS: MORE THAN ONE CAUSE
According to a recent review published in the International Journal of Women's Dermatology, Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review, hair loss in women is polygenic (can be influenced by more than one gene) and multifactorial (dependent on a number of factors) with the additional influence of environmental factors.
So we know there are a broad a range of causes from the obvious such as damaging it with peroxides and other chemicals, to hidden causes such as systemic inflammation and stress.
But since the cause can be multifactorial there are literally dozens of combinations. Women join Facebook groups hoping to find the answer from other women, but the truth is, what is causing the problem for one woman, may only be half the story for another.
And even worse, is that women are prescribing OTC medications to one another online! It is horrifying to see women telling other women to start taking over the counter supplements like iron or Vitamin D when they have absolutely no knowledge of the overall health of the other woman, nor any real idea what could be causing the other woman's hair loss.
FEMALE HAIR LOSS - TRIGGER PLUS CONTRIBUTING FACTORS
So while we have listed some of the most common causes below, it is becoming more and more evident as more research is done on this topic, that the real issue is likely to be a combination of factors.
A common combination is menopauseand poor diet or low nutrition often caused by women in menopause taking on crash diets or ketogenic diets to eliminate their menopause weight gain. So menopause is not the direct cause of hair loss in all women during menopause, but when combined with crash dieting, poor nutritional input, or strong genetic predisposition, (all of which are known to contributors to female hair loss) it would appear on the surface that menopause is the sole cause.
One of the main contributing factors (and not a cause of female hair loss on its own - necessarily), is stress. For the past sixty or seventy years, women have taken on professions once exclusively male dominated. Yet still women are child-bearing and child-raising. Combine this with the contraceptive pill and the resulting hormonal effect, full time work, family juggling as well as the long term stress effect, and you find women of all ages with all kinds of new ailments such as chronic weight gain, heart disease and hair loss. Not that these were unheard of previously, but they have become far more prevalent in the past thirty years than they ever were.
So as you read through these causes, look for contributing factors. Try to identify your initial trigger and then look to see if there is a secondary factor that is at play.
You hear of women who take iron supplements and their hair grows back, then you hear of a woman who changed her shampoo and her hair grew back. But there are equally as many, if not more, for whom those solutions did nothing. This is due to both the trigger and the contributing factor (or factors) working together.
Age and Menopause
While women are in their childbearing years, the body has a naturally protective level of oestrogen. Oestrogen is important for women for all sorts of health metrics. Brain function, memory, bone density, skin suppleness, cardiovascular health and yes, hair health and quality.
From about the age of forty, oestrogen levels begin to drop and amongst other things, the density of our hair begins to decline.
One of the reasons menopause is commonly linked with female hair loss is due to the associated drop in oestrogen, as with post-pregnancy, when hair loss can also occur due to a drop in oestrogen. These hormonal shifts change the density of hair as well as the health of the follicles.
However, unlike postpartum hair loss, postmenopausal hair is unlikely to return to its former glory. There are many reasons why a woman on the peri-to-post menopause spectrum may be suffering hair loss.
Some women are particularly susceptible to the lowering levels of oestrogen. Some women will have lost a lot of hair following pregnancy, while others lost none. Many women find a loss of hair density following a change in their contraceptive pill regimen.
If you are someone whose hair is sensitive to oestrogen levels when you are under forty, then you may be someone who finds hair loss is triggered easily post-partum or during peri-menopause and beyond.
There are other factors that may contribute to hair loss after the age of 50.Nutritional depletion is a major problem that often comes about through a woman making many and varied efforts to address weight gain that can take hold during menopause. This can lead to undereating, following a diet that lacks nutritional value and, sometimes severely disordered eating. A depleted nutritional state can result in hair loss, which is strongly associated with deficiencies in iron, vitamin D and other critical vitamins and minerals.
Other possible underlying causes around the menopausal phase can include irritable bowel syndrome (IBS), low thyroid hormones, and the side-effects of medications.
Some women may be in menopause or taking medications that are known to cause or trigger hair loss but not experience any form of hair loss, especially if they are otherwise healthy. However, if a woman has systemic inflammation then the medication or hormonal phase may trigger hair loss. This is why when women ask online groups and forums if others have found hair loss caused by a certain medication or trigger, there will always be a number of women who have also taken that medication successfully for many years, without a hair loss side effect.
This is a very important distinction and one I’d like you to always keep in mind. Remember correlation does not necessarily equal causation. One woman’s cause or trigger is not necessarily another’s!
Low Iron and B12
Feeling tired as well as noticing some hair loss? In that case, the cause of your hair loss could be low iron and/or vitamin B12. Think this is possible? Read more about low iron and hair loss here. The good news is that once the proper levels are restored with the help of supplements and/or diet changes, your hair loss may subside. Head to your doctor for a blood test to find out if this is your issue.
The hormonal changes in pregnancy are completely normal; required in the course of growing a human being. One of the most profound changes is the increase in oestrogen levels that is sustained throughout pregnancy. One of the side effects of the increase is a cessation or a slowing down of the hair growth/loss cycle. Many pregnant women comment on their luscious, thick hair when pregnant, only to find following birth, when the oestrogen levels drop back to normal levels, that the hair moves into the shedding phase and falls out. This is a very common process and no need for concern.
However, in some women, especially those with naturally fine or thin hair, or for someone who has had a previous bout of TE, this post-pregnancy hair loss can be quite distressing. When a woman consistently and relentlessly worries about the negative impact of the sudden and unexpected hair loss itself, hair loss can increase as a result. This cycle of stress confirms that worry about hair loss can contribute to further hair loss.
Worrying about hair loss while nurturing a totally dependent infant, while being sleep deprived, potentially skipping proper meals, breastfeeding and depletion makes a woman’s body vulnerable to further hair loss and thinning. A vicious cycle!
The good news is that most women find that their hair growth returns to normal after the post-partum phase, although this can take up to a year. Some women find that they go through this experience with all of their pregnancies, while others can be on their third or fourth pregnancy before experiencing it for the first time.
Unfortunately for others, the stress/hair loss cycle that can be triggered following pregnancy initiates a life-long battle, setting off contributing factor/s that have been lying dormant, revealed through pregnancy.
Polycystic Ovary Syndrome (PCOS)
This is a common underlying cause of hair loss in women that is not always otherwise evident or symptomatic. PCOS hair loss is caused by an excess of androgens – the same thing that causes men to lose their hair. Testosterone is broken down to Dihydrotestosterone (DHT) which binds to a receptor in the hair follicle and gradually kills it off. Some women are more sensitive to these receptors than others and some may be more efficient at producing DHT.
Women with PCOS are often also found to have an underactive thyroid (hypothyroidism) which is another cause of increased androgens. These are both known to cause hair loss in women.
In addition, many women with PCOS also have insulin resistance (a precursor to Type II Diabetes). Insulin resistance is one of the underlying causes identified as having the potential to cause female hair loss, on its own, without the added complication of PCOS.
If you have any or all of these underlying causes, they will need to be rectified before you will see any improvement in hair health. And making these diet and lifestyle changes will help hair loss whether caused by PCOS or not.
Although extra hair growth on the body is common in women with PCOS, in a cruel twist of fate the hormonal imbalances can also cause hair loss in women. To confirm this diagnosis you should see your GP. In the meantime, if you are conscious of a visible scalp, shake in a concealer like Boost N Blend™ and you will BOOST hair at the roots instantly.
If you’re taking any regular medications, you may not be in 100% tip top physical condition. Many illnesses or just being unwell can cause hair loss in some women and sometimes it can be the medication itself. It’s important not to overlook any medications you may have been on long term where you have altered your dosage or recently stopped taking them altogether.
Extreme Weight Changes
Putting yourself on a restrictive diet can mean you miss out on some essential nutrients and that can cause thinning hair in women. Likewise, gaining a significant amount of weight quickly can also put your body out of whack and mean that you experience thinning hair. So stay away from the fad diets if you don’t want to lose more than weight.
If you've recently been on a ketogenic diet you can read the full story on how ketogenic diets affect our hair here.
Because hair is viewed by the body as non-essential, it is often the first thing the body stops assigning resources to, meaning it can begin to fall. Hair loss is a common symptom of a lot of illnesses e.g. autoimmune diseases, but what you may be surprised to learn is that hair loss in women can be caused by acute illnesses like gastro. These short but intense illnesses can put enough temporary stress on the body which can lead to hair loss in women usually around three months later. Covid-19 is now a common cause of hair loss. Read more about Covid-19 and hair loss here. The good news is that this type of hair loss can usually right itself without intervention.
It’s probably not much of a surprise that heated styling products like straighteners, curling irons and hair dryers can cause hair loss in women, but did you know that your hairspray, gel or even the type of shampoo you use could also be causing your thinning hair? Be careful not to overuse styling products or opt for natural products. Whilst you’re at it, be careful with your poor head! Simple things like tight ponytails and harsh brushing can also cause hair loss.
It should be no surprise that a healthy gut is needed for an overall health body. It's all very well to be careful what you eat and to have a generally good diet, but if your gut is not healthy (eg IBS) and you are not able to absorb the nutrients in your food then your hair follicles are not getting fed.
What you eat goes through your intestinal system during which time your gut wall absorbs all the goodness out of your food, leaving just the waste.
If you have any kind of gut issue like chronic diarrhoea, IBS or if you are taking a medication that is affecting your gut health (some drugs can cause diarrhoea which can lead to malabsorption, antibiotics can also mess with gut health) then it is worthwhile seeing your doctor about it. If your hair loss cause is an unhealthy gut, the good news is, once fixed hair loss can be reversed.
An unhealthy scalp
An unhealthy scalp can cause inflammation which then makes it difficult for hair to grow. Some of the skin conditions that can lead to hair loss include seborrheic dermatitis (dandruff), psoriasis, and fungal infections such as ringworm. If you are a gardener, think of your scalp like the soil you put your plants in. Great soil = healthy plants. When the soil is dry, parched and lacking in nutrients, then nothing can grow. Our scalp is the same. Be careful with super hot water, use chemical free shampoos and conditioners and try to avoid getting your scalp sunburnt.
Hair loss in women can become your Achilles heel. For many women one bout of hair loss that rights itself following pregnancy or an illness reoccurs later when the same or another trigger hits.
If you are suffering sudden hair loss ask yourself what you were doing three months ago. Since hair goes through a three month cycle it is often the case that it was three months ago when your body was stressed that the damage was done.
Whilst some of these causes for hair loss in women may have their own solutions (e.g. changing the medications that are causing your hair loss), there is no absolute cure for hair loss in women available today.
- For post menopause causes of hair loss and solutions click here
- For post pregnancy causes of hair loss and solutions click here