Hair Loss and TRT / Testosterone

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According to the NHS, men’s testosterone levels decrease by 1% every year from the age of 30. All across the world, millions of men have found a solution to low testosterone through a treatment called testosterone replacement therapy (TRT). With the increase in awareness of testosterone levels, TRT has become more common. Even celebrities such as Joe Rogan and Mel Gibson utilise the treatment. 

If you’re considering TRT, you’ve likely done some research and encountered the term ‘hair loss’ more than a few times. This can be concerning, but don’t fear, taking TRT is not a one-stop road to hair loss. Understanding the connection between testosterone and hair health is crucial to making an informed decision about TRT. Testosterone, and particularly its more potent form dihydrotestosterone (DHT), can have significant effects on hair growth/loss. We’re here to let you know all about it. 

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Will increased levels of testosterone cause hair loss?

To answer this question, you first need to understand the relationship between testosterone and hair loss. The relationship between the two is complex and multifaceted.

One thing to know about testosterone is that it is one of the most important hormones in the male body. Testosterone is responsible for keeping you healthy in a variety of ways and that extends to hair growth, bone strength, muscle mass, mental state, motivation, focus, and other factors as well. Without the right level of testosterone, you can really suffer. So, it stands to reason that without the proper amount of testosterone, a male may experience hair loss as a result, among other symptoms as well.

However, that is often not the question that most men are asking when considering TRT. There is a belief that testosterone injections somehow cause a reduction in the hair follicles of the male body. This is then thought to lead to male pattern baldness and hair loss. The theory behind this is somewhat complex and the number of studies conducted in the area are limited.

The main argument is that natural testosterone when combined with other elements of the TRT treatment, affects the natural predisposition of the hair follicles on the head and other areas of the body. Thus, testosterone injections could be indirectly responsible for hair loss during TRT.

What about DHT?

The theory for testosterone replacement therapy (TRT) and testosterone injections causing increased baldness seems to be based on the assumption that an increase in testosterone in the body leads to an increase in the production of DHT. If you are researching the possible effects of testosterone on your hair and rate of balding, then you might have come across DHT in your reading.  Let’s look at what DHT is and why some people think TRT has a hand in increasing it’s amount.

DHT is a synthetic form of the testosterone in your body. It’s usually created when testosterone combines with other elements in your body. DHT is known for regulating many areas of the body. It is also known to reduce the size of the hair follicles and reduce hair growth. For men who are receiving testosterone injections or are looking into TRT this can be concerning.

Since DHT is known to cause a reduction in size and effectiveness of hair follicles in men, many believe that the increase in testosterone during TRT will cause your body to produce more DHT, thus accelerating the loss of your hair. Some even claim that this is a proven theory that is backed by studies and science.

What does the science say?

When making a medical decision, it’s best to listen to what proven studies and science have to say. There have been countless studies done on this topic, and none have found that an increase in testosterone leads to an increase in DHT, thus resulting in less hair on the head. So, if you are considering TRT, you can be confident that you won’t experience hair loss as a direct result.

Longitudinal study

A longitudinal study by Traish AM et al. (2014) looked at the long-term effects of testosterone therapy on various metabolic parameters in hypogonadal men, with a focus on cardiovascular risk factors, including hair loss.

The study followed 255 hypogonadal men receiving testosterone therapy for up to 8 years. They found that long-term testosterone therapy in hypogonadal men led to significant improvements. This included metabolic health, reductions in body fat percentage and improvements in lipid profiles and glucose metabolism. Notably, the study didn’t find evidence to suggest that testosterone therapy was associated with an increased risk of hair loss. This indicates that TRT may not be causatively linked to hair loss in this population.

It’s important to remember that everyone is different and people will likely have varying results based on their genetic makeup and other health factors. It’s not a guarantee that you won’t experience hair loss when you begin a new treatment. However, there is no data or science to suggest that it would be the result of testosterone injections. Hair loss in men is mainly caused by genetic makeup. This is the only real way of knowing if you are likely to suffer from male pattern baldness.

If you have heard of evidence that testosterone injections do directly cause hair loss, then they are likely anecdotal experiences.

Causes of baldness in men

There are many cases of men experiencing baldness when starting a TRT, but it’s not because of the treatment itself. Oftentimes, it’s caused by one of many factors that can affect a man’s ability to grow thick and healthy hair. This section will review some of the possible reasons for hair loss during TRT.

Stress

One of the most common reasons that men experience hair loss and many other symptoms is because of stress. Without a healthy way to relieve stress and put yourself in a better mental state, stress can quickly have very negative effects on the body, and that does extend to hair loss. If you are experiencing a stressful time in your professional or personal life around the time that you start a low testosterone treatment, then that could be causing any balding that you have been experiencing. You should seek a way to manage stress healthily if you wish to keep a full head of hair for longer.

Natural Aging Process

Though not every man will be pleased to hear it, sometimes, hair loss is just an effect of the natural ageing process. As you age, there will be several effects on your body that are unpleasant. Hair loss can certainly be one of them. Oftentimes, hair loss is caused by a natural lowering of testosterone as you age.

Though you cannot fight the process of natural ageing, there are things that you can do as you age to slow the effects. This includes learning how to manage stress, eating better, exercising more, and generally taking care of your body as you age. You’ll never be able to reverse the effects of ageing, but you can slow them so that you don’t have to deal with the side effects and negative aspects for as long.

Low Testosterone

There are a variety of reasons that you might be experiencing low testosterone, but regardless of what those reasons are, low testosterone is known to cause hair loss. Testosterone is the hormone in the male body that is largely responsible for a lot of different important functions. When your body is low on testosterone, it can wreak havoc on many processes in the body.

Ironically, you can experience these symptoms for up to a few days after you have started treatments for it, so you shouldn’t be too worried. If you have not experienced treatments for low testosterone as of yet, then you should look at treatments for low testosterone if you wish to combat the effects of having low testosterone (which include hair loss and hair thinning as you age).

Treatment Shock

Even though testosterone injections are designed to help you overcome the symptoms that you experience when you have low amounts of testosterone in the body, there are often side effects of new treatments. If your body has had low testosterone for a while, the shock of the treatment and the increased levels of testosterone could cause some unintended symptoms. One of the common side effects of this happening is a loss or thinning of some hair.

This is not an ideal situation, but you should know that it is typically very short-term. In the long run, testosterone injections are highly successful and very effective methods of treating low testosterone and the side effects that come along with it.

Genetics

Genetics are considered the primary factor at play when it comes to male pattern baldness. If male pattern baldness runs in your family then it’s likely you too will suffer. Though it’s not convenient, sometimes there is nothing that we can do to stop genetics. There are artificial treatments that can be done, but testosterone generally will not assist in this.

Male pattern baldness is most common around the age of 25-40 and this is often the time when people consider TRT, and it causes them to assume it is the TRT causing hair loss when in fact it is simply just their genetics and they would have experienced male pattern baldness whether on TRT or not.

The reason that understanding what role genetics plays is important is because many people often mistake the reason for their balding as something having to do with the testosterone injection, while the truth may be that they simply are genetically predisposed or inclined towards early male pattern balding.

What to do if you experience balding after starting TRT

Though we have established that testosterone injections are not directly responsible for balding and any evidence to suggest otherwise is purely anecdotal, there will undoubtedly be concern among men who experience balding shortly after starting TRT. If you do experience balding following your treatments, there are some steps that you should take to hopefully reverse the effects and get back to normal.

Talk to your doctor 

The first thing that you will want to do is speak to your doctor and let them know that you are experiencing some strange side effects and you feel that it might be because of the treatment or possibly the shock of the treatment on your body. They will do a customised health assessment and give you some possible reasons that you are experiencing balding. 

Based on their recommendation, you can take corrective action to reverse the effects or slow them if possible. They may suggest that you live a more active and healthy lifestyle, or that you learn to manage stress in a better way. It’s possible you could be put on some medication such as finasteride which is known to have benefits to hair follicles however you would likely need to speak to a specialist hair loss doctor to be put on alternative medication.

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Final Thought 

In conclusion, testosterone replacement therapy (TRT) offers a transformative solution for men suffering from low testosterone. It improves your overall health as well as quality of life. While concerns about hair loss are common, scientific evidence suggests that TRT does not directly cause hair loss. Instead, factors such as genetics, stress, and ageing play more significant roles. By managing these factors and consulting with healthcare professionals, you can enjoy the numerous benefits of TRT without undue fear of significant hair loss.

If you’re thinking about getting TRT or just would like more information on the treatment, you should get in touch with us. Here at Balance My Hormones our specialised doctors can assess your symptoms and create a bespoke treatment plan to suit your specific needs. Click the button above for your FREE consultation. 

References/Scientific studies/Further reading/Bibliography 

Traish AM, Haider A, Haider KS, Doros G, Saad F. Long-Term Testosterone Therapy in Hypogonadal Men Ameliorates Elements of the Metabolic Syndrome: An Observational, Longitudinal Registry Study. Int J Clin Pract. 2014 Apr;68(4):314-29. doi: 10.1111/ijcp.12353. PMID: 24386995.

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