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Medically Reviewed by Dr. George Touliatos
Men lose 50 to 100 hairs every day. Your hair falls out, and new hairs take their place as their growth cycle begins.
However, sometimes you start losing more hair than you grow. As a result, thin hair patches appear on your head. Data show more than 85% of men lose hair at some time in their lives. It might be due to male pattern hair loss that develops because of genetic and hormonal issues.
In this article, we have talked about male pattern hair loss in detail. We have also highlighted how it is linked to hormonal fluctuations and what you can do to improve it.
It is the most common kind of hair loss and can begin early. It mostly begins when men enter their 50s, but can also develop when you are in your late teens or early twenties.
You may not notice any prominent hair loss during the first few years. Your hair will become thin, fragile and brittle. Then you may first lose temple hair, and your hairline may become M or U-shaped. Next, you will lose hair from the top of your head.
Over time, you will lose most of your hair. You may only end up with a band of hair around your head’s sides.
Male pattern baldness is usually caused by three main reasons.
Hereditary: Hair loss can be a hereditary problem. Humans have two sex chromosomes, i.e. X and Y. Men are XY, while women are XX. Men receive the X chromosome from their mothers and the Y chromosome from their fathers. Some men inherit the ‘AR gene’ present on the X chromosome. Studies show that men having this gene are more likely to develop male pattern hair loss than men who don’t have it.
Hormonal imbalance: Fluctuation in your hormones can also cause hair loss. Dihydrotestosterone (DHT) and testosterone are the male sex hormones that help men enter puberty and improve their sexual function. Experts believe that their deficiency or access may increase hair loss risk.
Age: The rate of hair growth declines as men age. Hair strands become thinner and smaller. Data shows around 25% of men observe the first sign of hair loss before they enter their twenties.
As mentioned earlier, excess or lack of testosterone and DHT can lead to hair loss in some men. Let’s see how this happens.
As men get older, the production of the testosterone hormone, which regulates many body processes, starts declining. Men with testosterone deficiency become prone to bone fractures, obesity, and some other health conditions. Their hair also suffers as they do not get the testosterone levels they need for normal growth.
One of the best ways of restoring testosterone hormone in these men is testosterone replacement therapy (TRT) in which exogenous testosterone is administered to elevate serum testosterone levels. Doctors use different ways to release testosterone in the body, including testosterone injections, creams, gels, and patches.
The treatment will help you reverse the symptoms of testosterone deficiency. It will increase your bone density and lean muscle mass. Additionally, it may reduce your hair loss if it is due to testosterone deficiency and not because of some genetic problem.
High testosterone levels also contribute to male pattern hair loss. DHT is a sex hormone that develops secondary sex characteristics in boys; however, it does not play any significant role in adults.
5-alpha reductase enzyme converts testosterone into DHT throughout a man’s life. Small amounts of DHT usually do not cause any serious effects. However, when the hormone is produced in larger amounts, it can shrink your hair follicles by attaching to certain receptors. It disturbs their normal hair growth cycle and prevents hair growth. As a result, their hairs become thin and start falling out.
Men having hair loss due to high DHT levels often take DHT blockers or inhibitors. As the name suggests, DHT blockers prevent DHT attachment with receptors, and DHT inhibitors reduce DHT synthesis.
Some people have normal DHT levels like others, but they still experience hair loss. This is because they are genetically more sensitive to DHT. Even small amounts of this hormone can affect their follicles.
If you are losing more hair than normal, you should visit a doctor and discuss the problem before it gets too late. Your doctor will first observe your scalp to diagnose hair loss, and when the hair loss is diagnosed, he will run different tests to identify the cause of the problem.
You should share your concerns with your doctor if you think low T is the true culprit behind hair loss. They will look for other apparent low T signs and may have a serum testosterone test.
In this test, they will take your blood sample in the morning when men have the highest testosterone levels. This test will measure levels of free and total testosterone. Free testosterone is the form of testosterone that is biologically available to cells, while total testosterone is the sum of free testosterone and protein-bound testosterone.
You will be testosterone deficient if your testosterone levels are below 300 nanograms per deciliter (ng/dL).
Your doctor might prescribe you TRT if you are a suitable candidate. Once you start taking testosterone, they will ask you to come for follow-up sessions, during which they will examine your testosterone levels and their effects on your body. If your testosterone levels are more or less than the desired levels, they will readjust your dose.
Here are the tips you can use to maintain your hair growth and testosterone levels.
Your hair is made up of keratin protein; hence, you should eat protein-rich foods such as eggs, lean meats, and legumes. Vitamin D, vitamin C and iron are also important for normal hair growth.
You can maintain your testosterone levels by eating plenty of veggies, fruits, and whole-grain foods. You should lower your alcohol consumption as it directly as well as indirectly influences testosterone production.
High stress levels cause hair loss and low testosterone levels in different ways. You need to add meditation, yoga, and stress-management exercises to your life and avoid daily stressors.
Hair products you use to wash and nourish your hair significantly affect how they look or grow. Therefore, check the ingredients list before investing in a product or exposing your hair to its chemicals.
You should also treat your hair gently. Try not to wash them with very hot water. Rub your hair gently while towel-drying.
There is no scientific evidence showing a connection between TRT and hair loss. But still, some people may lose more hair after starting TRT. It can be because they are genetically more susceptible to hair loss, or they are experiencing an uncommon side effect of TRT.
TRT offers many benefits, but it also produces side effects. You should never ignore these side effects if you ever experience them and instead discuss them with your doctor as soon as possible.
So, if you think your hair loss is due to TRT, you should visit your doctor to talk about this matter and solve it. Your doctor will identify whether or not TRT is the culprit behind the issue. They may change your testosterone dose or prescribe you some hair growth medication.
People who have a family history of hair loss on either the maternal or paternal side are at a high risk of developing this problem.
It is an easy-to-recognize condition. Still, you should visit a doctor to diagnose the problem and find its solution. Your doctor will examine your scalp to find signs of baldness. They will ask you different questions about your medical history to determine whether or not it is a hereditary problem.
Male pattern hair loss is a common problem among older men, but it is also found in teens. You can experience male pattern balding due to genetic or hormonal fluctuations.
If you have recently started losing more hair than normal, you should get in touch with your doctor. They will help you identify the underlying cause and start treatment before it gets too late.
References/Bibliography/Scientific Studies/Further Reading
Corona, G., Sforza, A. and Maggi, M., 2017. Testosterone replacement therapy: long-term safety and efficacy. The World Journal of Men’s Health, 35(2), pp.65-76.
Farthing, M.J.G., Mattei, A.M., Edwards, C.R.W. and Dawson, A.M., 1982. Relationship between plasma testosterone and dihydrotestosterone concentrations and male facial hair growth. British Journal of Dermatology, 107(5), pp.559-564.
Olsen, E.A., Messenger, A.G., Shapiro, J., Bergfeld, W.F., Hordinsky, M.K., Roberts, J.L., Stough, D., Washenik, K. and Whiting, D.A., 2005. Evaluation and treatment of male and female pattern hair loss. Journal of the American Academy of Dermatology, 52(2), pp.301-311.
This article has been researched and written based on scientific evidence and fact sheets that have then been crossed checked by our team of doctors and subject matter experts.
References, sources and studies used alongside our own in-house research have been cited below, most of which contain external clickable links to reviewed scientific paper that contain date stamped evidence.
Our team of healthcare experts and GMC registered doctors are licensed to UK GMC standards. We strive to provide you with the latest evidence based, researched articles that are unbiased, honest and provide you with accurate insights, statistics and helpful information on the discussed topic to ensure you gain a better understanding of the subject. You can read more about our Editorial Process by clicking here.
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If you know your total testosterone reading from a previous blood test input the results to the left above to see if your testosterone levels are normal.
You may have low testosterone depending on the symptoms you have, please contact us to find out how we can help.
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Mike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones Ltd which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy (TRT) and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.
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