Is male pattern baldness, or androgenic alopecia, caused by high testosterone?

Male pattern baldness occurs in predominantly men and rarely in women who inherit hair follicles with a genetic sensitivity to the hormone dihydrotestosterone (DHT). Hair follicles sensitive to DHT causes the hairs to get thinner and die off earlier. The areas of the male scalp sensitive to DHT include the crown and hairline, which can progress to more apparent baldness leaving a small area or “horseshoe” pattern of hair in men if left untreated.

DHT is a byproduct of testosterone breakdown. Testosterone is converted to DHT in your body by the enzyme 5-alpha-reductase. Keeping DHT levels lower in your body allows the hair follicles to continue to thrive. Some males have a higher tendency to convert their testosterone to DHT causing hair to shrink and fall out. We usually suggest natural nutrients that decrease that conversion or block the 5-alpha-reductase enzyme, like the natural substance saw palmetto or prescription DHT blockers like Finastride or Avodart. Fortunately women rarely convert down this pathway and don’t experience hair loss with testosterone pellet therapy.

Hair loss in postmenopausal females is not associated with androgen excess because their levels of androgens are usually low. In fact, most of the thinnest, brittle hair we see in our clinics is in postmenopausal women with the lowest testosterone levels. Within 3-4 months of optimizing their hormones we see new hair growth and healthier scalps.