Hair collecting around your shower drain can be hard to ignore each morning. A broader section or a shorter ponytail might cause another concern.
These symptoms do not guarantee that hormones are low, and therefore responsible for thinning hair. Your clinician looks at the scalp and asks about the time of the first hair loss.
Any recent illness, childbirth, weight gain/loss or prescription can provide a helpful clue. Blood tests may be required, but there are choices, and symptoms should dictate which ones are relevant.
There are certain causes that require hormonal treatment and there are others that require a closer look by a dermatologist. The goal is to identify the actual cause before you commit to any hair treatment.
Hormonal and Medical Evaluations for Hair Thinning at a Hormone Therapy Clinic
Your symptoms guide the following evaluations at a Hormone Therapy Clinic.Assessing Androgen Levels and Their Effect on Hair Follicles
Androgens are hormones that have an effect on the growth of body hair and on the activity of scalp hair follicles. These follicles may be naturally sensitive and slowly turn into very fine, short hair. This process, called miniaturization, can leave your central part looking noticeably wider over several years.
But scalp thinning doesn’t mean that your androgen levels are high. Other questions asked by clinicians include whether someone has had acne and whether their period has changed.
Certain tests may be conducted such as testosterone and DHEAS, which is an androgen that is primarily manufactured by the adrenal glands. Your medications and supplement usage, as well as your family history, all influence the results.
Evaluating Testosterone and DHT-Related Imbalances
Some of your body’s testosterone is converted into dihydrotestosterone (DHT). In the skin (and other tissues), this conversion is catalyzed by an enzyme called 5-alpha reductase. Inherited follicle sensitivity can cause DHT to reduce hair growth cycles in individuals.
Thinning around the temples is something that occurs naturally, and not after a recent sickness. But blood DHT levels cannot be used to directly indicate activity or sensitivity in individual scalp follicles.
Your clinician will review lab results, evaluate your scalp and history. When assessing possible contributors, the clinician will review possible testosterone prescriptions, pellets and supplements.
If the increase in the dose was in the past, it may be relevant if the shedding began at the same time as new acne breakouts. The decision to perform a testosterone level test depends on your symptoms, age, sex, medications and examination.
Examining Thyroid Function and Hair Growth Disruption
Both hyperthyroidism and hypothyroidism can affect the normal functioning of hair growth. Although you may see one bald spot, you also may start to notice hair falling all over your scalp.
Rapid heart rate and trembling hands could be signs of elevated thyroid hormone. Initially, blood tests are typically ordered that check for thyroid dysfunction, such as thyroid-stimulating hormone (TSH).
Inform your clinician of any use of biotin before your thyroid blood tests are ordered. There are hair supplements that contain excess biotin, which can give false positive results in the laboratory.
If thyroid disease has been diagnosed, treatment can help minimize shedding, but it takes time for the symptoms to become apparent. If the thinning continues, it merits further review as there can be many contributing factors.
Evaluating Estrogen, Progesterone, and Reproductive Hormones
Recent childbirth, menopause, and changes in contraception should be added to your hair history. With variations in estrogen, the entire cycle of hair may be disrupted; however, these changes are not necessarily diagnostic.
As ovarian production slows down during perimenopause, so does hair on the top of the head. A comparison is made between these changes and hot flushes, missed periods and other symptoms.
But estrogen and progesterone levels fluctuate during the menstrual cycle and during each cycle of perimenopause. If you get one low level result, it may not mean that either of these hormones is responsible for your thinning.
Follicle-stimulating hormone testing can be included if periods of menstruation cease unexpectedly before age forty-five. The interpretation of blood test results can be different because of current hormone prescriptions you might be taking.
Menopausal hormone therapy cannot be used to treat age-related hair loss alone. A prescription should always be given for a specific indication after evaluation of personal health risk factors.
Screening for PCOS and PCOD
It is recommended that they undergo closer evaluation if they experience scalp thinning with irregular intervals, acne and/or coarse facial hair. Within the U.S., the diagnosis is polycystic ovary syndrome (PCOS). In the United States, there is no separate diagnosis for polycystic ovarian disease (PCOD).
Hair thinning isn’t definitive and the presence of ovarian cysts is not required. Two characteristic findings are usually necessary for diagnosis in adults after excluding other similar conditions. These encompass irregular ovulation, androgen excess or polycystic ovaries on imaging.
Your clinician may choose to use tests of testosterone, thyroid, prolactin, and other tests as needed. Other tests are also ordered to monitor issues with metabolism, such as testing glucose and cholesterol.
If an ovarian ultrasound is performed, it may be useful but may not be required. Reproductive symptoms can be treated simultaneously with coordinated endo and gynecologic treatment as well as changes in the scalp.
Identifying Scalp Scarring and Autoimmune Conditions
Even if the results of the hormones are normal, a flaky, itchy scalp should be treated immediately. Redness, scaling and smooth, shiny areas may be indications of active inflammation or continuing scarring.
If the above warning signs are exhibited, a hormone specialist should make dermatology appointments. The hairline may recede and the density of the eyebrows might decrease as a result of Frontal fibrosing alopecia.
Another feature of alopecia areata is the smooth, round balding areas. This autoimmune disorder typically doesn’t cause scarring. A dermatologist could make use of a magnified examination of the scalp known as trichoscopy to do this.
A small scalp biopsy may help to determine unclear or possible scarring cases. When symptoms or history indicate that there may be a connection with thyroid disease, testing is done. Early treatment is designed to attempt to spare follicles from permanent damage due to treatment.
Conclusion
You can find clues about hair loss at a U.S. hormone clinic. Your doctor will ask when thinning began and what else changed. You may need blood tests if other signs point that way.
