Background:
Androgens are thought to have an adverse effect on female scalp hair growth.
However, our clinical experience of androgen replacement therapy in women with
androgen deficiency, in which hair loss was seldom reported, led us to question
this concept.
Objectives:
This study was designed to evaluate the effect of subcutaneous testosterone
therapy on scalp hair growth in female patients.
Methods:
285 women, treated for a minimum of 1 year with subcutaneous testosterone
implants for symptoms of androgen deficiency, were asked to complete a survey
that included questions on scalp and facial hair. Age, BMI, and serum
testosterone levels were examined.
Results:
76 of 285 patients (26.7%) reported hair thinning prior to treatment. 47 of
these patients (63%) reported hair re-growth on testosterone therapy
(responders). Non-responders (i.e. no reported hair re-growth on therapy) had
significantly higher BMIs than responders (P=0.05).
Baseline serum testosterone levels were significantly lower in women reporting
hair loss prior to therapy than those who did not (P=0.0001). There was no
significant difference in serum testosterone levels, measured four weeks after
testosterone implantation, between responders and non-responders. No patient in
this cohort reported scalp hair loss on testosterone therapy. 262 women (92%)
reported some increase in facial hair growth.
Conclusions:
Subcutaneous testosterone therapy was found to have a beneficial effect on scalp
hair growth in female patients treated for symptoms of androgen deficiency. We
propose this is due to an anabolic of testosterone on hair growth. The fact that
no subject complained of hair loss as a result of treatment casts doubt on the
presumed role of testosterone in driving female scalp hair loss. These results
need to be confirmed by formal measurements of hair growth.
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