As with loss of hair in men, women genetic hair fall
largely stems from a complex stew of genes, hormones and age. However, in
female there are even more players. In addition to 5-a reductase, testosterone,
and dihydrotestosterone (DHT); which are also found in men’s hair loss; also
current in women are the enzyme aromatase and the women hormones estrone and
estradiol. So let’s break down the process that leads to common hair shedding
in women.
In both men and women, 5-a reductase reacts with
testosterone to produce DHT, the hormone responsible for the shrinking and
gradual disappearance of concerned hair follicles. This explains why both men and
women lose their hair. But one of this reasons why women rarely have the
conspicuous bald areas that men do is because women naturally have only half
the amount of 5-a reductase compared to men.
Adding to this complexity, in women, the enzyme
aromatase is responsible for the formation of the women hormones, estrone and
estradiol, counteract the action of DHT. Female have higher levels of aromatase
than men, especially at the frontal hairline. It is this existence of aromatase
which may help explain why hair loss in women looks so different than in men,
particularly with respect to the preservation of the frontal hairline. It may
also explain why women have a poor response to the drug finasteride (Propecia),
a medication widely used to treat hair loss in men that works by blocking the
formation of DHT.
The
following is a schematic graph of how the female hormones estrone and estradiol
are produced and their relationship to DHT:
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