Hair loss can be temporary or long lasting. Temporary hair loss can be easy to fix when its cause is identified and dealt with or it can be difficult when it is not immediately clear what the cause is. Hair loss that could have been merely temporary may become long lasting as a result of an incorrect diagnosis. The potential for such misdiagnoses is perhaps the most frustrating aspect of hair loss for women. The information in this section will help you identify the cause of your hair loss and ideally lead you and your doctors to the right treatments for your particular kind of hair loss sooner rather than later.

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Alopecia is the medical term for excessive or abnormal hair loss. There are different kinds of alopecia. What all hair loss has in common, whether it’s in men or women, is that it is always a symptom of something else that’s gone wrong in your body. Your hair will remain on your head where it belongs if hormone imbalance, disease, or some other condition is not occurring. That condition may be as simple as having a gene that makes you susceptible to male or female pattern baldness or one of the forms of alopecia areata. It could also be as complex as a whole host of diseases. Fortunately, hair loss may also be a symptom of a short-term event such as stress, pregnancy, and the taking of certain medications. In these situations, hair will grow back when the event has passed. Substances (including hormones), medications, and diseases can cause a change in the hair growth and shedding phases and in their durations. When this happens, synchronous growth and shedding occur. Once the cause is dealt with, hairs go back to their random pattern of growth and shedding, and your hair loss problem stops.

Dihydrotestosterone (DHT), a derivative of the male hormone testosterone, is the enemy of hair follicles on your head. Simply put, under certain conditions DHT wants those follicles dead. This simple action is at the root of many kinds of hair loss.

Androgenetic alopecia, commonly called male or female pattern baldness, was only partially understood until the last few decades. For many years, scientists thought that androgenetic alopecia was caused by the predominance of the male sex hormone, testosterone, which women also have in trace amounts under normal conditions. While testosterone is at the core of the balding process, DHT is thought to be the main culprit.

The hormonal process of teosterone converting to DHT, which then harms hair follicles, happens in both men and women. Under normal conditions, women have a minute fraction of the level of testosterone that men have, but even a lower level can cause DHT- triggered hair loss in women. And certainly when those levels rise, DHT is even more of a problem. Those levels can rise and still be within what doctors consider “normal” on a blood test, even though they are high enough to cause a problem. The levels may not rise at all and still be a problem if you have the kind of body chemistry that is overly sensitive to even its regular levels of chemicals, including hormones.

Since hormones operate in the healthiest manner when they are in a delicate balance, the androgens, as male hormones are called, do not need to be raised to trigger a problem. Their counterpart female hormones, when lowered, give an edge to these androgens, such as DHT. Such an imbalance can also cause problems, including hair loss.

Hormones are cyclical. Testosterone levels in some men drop by 10 percent each decade after thirty. Women’s hormone levels decline as they approach menopause and drop sharply during menopause and beyond. The cyclic nature of both our hair and hormones is one reason hair loss can increase in the short term even when you are experiencing a long-term slowdown of hair loss (and a long-term increase in hair growth) while on a treatment that controls hair loss.

When your body goes through something traumatic like child birth, malnutrition, a severe infection, major surgery, or extreme stress, many of the 90 percent or so of the hair in the anagen (growing) phase or catagen (resting) phase can shift all at once into the shedding (telogen) phase. About 6 weeks to three months after the stressful event is usually when the phenomenon called telogen effluvium can begin. It is possible to lose handful of hair at time when in full-blown telogen effluvium. For most who suffer with TE complete remission is probable as long as severely stressful events can be avoided. For some women however, telogen effluvium is a mysterious chronic disorder and can persist for months or even years without any true understanding of any triggering factors or stressors.

Anagen effluvium occurs after any insult to the hair follicle that impairs its mitotic or metabolic activity. This hair loss is commonly associated with chemotherapy. Since chemotherapy targets your body’s rapidly dividing cancer cells, your body’s other rapidly dividing cells such as hair follicles in the growing (anagen) phase, are also greatly affected. Soon after chemotherapy begins approximately 90 percent or more of the hairs can fall out while still in the anagen phase.

The characteristic finding in anagen effluvium is the tapered fracture of each hair shafts. The hair shaft narrows as a result of damage to the matrix. Eventually, the shaft fractures at the site of narrowing and causes the loss of hair.

Traction alopecia is caused by localized trauma to the hair follicles from tight hairstyles that pull at hair over time. If the condition is detected early enough, the hair will re-grow. Braiding, cornrows, tight ponytails, and extensions are the most common styling causes.