Your Ultimate Guide to Female Hair Loss: What Causes Hair Loss and How To Prevent It
If you’ve struggled with hair loss, you know how hard it can be to find solutions. Maybe you’ve tried everything from nutritional supplements to hair products to hair treatments, but you’re not seeing much improvement. Maybe you’ve asked your doctor about a nutritional or hormonal cause, but “all your tests are normal.” As with many symptoms, there isn’t just one cause, and it’s important to explore all possibilities before giving up. Let’s explore the top 10 causes why you may be losing hair that shouldn’t be overlooked (including the hair loss and gut health connection) – you might find your answer!
Key Takeaways
- There are 3 categories of female hair loss: hereditary, telogen effluvium, and autoimmune.
- Hereditary or androgenetic alopecia relates mainly to hormone balance.
- Telogen effluvium is temporary and involves a stressor or shock to the system.
- Autoimmune hair loss is caused by the immune system attacking the hair follicles.
- Different types of hair loss can coexist.
- There are 10 common underlying triggers to consider. When underlying factors for hair loss are addressed, hair can regrow.
- It’s important to be patient – hair regrowth can take time.
Table of Contents
3 Categories of Female Hair Loss
The majority of female hair loss falls into 3 categories: hereditary, telogen effluvium, and autoimmune.
Hereditary Hair Loss
The most common type of hair loss is hereditary – also known as female pattern hair loss or androgenetic alopecia. With this type of hair loss, hormone receptors in your hair follicles are MORE SENSITIVE to a potent form of testosterone called dihydrotestosterone (DHT). Over time, this hormone interaction produces smaller hair follicles that result in thinner and finer hair.1 DHT is something that can be measured on blood labs or through urine metabolites on a DUTCH test.
Other hormones are also thought to play a role since many women experience hereditary hair loss after menopause although some women may notice hair loss much younger.2 The pattern of hair loss or thinning is generally seen throughout the top of the head, and sometimes near the temples. And we don’t typically see EXCESS hair shedding with female pattern hair loss.1
It’s important to know that even though this type of hair loss is considered “hereditary” or “genetic”, there is still a lot you can do to optimize health and hormone balance to prevent hair loss.
Telogen Effluvium Hair Loss
Telogen effluvium is a TEMPORARY hair loss that is triggered by a shock to the system such as child-birth, surgery, medication, toxicity, malnutrition, crash dieting, or even psychological stress. Telogen refers to the resting or shedding phase of the hair cycle. Normally, we have about five to ten percent of our hair in this resting stage. With telogen effluvium, approximately thirty percent of hair can enter the resting stage which results in a LOT of hair shedding. It’s important to know that the hair loss is delayed and can start anywhere from 6 weeks to 3 months AFTER the stressful event.3
Telogen effluvium can be considered acute or chronic. In acute telogen effluvium, the excess hair shedding will resolve within 6 months and it can take about a year for the hair to regrow. If the source of the stressor is not addressed, the hair shedding can continue and result in chronic telogen effluvium. In this case the hair loss can continue for years.
In the case of child-birth or surgery, it’s easy to identify the trigger for telogen effluvium. But when it comes to toxins, chronic infections, and nutrient deficiencies, the cause can be more difficult to identify. This is where functional lab testing can be helpful to identify the underlying cause.
Alopecia Areata – Autoimmune Hair Loss
The third type of hair loss is alopecia areata. This is an autoimmune condition where the immune cells mistakenly attack the hair follicles. This has a distinct appearance with one or more round patches of hair loss. It can spread to the entire scalp which is called alopecia totalis – and if the hair loss affects the scalp and body, it’s known as alopecia universalis. Finally, ophiasis is a form of alopecia areata that occurs in a wave pattern around the hairline – typically seen at the back of the neck.4
It’s also important to know that different types of hair loss can coexist. For example, some women will have a stressful event that triggers telogen effluvium that unmasks a female pattern hair loss. This is why I find it so important to evaluate all of the potential factors that can lead to hair loss.
If you’re looking for a personalized approach to transform your health, you can schedule a discovery call here.
10 Underlying Factors Associated with Hair Loss
Female hair loss can be a complex and frustrating issue. It’s also one of the most stressful
symptoms that my female patients can experience. As a naturopathic doctor and functional medicine practitioner, my goal is to figure out the underlying causes for a patient’s hair loss. And
in most cases, there are MULTIPLE factors involved.
Hormones
First, we have to look at hormones – this is especially important for those with androgenetic or androgenic alopecia. Healthy levels of blood sugar and the hormone insulin are extremely important for our other hormones to be in balance. For example, insulin resistance in females can contribute to the androgen or male hormone excess that we see in polycystic ovarian syndrome (PCOS).5 One of the common symptoms of PCOS is hair thinning.
It is also known that starting or stopping hormonal birth control can lead to hair loss.6 And many women experience postpartum hair loss which may be due to a combination of hormone fluctuation and stress on the body.7
Scalp Infections
If you have a lot of itching or irritation on the scalp, it can be helpful to see a dermatologist to rule out a yeast or bacterial infection.8 An infection can lead to scaly and inflamed areas on your scalp and once the infection clears, hair tends to regrow.
Thyroid Conditions
Hypothyroidism involves low output of thyroid hormones and is a very common condition associated with hair loss. Hyperthyroidism, or thyroid hormone excess, is less common but can also cause hair loss. Methimazole, which is a treatment for hyperthyroidism, can also cause hair loss.9 I prefer seeing the complete thyroid picture with comprehensive thyroid testing that includes thyroid-stimulating hormone (TSH), free T3, free T4, reverse T3, and antibodies to thyroid peroxidase (TPO) and thyroglobulin (TG). Some people have thyroid disorders that are missed when their doctor only orders TSH and/or fT4 as an initial screen.
Psychological Stress
Intense emotional stress, such as the loss of a loved one, can be a trigger for telogen effluvium. Finding healthy ways to manage stress daily can include gentle movement, such as yoga or walking, meditation, deep breathing exercises, journaling, spending time outside in nature, counseling, or using HeartMath. Engaging in these activities may help mitigate the effects of hair loss and other stress-related symptoms.
Physical Stressors
Physical stressors such as eating too little, injury, or surgery, especially weight-loss surgery, can be a cause for hair loss.3,10 Nutrition is important for recovery – more on this below.
Hair Chemicals and Hair Styling
Harsh chemicals used for coloring, perms, or relaxing your hair can damage your hair and hair follicles, leading to hair loss. If you discontinue these products, hair may regrow as long as the follicle is not damaged. Hair styling, such as tight braids, can also lead to hair loss and is known as traction alopecia.
Toxic Exposures
Toxic exposures, including heavy metals such as thallium and mercury, are well-known to cause hair loss. Other toxic metals and compounds associated with hair loss include arsenic, lithium, cadmium, aluminum, lead, and boric acid.11,12 In my practice, I’ve also seen a connection between mold toxicity and hair loss.
Medications
You’re probably aware that anti-cancer drugs can cause hair loss. Still, many other common medications are also linked to hair loss, including antibiotics, antifungals, acne medications, antidepressants, cholesterol-lowering medications, and medications that affect blood flow, such as blood thinners, beta blockers, and calcium channel blockers.13,14 Colchicine, a medication typically used for gout, is well-known to cause hair loss.11
I was REALLY surprised when I learned that NSAIDS such as aspirin, ibuprofen, and naproxen are also linked with hair loss.One thing to remember about medication is that hair loss is often delayed and can start 3 months or more after starting the medication.
Nutrient Deficiencies
The most common nutrient deficiencies associated with hair loss include iron, zinc, vitamin D, and biotin. Insufficient protein intake can also lead to hair loss. Several other nutrient deficiencies that can affect our hair include vitamins A, C, and E in addition to B-complex vitamins, magnesium, selenium, and essential fatty acids, including omega 3s. It’s also important to know that TOO MUCH iron, vitamin A, copper, and selenium have been linked with hair loss.16-18 This is why testing for nutrient levels is so important. I use the SpectraCell Micronutrient Test.
It’s also important to make sure you are digesting and absorbing what you’re taking in. I find gut health testing with the GI-MAP test to be helpful for my patients with hair and skin problems. Testing sometimes reveals hidden infections, microbiome imbalances, inflammation, or digestive enzyme deficiencies that can be easily treated. A dysfunctional gut barrier leading to increased permeability, or leaky gut, can result in systemic autoimmune diseases, including alopecia areata.19
Environmental Pollution
Environmental factors include air pollution and radiation. I don’t think this is often considered, but air pollution can contribute to scalp irritation and hair loss. Multiple compounds found in particulate matter can adhere to hair shafts, causing damage.20
One study also linked hair loss with cell phone radiation. The patient had noticeable hair thinning on one side of the head. They reported using their cell phone 6-7 hours per day for work. There is some research to suggest that cell phone radiation causes DNA damage of the hair root cells. The good news is that the hair loss was temporary and grew back after the patient completed a hair care program and switched to a hands-free option.I like the air-tube headphone options that reduce radiation exposure from cell phones.
Find the Root Cause, Hair Can Regrow
Again, I usually find that multiple factors are involved in female hair loss, so it’s essential to be thorough when searching for the cause. It’s also important to be patient with hair re-growth. It can take some time. Having a clear understanding of the cause of your hair loss can help you choose the most suitable treatment, allowing your hair to regrow.
Frequently Asked Questions
Is a collagen supplement good for hair loss?
Collagen is a protein that helps to build keratin found in hair and skin. However, human studies on the effects of collagen on hair are lacking. There are several studies on collagen having an anti-aging effect on skin and helping with wound healing. Collagen is generally safe with no adverse effects.21 One study looked at multiple ingredients in a supplement including collagen, taurine, cysteine, methionine, iron, and selenium and found that it improved hair growth. But this was also taken in combination with a drug treatment for hair growth.22
In my experience, focusing on overall protein intake is more important. Protein provides the building blocks for hair, muscle, and other body tissues, and I find that most people require more protein than they are eating. Healthy protein can be found in lean meats, bone broth, fish, nuts, seeds, eggs, legumes, and Greek yogurt.
What naturally helps hair growth?
Many people try supplements, hair products, and other natural hair growth remedies to avoid medications or invasive interventions. In my opinion, before trying these things, it’s best to understand the cause first, as outlined in this article. Properly addressing the root cause(s) will help alleviate the symptom of hair loss.
There are many supplements on the market that promise hair and skin benefits, but may be the incorrect dose or may be poor quality and contain contaminants. It’s best to get physician grade supplements from your functional medicine practitioner. These supplements have rigorous quality control standards and you will be prescribed the proper dose based on your unique test results.
What are the main hormonal factors contributing to female hair loss?
Hormonal imbalances, particularly those related to androgenetic alopecia, can significantly contribute to hair loss in women. Conditions like polycystic ovarian syndrome (PCOS), which is often linked to insulin resistance and excess androgens (male hormones), can cause hair thinning. Additionally, starting or stopping hormonal birth control and postpartum hormone fluctuations can trigger hair loss. Comprehensive hormone testing, including blood sugar and insulin levels, is crucial to identify and address these underlying issues.
How can nutrient deficiencies affect hair health, and what tests can help identify them?
Nutrient deficiencies, such as low levels of iron, zinc, vitamin D, biotin, and protein, are common causes of hair loss. Excess levels of nutrients like iron, vitamin A, copper, or selenium can also lead to hair thinning. Testing, such as the SpectraCell Micronutrient Test, can provide a detailed analysis of nutrient levels. Additionally, gut health testing with the GI-MAP test can reveal issues like poor digestion, microbiome imbalances, or leaky gut
What is the difference between hereditary hair loss and telogen effluvium?
Hereditary hair loss, or female pattern hair loss (androgenetic alopecia), is caused by a genetic sensitivity of hair follicles to dihydrotestosterone (DHT), leading to thinner, finer hair over time, typically on the top of the head or near the temples. It does not usually involve excessive shedding and is influenced by hormonal changes, such as those after menopause. In contrast, telogen effluvium is temporary and triggered by a shock to the body, like childbirth, surgery, stress, or nutrient deficiencies, causing up to 30% of hair to enter the resting (shedding) phase. This results in significant hair shedding, often delayed by 6 weeks to 3 months after the trigger. While hereditary hair loss is chronic unless treated, telogen effluvium can resolve within 6 months if the trigger is addressed.
How can I identify if my hair loss is due to alopecia areata, and can it coexist with other types?
Alopecia areata is an autoimmune condition where the immune system attacks hair follicles, causing distinct round patches of hair loss. It may progress to alopecia totalis (complete scalp hair loss), alopecia universalis (scalp and body hair
If you’re looking for a personalized approach to transform your health, you can schedule a discovery call here.
References
- Ho CH, Sood T, Zito PM. Androgenetic Alopecia. In: StatPearls. Treasure Island (FL) companies. StatPearls Publishing Copyright © 2025, StatPearls Publishing LLC.; 2025.
- Ho CY, Chen JY, Hsu WL, et al. Female Pattern Hair Loss: An Overview with Focus on the Genetics. Genes. 2023;14(7).
- Grover C, Khurana A. Telogen effluvium. Indian journal of dermatology, venereology and leprology. 2013;79:591.
- Spano F, Donovan JC. Alopecia areata: Part 1: pathogenesis, diagnosis, and prognosis. Canadian family physician Medecin de famille canadien. 2015;61(9):751-755.
- Quinn M, Shinkai K, Pasch L, Kuzmich L, Cedars M, Huddleston H. Prevalence of androgenic alopecia in patients with polycystic ovary syndrome and characterization of associated clinical and biochemical features. Fertility and sterility. 2014;101(4):1129-1134.
- Rayinda T, McSweeney SM, Christou E, et al. Gene-Environment Interaction Between CYP1B1 and Oral Contraception on Frontal Fibrosing Alopecia. JAMA dermatology. 2024;160(7):732-735.
- Hirose A, Terauchi M, Odai T, et al. Investigation of exacerbating factors for postpartum hair loss: a questionnaire-based cross-sectional study. International journal of women’s dermatology. 2023;9(2):e084.
- Mounsey AL, Reed SW. Diagnosing and treating hair loss. American family physician. 2009;80(4):356-362.
- Hussein RS, Atia T, Bin Dayel S. Impact of Thyroid Dysfunction on Hair Disorders. Cureus. 2023;15(8):e43266.
- Zhang W, Fan M, Wang C, et al. Hair Loss After Metabolic and Bariatric Surgery: a Systematic Review and Meta-analysis. Obesity surgery. 2021;31(6):2649-2659.
- Yu V, Juhász M, Chiang A, Atanaskova Mesinkovska N. Alopecia and Associated Toxic Agents: A Systematic Review. Skin appendage disorders. 2018;4(4):245-260.
- Abdel Aziz AM, Sh Hamed S, Gaballah MA. Possible Relationship between Chronic Telogen Effluvium and Changes in Lead, Cadmium, Zinc, and Iron Total Blood Levels in Females: A Case-Control Study. Int J Trichology. 2015;7(3):100-106.
- Alhanshali L, Buontempo M, Shapiro J, Lo Sicco K. Medication-induced hair loss: An update. Journal of the American Academy of Dermatology. 2023;89(2s):S20-s28.
- Patel M, Harrison S, Sinclair R. Drugs and hair loss. Dermatologic clinics. 2013;31(1):67-73.
- Meyer HC. Alopecia associated with ibuprofen. JAMA. 1979;242(2):142.
- Guo EL, Katta R. Diet and hair loss: effects of nutrient deficiency and supplement use. Dermatology practical & conceptual. 2017;7(1):1-10.
- Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatology and therapy. 2019;9(1):51-70.
- Siddappa H, Kumar YHK, Vivekananda N. Evaluation of Association of Vitamin D in Alopecia Areata: A Case-control Study of 100 Patients in a Tertiary Rural Hospital of Southern India. Indian dermatology online journal. 2019;10(1):45-49.
- Borde A, Åstrand A. Alopecia areata and the gut-the link opens up for novel therapeutic interventions. Expert opinion on therapeutic targets. 2018;22(6):503-511.
- Rajput R. Understanding hair loss due to air pollution and the approach to management. Hair Ther Transplant. 2015;5(133):2.
- Choi FD, Sung CT, Juhasz ML, Mesinkovsk NA. Oral Collagen Supplementation: A Systematic Review of Dermatological Applications. Journal of drugs in dermatology: JDD. 2019;18(1):9-16.
