HAIR HARMONAL TREATMENTS

Hair loss in women isn't always as straightforward as it is in most men. In men about 90 percent of all cases are caused by hereditary male pattern baldness. In women, however, hair loss can be triggered by a multitude of conditions and circumstances.

The below battery of diagnostic tests should be performed when attempting to pinpoint the hair loss trigger. These tests can at the very least eliminate the possibility of certain disorders causing your hair loss and perhaps aid in finding the actual cause. The truth of the matter is that for many patients these test usually come back with a reading of "within the normal range," but it's important to remember that the proper diagnosis of female hair loss usually starts of with the process of elimination.

• * Diagnostic Tests,
• * Hormone levels (DHEAs, testosterone, androstenedione, prolactin, follicular stimulating hormone, and leutinizing hormone)
• * Serum iron,
• * Serum ferritin,
• * Total iron binding capacity (TIBC),
• * Thyroid stimulating hormone (T3, T4, TSH),
• * Hormonal imbalance,
• * Complete blood count (CBC),

Scalp biopsy

A small section of scalp usually 4mm in diameter is removed and examined under a microscope to help determine the cause of hair loss.

Hair pull

The hair pull test is a simple diagnostic test in which the physician lightly pulls a small amount of hair (approx 100 simultaneously) in order to determine if there is excessive loss. Normal range is one to three hairs per pull.

Densitometry

The densitometer is a handheld magnification device which is used check for miniaturization of the hair shaft.

TREATMENT OPTIONS

Women are in a "Catch-22" position when it comes to drug treatments for androgenetic alopecia. While many drugs may work to some degree for some women, doctors are reluctant to prescribe them, in HHY we are giving lot of importance to treatments for women with hair

The best results from treatment happen when you begin treatment as soon as possible after the hair loss begins because prolonged androgen tic alopecia may destroy many of the hair follicles. The use of anti-androgens after prolonged hair loss will at least help prevent further hair loss and encourage some hair regrowth from those follicles that have been dormant but are still viable. Maintaining your vitamin and mineral levels helps even if you're on anti-androgen medications.

As always, treatments have the best chance of being effective if they are geared to the cause of the hair loss as well as to triggering hair growth.

Currently there is only one FDA approved treatment for female pattern hair loss.

Below you will find a list of treatments currently being used to treat hair loss in women. Some of these drugs have not been approved by the FDA for this particular application, however they have all been approved for other applications and are used "off label" to treat hair loss.

The effectiveness of these agents and methods vary from person to person, but many women have found that using these treatments have made a positive difference in their hair and their self-esteem.

Minoxidil 2% Topical Treatment

Minoxidil was first used in tablet form as a medicine to treat high blood pressure (an antihypertensive). It was noticed that patients being treated with minoxidil experienced excessive hair growth (hypertrichosis) as a side effect. Further research showed that applying a solution of minoxidil directly to the scalp could also stimulate hair growth. The amount of minoxidil absorbed through the skin into the bloodstream is usually too small to cause internal side effects.

Women with diffuse androgenetic alopecia can use minoxidil and it actually seems to be more effective for women compared to men. The makers of minoxidil recommend women only use the 2% concentration of minoxidil and not 5%.

Other treatments can be tried out like

1) Androgen Receptor Inhibitors. Aldactone / spironolactone

Spironolactone is an antiandrogen that works in two ways. Primarily it slows down the production of androgens in the adrenal glands and ovaries. Secondly it blocks the action of androgens in part by preventing dihydrotestosterone from binding to its androgenetic receptor.

Cimetidine

Cimetidine also has a fairly powerful anti-androgenic effect and has shown to block dehydrotestosterone form binding the follicle receptor sites

Cimetidine has been used to treat hirsuitism in women (excess facial hair growth) and has been studied in women with androgenic alopecia showing promising results. Because of the high doses needed to achieve it's hair raising results, men should not take cimettidine to treat their hair loss due to possible feminizing effects including adverse sexual side effects.

Cyproterone Acetate

Cyproterone Acetate is used to reduce sex drive in men which have excessive sex drive and for the treatment of pronounced sexual aggression. It is also prescribed to treat severe hirsuitism in woman of childbearing age and also androgenetic alopecia in women. Cyproterone acetate exerts its effects by blocking the binding of DHT dihydrotestosterone to its.

Estrogen/Progesterone

Also known as hormone replacement therapy (HRT) and commonly prescribed at menopause, estrogen and progesterone pills and creams are probably the most common systemic form of treatment for androgenetic alopecia for women in menopause or whose estrogen and/or progesterone are lacking for other reasons.

Oral Contraceptives

Since birth control pills decrease the production of ovarian androgens, they can be used to treat women's androgenetic alopecia.Discuss your medical and lifestyle history thoroughly with your doctor. Contraceptive pills come in various hormonal formulations, and your doctor can determine which is right for your specific needs, switching pills if necessary until you are physically and emotionally comfortable with the formulation.

Nizoral/Ketoconazole

Available as a topical treatment by prescription, Ketoconazole is currently used as an antifungal agent in the treatment of fungal infections. It also has anti-androgenic effects and can cause a reduction in the production of testosterone and other androgens by the adrenal gland and by the male and female reproductive organs (in women, the ovaries). Because of this action, it can be used to help treat hair loss. Nizoral shampoo contains 2 percent Ketoconazole and is prescribed not only for the treatment of scalp conditions, but also in combination with other treatments for androgenetic alopecia. A 1 percent version is now available over-the-counter, but it may not be as effective as the 2 percent prescription strength. There are no significant side effects.

Propecia/Proscar

The drug finasteride inhibits the enzyme 5-alpha reductase, thereby inhibiting the production of prostate-harming, follicle killing DHT. It was first marketed to treat the prostate under the brand name Proscar in 5 mg pills. In 1998, a 1 mg version with the brand name Propecia entered the market as the first pill approved by the FDA for men's hair loss. It works quite well for most men in both preventing hair loss and triggering regrowth, and it may work for some women, although women must not take it if they are pregnant and must not get pregnant while on the drug because of the risk of birth defects in a male fetus. Less than 2 percent of men experience transient sexual side effects including erectile and libido difficulties. In women these side effects do not occur.

Cyproterone Acetate with Ethinyloestradiol

Sold under the brand name Diane 35 and Diane 50, this contraceptive tablet is prescribed in Europe for women's androgenetic alopecia. The drug works by blocking some of the actions of male hormones commonly present in women. Although it's possible for the drug to stop further hair loss and trigger regrowth of hair within about a year, it needs to be used on an ongoing basis in order to maintain regrowth and eliminate hair loss. Possible side effects include breast tenderness, headaches, and decreased libido. It does have one good side effect- it helps prevent osteoporosis. The drug is a combination of cyproterone and estradiol, an estrogen. Both Diane 35 and Diane 50 contain 2 mg of cyproterone. Diane 35 contains 0.035 mg of estradiol. Diane 50 contains 0.050 mg of estradiol. The drug is as effective as, if not more than, spironolactone. Currently this drug is not available in the US.