Hair Loss in Women: Treatments
Minoxidil (Rogaine) continued...
Many dermatologists do prescribe 5% for women with androgenetic alopecia if
used under their supervision. Small clinical trials have shown that the 5%
minoxidil solution is significantly more effective in both retaining and
regrowing hair in women with androgenetic alopecia than the 2% solution.
Results from clinical studies of mostly white women ages 18 to 45 years with
mild to moderate degrees of hair loss report that after using minoxidil for
eight months, 19% of users had moderate regrowth and 40% had minimal regrowth.
Of those using a liquid without active minoxidil (a placebo) during the same
time period, 7% reported moderate hair regrowth while 33% had minimal
Androgen Receptor Inhibitors
Spironolactone, brand name Aldactone, is in a class of drugs called
potassium-sparing diuretics (often called water pills). Spironolactone is
typically used to reduce fluid in your body without causing the loss of
potassium. It is also used to treat potassium deficiency, high blood pressure
(hypertension), swelling (edema), and a hormonal disorder
Spironolactone acts as an anti-androgen in two ways. First, it slows down the
production of androgens in the adrenal glands and ovaries. Second, it blocks
the action of androgens in part by preventing dihydrotestosterone (DHT) from
binding to its androgenetic receptor.
Cimetidine, brand name Tagamet, belongs to a class of histamine blockers used
mainly to treat gastrointestinal ulcers. The histamine-blocking action prevents
the stomach from producing excess acid, allowing the body to heal the ulcer.
Cimetidine also has a fairly powerful anti-androgenic effect and has been shown
to block dihydrotestosterone from binding the follicle receptor sites.
Cimetidine has been used to treat excess facial hair growth (hirsutism) in
women and has shown promising results in studies of women with androgenic
alopecia. High doses are needed to achieve results, so men should not take
cimetidine to treat their hair loss due to possible feminizing effects,
including adverse sexual side effects.
Cyproterone acetate is used to reduce excessive sex drive in men and to treat
pronounced sexual aggression. It is also prescribed for severe hirsutism in
woman of childbearing age and for androgenetic alopecia in women. Cyproterone
acetate exerts its effects by blocking the binding of dihydrotestosterone (DHT)
to its receptors.
Cyproterone acetate is not available in the U.S. Doctors consider it one of the
last resorts for treating female pattern hair loss because of its possible
toxicity and long-term side effects. As with any drug, side effects other than
those listed on the package may occur. Contact your doctor if you notice a side
effect that is unusual or particularly bothersome.
Estrogen and Progesterone
Estrogen and progesterone pills and creams may be an effective treatment for
women with androgenetic alopecia who are going through menopause or whose
estrogen and/or progesterone are lacking for other reasons.