Causes of Hair Loss in Women: What Dr. Zandifar Wants You to Know
Many women are surprised to learn that hair loss is not just a men’s issue. In this ZMDHair video, double board-certified surgeon Dr. Hootan Zandifar—trained at UCLA and a member of the American Society of Hair Restoration Surgery—walks through the leading causes of female hair loss and explains why a thorough medical evaluation is essential before any treatment plan is considered.
Dr. Zandifar draws on his expertise in facial plastic surgery and hair restoration to help women understand that identifying the root cause of their hair loss is the critical first step toward effective care.
- The most common cause of hair loss in women is androgenetic alopecia, driven by the effects of DHT on hair follicles—the same mechanism seen in men.
- Anemia and iron deficiency are significant and treatable causes of female hair loss that require blood testing to identify.
- Thyroid dysfunction can cause hair loss and brittle hair in women and should be part of any diagnostic workup.
- Hormonal imbalances beyond thyroid function are more commonly evaluated in women than in men and can play a meaningful role in hair loss.
Androgenetic Alopecia: The Most Common Cause in Women
As Dr. Zandifar explains in the video, the most common cause of hair loss in women is androgenetic alopecia—the same condition responsible for the majority of hair loss in men. In this condition, hair follicles on the scalp react to dihydrotestosterone (DHT), a byproduct of testosterone, causing the hairs to progressively thin and eventually fall out. While women typically experience this as a diffuse thinning across the top of the scalp rather than a receding hairline, the underlying hormonal mechanism is closely related to what occurs in men.
Because androgenetic alopecia is a chronic, progressive condition, early evaluation by a qualified hair restoration specialist can help slow its progression and preserve existing hair density.
Iron Levels, Anemia, and Thyroid Function
Dr. Zandifar emphasizes that women experiencing hair loss should be evaluated for anemia and iron deficiency, which he identifies as a significant contributing cause. Low iron levels can disrupt the normal hair growth cycle, leading to increased shedding. Thyroid dysfunction—whether an overactive or underactive thyroid—is another important factor he highlights, as it can cause hair loss, brittle hair, and excessive shedding that may be mistaken for androgenetic alopecia.
A comprehensive blood panel that includes ferritin, complete blood count, and thyroid function tests (TSH, T3, T4) is typically part of the diagnostic workup Dr. Zandifar recommends for female patients presenting with hair loss concerns.
Hormonal Testing and Its Importance in Women
Beyond thyroid and iron levels, Dr. Zandifar notes that broader hormonal testing plays a more prominent role in evaluating hair loss in women than it does in men. Imbalances in estrogen, progesterone, DHEA, and other androgens can all contribute to hair thinning and shedding. Conditions such as polycystic ovary syndrome (PCOS) are known to elevate androgen levels in women, which can accelerate follicle miniaturization in those who are genetically predisposed.
By identifying and addressing underlying hormonal imbalances, patients and their medical team can develop a more targeted and effective treatment strategy—whether that involves medical management, lifestyle changes, or hair restoration procedures.
Full Video Transcript
you may find it surprising but the most common cause of hair loss in women is the same as the most common cause of hair loss in men it is androgenetic alopecia where the hairs in women's scalp are reacting to the effects of dihydro testosterone thinning and eventually falling now in women there are also other causes that we do have to look at um iron levels and anemia is a big cause and we want to make sure that anemia is not a cause of air loss thyroid levels need to be worked up as well in women because thyroid levels can cause hair loss and brittle hair and falling hair as well as well as other types of hormonal uh testing that needs to be done that is tends to be a little bit more prominent in women than it is in men uh but again the most common cause of hair loss in women is the same as men it is the effects of testosterone on the hair follicles that causes them to thin and fall
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Frequently Asked Questions
- Is hair loss in women caused by the same thing as in men?
- According to Dr. Zandifar, yes—the most common cause is the same: androgenetic alopecia, where hair follicles react to the effects of dihydrotestosterone and begin to thin and fall. However, women also have additional causes that require investigation, such as anemia, thyroid issues, and hormonal imbalances.
- What blood tests should women with hair loss have done?
- Dr. Zandifar recommends evaluating iron levels and checking for anemia, as well as thyroid function and other hormonal markers. These tests help identify treatable underlying causes that may be contributing to or worsening hair loss.
- Can thyroid problems really cause hair loss?
- Yes. As Dr. Zandifar explains, thyroid dysfunction can lead to hair loss, brittle hair, and increased shedding. Both an overactive and underactive thyroid can affect the hair growth cycle, making thyroid testing an important part of any female hair loss evaluation.
- How can I find out what is causing my hair loss?
- A consultation with a qualified hair restoration specialist like Dr. Hootan Zandifar at ZMDHair in Beverly Hills is the best starting point. A thorough evaluation—including a review of your medical history, a scalp examination, and appropriate lab work—can help pinpoint the cause and guide an effective treatment plan.
