Women's Hair Loss Medications
Doctors refuse using systemic medications to treat hair loss (pills or other forms of systemic treatment that affect the whole body), unless they know that hair loss is caused by androgen excess or androgen hypersensitivity (increased response) to normal amounts of androgen in the body, as these systemic treatments may reduce the androgen levels in the body. Therefore, doctors often choose topical treatments (these medications are applied topically directly to the head scalp).
The best results from the medications happen when they are taken as soon as the androgenetic alopecia starts, this pattern of prolonged hair loss may destroy many hair follicles over time. Using anti-androgen after prolonged hair loss will at least help you in preventing more hair loss, and stimulate the regrowth of some hair from those follicles that are dormant but still viable. Stopping treatment will lead to hair loss resuming if the androgens are not kept under control in other ways. Maintaining the levels of vitamins and minerals will help you when you use antiandrogen medications.
Currently there is only one FDA-approved medication for women's hair loss. You can find below a list of medications that are currently being used for women's hair loss treatment. Some of these medications are not approved by the FDA to be used for this case, but they were approved for other indications, however, they are used for hair loss treatment. The effectiveness of these factors and methods vary from one person to another, but many women have found that using these medications have made a positive difference in their hair loss and their self-esteem.
Minoxidil 2% (topical treatment):
Minoxidil was first used in the form of pills as a medication to treat high blood pressure (hypertensive), where it was noticed that patients treated with minoxidil suffer from excessive hair growth (hypertrichosis) as a side effect. In-depth researches revealed that applying minoxidil solution directly onto the scalp may stimulates hair growth. The amount of minoxidil absorbed through the skin into the bloodstream is usually too small to cause internal side effects. Women with defuse androgenetic alopecia can use minoxidil, which seems more effective for women compared to men. Minoxidil manufacturing company recommend using only 2% concentration of minoxidil for women, and not using the 5% concentration minoxidil. The company didn't get the FDA approval to promote 5% concentration minoxidil to be used by women. However, many dermatologists do prescribe 5% concentration minoxidil for women with androgenetic alopecia to be used under supervision.
Androgen Receptor Inhibitors
Spironolactone, with the more famous trade name Aldactone, is classified among the potassium sparing diuretics. It is used to reduce fluids amount in your body without reducing potassium. It's also used to treat hypertension (high blood pressure), edema (swelling), potassium deficiency and hyperaldosteronism syndrome (hormonal disorder). Spironolactone is anti-androgen that works in two ways, first it slows down androgens production in the adrenal gland and ovaries, second it inhibits the work of androgens by preventing dihydrotestosterone from binding with androgen receptors.
Cimetidine is classified among histamine blockers, and it's used mainly to treat peptic ulcers. The inhibiting effect of histamine prevents the stomach from producing excessive acid, allowing the body to treat the ulcer. Cimetidine has also a strong antiandrogen effect, and it has shown its ability to inhibit dihydrotestosterone binding with receptors in the follicles. Cimetidine was studied in women with androgenetic alopecia, and it has shown promising results. Due to the high dosages needed for hair growth, men should not take cimetidine for hair loss treatment because of potential feminine effects including the reversed sexual side effects.
Cyproterone acetate is used to reduce strong sexual drive in men, and to treat hypersexuality. It is also prescribed to treat androgenetic alopecia in women. Cyproterone acetate exerts its effects by prohibiting the binding between dihydrotestosterone and its receptors. Cyproterone acetate is not available in the United States and it is considered one of the last options for women's hair loss treatment because of its potential toxicity and its long-term side effects.
Also known as hormonal replacement therapy, and is usually prescribed at menopause. Estrogen and progesterone pills and creams are probably considered the most common systemic form for androgenetic alopecia treatment for women at menopause or in other cases that cause estrogen and/or progesterone hormone deficiency.
Given that oral contraceptives reduce ovarian androgen production, they can be used for women's androgenetic alopecia treatment. However, you should keep in mind that the same cautions should be followed whether a woman is taking contraceptives for birth control only or for women's hair loss treatment.
For example, women who smoke, are over 35 years, and taking contraceptive are considered more vulnerable to blood clotting and other serious issues. You should carefully discuss your medical history and lifestyle with your doctor. Contraceptives come in various hormonal combinations, and the doctor can determine the one appropriate for your specific needs, and he may change the contraceptives if needed to adapt to this combination physically and emotionally.
Ketoconazole is available as prescription topical treatment, it is currently used as antifungal to treat fungal infections. It also has antiadrogenic effects, and may reduce testosterone production and other androgens from the adrenal gland and genital organs in males and females (ovaries for women). Therefore, it can be used to help treating hair loss. Nizoral shampoo contains 2% ketoconazole, and it's prescribed not only for head scalp conditions treatment, but also as a combination with other medications to treat hair loss. There is 1% concentration product available now over-the-counter, however it may not be as effective as the 2% concentration formulation. The product has no serious side effects.
Finasteride inhibits 5-alpha reductase, inhibiting dihydrotestosterone that causes harm to prostate, and kills hair follicles.
It was first sold under the brand name Proscar as 5 mg tablets. In 1998, the first 1 mg product was introduced to the market under the brand name Propecia, as the first FDA approved medication in the form of tablets for men's hair loss.
It is very effective for most men in preventing hair loss as well as helping it grow back. It can be effective for some women; however, women should not take it in case of pregnancy, and they should not get pregnant when they're taking the medication because it increases the risk of congenital defects in male fetus. Less than 2% of men have temporary sexual side effects including erection and sexual drive problems, whereas women do not have these side effects.
Cyproterone Acetate with Ethinylestradiol:
It is sold under the brand name Diane 35 and Diane 50; this treatment is prescribed in Europe to treat androgenetic alopecia in women. This medication works by blocking some effects of the male hormones that women commonly have.
Although this medication can stop hair loss and help in the regrowth of hair in about one year, it should be used continually to keep hair regrowth and prevent hair loss. Potential side effects include gynecomastia, headache, and decreased sexual drive. It has one positive side effect as it helps preventing osteoporosis. The medication is a combination of cyproterone and estradiol, which is estrogen hormone. The medication is as effective as spironolactone, if it wasn't more even more effective. This medication is currently not available in the United States.