Hair loss in women: the common causes, explained

Hair loss is often thought of as a male problem, but it is common in women too, and it can be especially distressing. The good news is that many causes can be identified and some respond to treatment. The first step is working out which type you have.

Pattern hair loss in women

Female pattern hair loss is the most common cause of gradual thinning in women ¹. It usually shows up as:

• A widening parting on the top of the head
• Thinner hair over the crown, while the front hairline is usually kept
• A ponytail that feels smaller than it used to

It tends to run in families and becomes more common with age, particularly after menopause ^{2 3}. It does not usually lead to complete baldness. Treatments that may help include topical minoxidil ⁴, and in some cases a doctor may consider other medicines ⁵. Read more in pattern hair loss explained.

Telogen effluvium: shedding after a trigger

Telogen effluvium causes heavy, even shedding all over the scalp, typically two to three months after a trigger ⁶. Common triggers in women include:

• Childbirth (see postpartum hair loss)
• Fever, infection or surgery
• Rapid weight loss or a very restrictive diet ⁷
• Severe emotional stress
• Starting or stopping some medicines, including hormonal contraception ⁸

Shedding usually settles within several months once the trigger has passed. If it continues for more than six months, see a doctor.

Iron deficiency and other nutrients

Women who have heavy periods, are pregnant or have recently given birth, or follow a diet low in iron are at higher risk of iron deficiency. Iron deficiency anaemia can cause tiredness, breathlessness, pale skin and hair loss ⁹. A blood test can check your iron levels. Do not take iron supplements without advice, as too much iron can be harmful ¹⁰. See vitamin deficiencies and hair loss.

Thyroid problems

Both an underactive and an overactive thyroid can cause hair thinning, along with other symptoms such as changes in weight, energy and temperature tolerance ^{11 12}. Thyroid problems are more common in women and can be diagnosed with a blood test.

Hormonal conditions such as PCOS

Polycystic ovary syndrome (PCOS) can cause thinning hair on the scalp, along with irregular periods, acne and extra hair on the face or body ¹³. If you have these symptoms, mention them to your doctor.

Hairstyles and hair care

Hairstyles that pull tightly on the hair for long periods, such as tight ponytails, buns, braids and extensions, can cause traction alopecia, often along the hairline ^{14 15}. Wearing a tightly fastened inner cap under a headscarf every day may also pull on the hairline for some women ¹⁶. Loosening styles early may allow recovery, but long-standing traction can cause lasting damage. Chemical straightening, bleaching and frequent heat styling can damage the hair shaft and cause breakage ¹⁷.

Alopecia areata

Alopecia areata causes round, smooth bald patches and can affect women and men of any age ¹⁸. Read alopecia areata explained.

Menopause

Hormonal changes around menopause can be associated with hair thinning on the scalp ^{19 20}. Some women also notice hair becoming finer and drier.

When to see a doctor

See a doctor if your hair loss is sudden or patchy, your scalp is sore, itchy or scaly, you have other symptoms, or you are worried ²¹. A doctor may ask about your periods, pregnancies, diet, medicines and family history, look at your scalp and arrange blood tests. A dermatologist can help if the cause is unclear or if a scarring type of hair loss, such as frontal fibrosing alopecia, is suspected ²².

A note on treatments

Some treatments are not suitable for women who are pregnant, breastfeeding or could become pregnant. For example, finasteride must not be used by women who are or may become pregnant ²³. Always discuss options with a doctor or pharmacist. If you are not sure where to start, read what to do about hair loss.

Frequently asked questions

What is the most common cause of hair thinning in women?

Female pattern hair loss is the most common cause of gradual thinning, usually showing as a widening parting ¹.

Can stress cause hair loss in women?

Yes. Severe stress can trigger telogen effluvium, a temporary shedding that usually starts two to three months later and settles over time ⁶.

What blood tests are done for hair loss in women?

Doctors commonly check iron levels and thyroid function, and may test for other conditions depending on your symptoms ^{9 11}.

Can wearing a tudung cause hair loss?

A headscarf itself is not known to cause hair loss, but tight styles or tightly fastened inner caps that pull on the hair over time may cause traction alopecia for some women ¹⁶.

Educational content. Not medical advice.