Androgenetic Alopecia: Is it Age or Hormones?
The majority of otherwise healthy people have thinning hair as they get older. If there is no underlying medical condition to explain it is called senescent hair loss. So how can you tell if your progressively thinning hair is related to androgen hormones (male pattern balding or female pattern hair loss) or simply a biological effect of getting older?(16)
Hair loss from age and hormones both show that as the terminal scalp hairs go through the hair growth cycle the hair follicles miniaturize. The new hairs progressively get shorter and shorter (in effect reverting to the vellus hairs seen at birth) until they disappear. This is because the growth phase (anagen) in hair becomes briefer while the resting phase gets longer.(13, 22)
Is Senescent Hair Loss Really a Separate Category of Thinning Hair?
Some clinicians have argued against purely age-related (senescent) balding isn't a type of hair loss. Their reasoning is because androgenetic hair loss (AGA) is typically found in older adults.(16)
However, genetic studies provide strong evidence supporting that there is a difference between senescent and AGA hair loss. Researchers discovered 431 genes associated with aging hair. In contrast, over 1700 genes were expressed in AGA balding.(16)
Medical Conditions Affecting Hormones Linked to Hair Loss
If you have an endocrine disorder that causes excess androgen secretions, most likely your hair loss is androgenetic alopecia. These conditions include:(16)
If there is no underlying condition, the most obvious clue to the cause of your thinning hair is how old you are. Age-related hair loss begins after age 60, while AGA balding can begin as early as the teenage years.(16)
Another indication of hormone-driven hair loss is the distinctive patterns associated with male and female androgenetic alopecia. Typically all-over hair thinning associated only with age tends to be more diffuse rather than patterned.(16)
Diagnostic Tests to Expect
In a woman with patterned hair loss) and other signs of androgen hormones, a number of different blood and urine tests can be conducted to determine the cause. For example, adrenal gland tumors may or may not be related to Cushing's syndrome. Testing urinary and serum cortisol levels will help distinguish between Cushing's, congenital adrenal hyperplasia, and PCOS.(30, 81)
PSA tests are typically used to find prostate problems in men. Interestingly, this lab test can also be used to detect ovarian or adrenal causes of hormonal hair loss in women. Higher than normal for premenopausal and postmenopausal women are linked to conditions where the ovaries or adrenal glands produce excess androgens.(30)