Androgenic alopecia (AGA) is a common form of hair loss in women, affecting 20-40% of women depending on menopause status. AGA is caused by a genetic predisposition combined with the effects of dihydrotestosterone (DHT), a byproduct of testosterone that miniaturizes hair follicles. Oral contraceptives can help lower testosterone levels but are not an adequate treatment alone. Blocking DHT with prescription medications like spironolactone or finasteride are more effective treatments. Minoxidil is the only over-the-counter treatment approved for female hair loss, but it requires twice daily application and regained hair is lost if treatment ends.

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2. There is a large percentage of women who suffer from Androgenic Alopecia
(AGA). A reasonable estimate is 20% of women experience it prior to
menopause and up to 40% after menopause.
As the name implies, androgenic alopecia is due to a genetic predisposition to
hair loss combined with the byproduct of testosterone called dihydrotestosterone
(DHT). The effect of DHT in the scalp makes it the main culprit of hair loss.
The genes for thinning hair is inherited from either parent. It can start at any age
after puberty but in most cases it occurs with menopause. The genetically
affected hair follicles are susceptible to DHT which causes the follicles to shed
the normal hair and produce thinner, shorter, and colorless hair. This peach fuzz
hair makes the scalp look thinner. Over time, the miniaturized hair follicles
atrophy and die causing permanent hair loss.

3. Oral contraceptives can lower free testosterone levels by about
half. Some OCs seem to be better than others for women with
androgenic alopecia. Though they sometimes help, OCs by
themselves are not an adequate hair loss treatment for AGA. An
additional hair loss treatment in conjunction with OCs is necessary.
Because androgenic alopecia is due to the effects of DHT, the
logical hair loss treatment is a DHT blocker. Several prescription
medications have this action, though they are approved by the FDA
for uses other than female alopecia. The most widely useful is
spironolactone (Aldactone). Finasteride (Propecia and Proscar)
also seems to help androgenic alopecia.

4. Minoxidil (Rogaine) is the one medical hair loss treatment officially
approved for alopecia in women, although it can also be used by men.
Rogaine is non-prescription and comes in two strengths: 2% and 5%.
The 5% is to be used by men while the 2% is for women. As a
treatment for hair loss, it promotes hair regrowth. A common side effect
of this drug is skin irritation and scalp flaking, among others. To tell if
minoxidil is working usually takes three to nine months. Results vary
and not everyone sees positive results.
The main problem with minoxidil is that it must be applied to the entire
scalp twice a day. For men, this is not too difficult, but for women
whose hair is almost always longer, it is easier said than done. Also,
whatever hair regrowth brought about by the drug will fall out if use is
discontinued.