ANDROPAUSE AND HAIR LOSS: A Comprehensive Guide for Men
Andropause, often called “male menopause,” marks a significant change in a man’s life due to a gradual decrease in testosterone production. While similar to menopause in women, there is a major difference: females experience a rapid hormonal decline, whereas males experience a slow and steady decline over many years. This impacts how symptoms like hair loss manifest.
In our latest blog article, we examine the relationship between andropause and hair loss, providing a comprehensive guide to understanding the underlying mechanisms, recognising the signs, and exploring hair loss treatments and solutions. We’ll unpack the science behind hormonal shifts and discuss the connection between testosterone and dihydrotestosterone (DHT), to help you cope with this challenging phase with confidence and informed choices.
The Link Between Andropause and Hair Loss
Testosterone levels typically reach their peak during adolescence and early adulthood, then start to decline around age 30 or 40 at a rate of 1% to 2% per year. Despite this decline, most older men maintain testosterone levels within the normal range of 450-600 ng/dL. However, 10% to 25% of older men experience clinically low testosterone (below 300 ng/dL), and this prevalence increases with age.
The gradual decline in testosterone levels during andropause is a significant factor in hair loss among ageing men. While decrease in testosterone is characteristic of this phase, it’s actually dihydrotestosterone (DHT), which is derived from testosterone, that causes hair loss.
DHT is a potent androgen hormone essential for developing male sexual characteristics. It is produced from testosterone by the enzyme 5-alpha reductase, and about 10% of circulating testosterone is converted to DHT daily. This hormone plays a crucial role in body and facial hair growth. However, in genetically predisposed individuals, DHT can also contribute to male pattern baldness or androgenetic alopecia.
Hormonal Shifts Beyond Testosterone
Testosterone production decreases, while sex hormone-binding globulin (SHBG) levels rise, reducing bioavailable testosterone. In simpler terms, less free testosterone is available for the body to use, which can exacerbate the effects of other hormonal changes. The hormonal balance shifts, leading to a relative increase in oestrogen compared to testosterone, can contribute to various symptoms, including hair thinning. Even with a gradual decline in testosterone, the increased relative presence of DHT, alongside other hormonal shifts, can still trigger or accelerate hair loss in susceptible men.
Andropause causes hair follicles to shrink and the hair growth cycle to be disrupted due to high androgen levels, DHT in particular, accumulating around the follicles. This process of DHT-induced miniaturisation results in hair that is thinner and more brittle, and eventually, the follicles stop producing hair altogether. The gradual nature of hair loss associated with andropause is due to this slow process of miniaturisation.
DHT interrupts the hair growth cycle, causing hair follicles to stay longer in the catagen and telogen phases (resting and shedding phases) and have a shortened growth phase. This results in more hair shedding and less new hair growth, leading to thinning hair and balding.
The sensitivity of hair follicles to DHT, particularly in the frontal and crown areas, is primarily influenced by genetic predisposition. This susceptibility can be inherited, with a family history of hair loss indicating a heightened risk. Additionally, genetic factors, like the AR gene, influence how sensitive hair follicles are to DHT, thereby impacting hair loss.
Recognising Patterns of Hair Loss
Andropause-related hair loss typically presents as male-pattern baldness, also known as androgenetic alopecia. This condition is characterised by a receding hairline that often forms an “M” or “U” shape, and thinning hair on the crown of the head. Male pattern baldness progresses in a predictable pattern, usually beginning with subtle thinning at the temples and gradually extending to the crown and mid-scalp areas.
The severity of male pattern baldness is commonly classified using the Norwood Scale (or Norwood-Hamilton Scale), which categorises hair loss into seven stages based on the extent of hair loss, and the shape of the receding hairline. While hormonal changes associated with andropause are a primary factor in hair loss, there are other factors that contribute to or exacerbate the condition. These include:
- Chronic stress, which can disrupt hormone levels and accelerate hair shedding
- Some medications that may have hair loss as a side effect
- Significant life events, such as illness or trauma, which can trigger temporary hair loss
- Tight hairstyles that pull on the hair causing traction alopecia, a form of hair loss
- Lifestyle factors, such as poor nutrition, smoking, or excessive alcohol consumption
- Hormonal imbalances, including thyroid disease and diabetes
- Genetics or a family history of hair loss
If you are experiencing hair loss, it’s best to consult a healthcare professional for an accurate diagnosis, and to discuss potential treatment options. Your doctor can assess your medical history, conduct necessary tests, and rule out any underlying medical conditions that may be contributing to your hair loss. They can also provide guidance on lifestyle changes and recommend treatments, which may include hair restoration procedures or hair therapies.
Common Treatments for Andropause-Related Hair Loss
There are several clinically proven treatments to address hair loss linked to andropause. For one, Hair Rejuvenation Micrografts utilise your own skin cells to stimulate natural hair regrowth. This minimally invasive procedure involves extracting minuscule grafts from a non-hair-bearing area and injecting them into balding regions of the scalp, triggering follicle regeneration. Results are often visible within two months, with significant improvements typically observed in 23 weeks, lasting one to 1.5 years.
Meanwhile, the Regenerative Hair Booster system combines various treatments, products, and lifestyle adjustments for a comprehensive approach. Designed to strengthen existing hair, reduce shedding, and encourage new growth, this system offers visible results. It features Hair Booster Microneedling alongside specialised growth serums, for minimal discomfort and no downtime.
Another popular hair loss treatment in Singapore, Low-Level Laser Therapy (LLLT). This FDA-approved non-invasive treatment utilises focused light energy to stimulate cellular activity and promote hair regrowth. LLLT sessions last 20 minutes, initially recommended three times weekly, then tapering to monthly maintenance.
Finally, Follicular Unit Extraction (FUE) offers a more permanent solution. This minimally invasive hair transplant technique extracts individual follicles from a donor area, usually the back or sides of the head, using a small punch tool. These follicles are then transplanted into balding areas, providing natural-looking results with minimal scarring. FUE boasts a short recovery period and offers a “no-shave” option. The procedure duration varies, typically lasting 4 to 8 hours under local anaesthetic, depending on the number of grafts required.
Singapore Hair Loss Solutions
If you’re looking for avenues to address andropause-related hair loss, we offer hair loss solutions customised to your specific requirements. At the helm of Dr. Tyng Tan Aesthetics and Hair Clinic is Dr. Tan Tyng Yuan, MBBS, who has more than a decade of experience in hair loss solutions. Holding degrees from University College London and Cardiff University, and recognised by the ISHRS, she is one of the few doctors certified by the Singapore Medical Council for both FUT and FUE hair transplants.
The clinic offers FUE hair transplants with a discreet ‘no-shave’ option—ideal for those desiring minimal downtime and reduced risk of keloid scarring. For those experiencing mild to moderate hair loss, non-surgical approaches are likewise available, such as Hair Rejuvenation Micrografts, Regenerative Hair Booster, LLLT, Hair Booster Microneedling, and combination solutions based on your unique condition.
To explore your personalised hair restoration options, schedule a consultation by calling +65 6235 0010.
References:
- Andropause and the development of cardiovascular disease presentation—more than an epi-phenomenon
- Male menopause: Myth or reality? – Mayo Clinic
- Is Male Menopause Real? – Scripps Health
- What Is Male Menopause (Andropause)? – Alliance Urology Specialists
- Is it Just Aging, or Something More? Learn the 3 Main Types of Andropause Symptoms
- The ‘male menopause’ – NHS
- Testosterone Levels by Age: Normal Levels for Males and Females – Healthline
- How Aging Affects Testosterone and Muscle Mass in Men | HSS
- Testosterone for the aging male; current evidence and recommended practice – PMC
- DHT (Dihydrotestosterone): What It Is, Side Effects & Levels – Cleveland Clinic
- Aging changes in hair and nails: MedlinePlus Medical Encyclopedia
About Dr Tyng Tan
Dr Tyng Tan has over ten years of experience treating male pattern baldness with the minimally invasive, non-strip method known as FUE (Follicular Unit Extraction) Hair Transplantation.
