Testosterone supplementation in women with low testosterone

We will occasionally request blood tests in women suffering from hair loss if the diagnosis is unclear. One of the tests we do is a testosterone (T) level as elevated levels of testosterone can be associated with hair loss and we want to rule out this possibility. Many times, however, the test result will reveal that the  level is actually low. The question that arises is whether or not anything should be done about this. Dr. Nakatsui usually requests that the patient discuss this with her family physician to see if testosterone supplementation is reasonable. Over the years, some of the patients who went on supplementation have reported to us that their hair loss actually improved!

Should a woman with low T go on supplementation?

Whether or not to go on supplementation depends on a number of factors. Firstly, does the patient have any other symptoms of low testosterone, such as insomnia, fatigue, depressed mood, hot flashes, and vaginal dryness? If so, perhaps a case could be made to go on supplementation.

The other issue is that of side effects as one of the possible side effects is increased facial hair. Is the patient willing to deal with this?

The last question is whether or not supplementation will actually improve the hair loss.

Evidence that supplementation is helpful

In one study, 76 women with hair loss and low T were placed on supplementation and assessed with respect to their hair loss. Interestingly, 63% of women noticed an improvement in their hair density and most importantly, further hair loss was not noted. The main side effect, though, was increased facial hair growth in the majority of patients.

This study suggests that testosterone supplementation in women with low testosterone may be helpful with respect to hair loss and is not associated with additional hair loss. However, the advantages must be weighed against the potential disadvantages and discussed with the family physician.

Reference

Glaser RL et al. Improvement in scalp hair growth in androgen-deficient women treated with testosterone: a questionnaire study. Br J Dermatol. 2012 Feb;166(2):274-8