Male vs. Female Pattern Baldness (Androgenetic Alopecia): What’s the Difference?

Male vs. Female Pattern Baldness (Androgenetic Alopecia): What’s the Difference?

From causes to treatment options, androgenetic alopecia differs in men and women. Here are 6 ways that’s true, according to experts.
Male vs. Female Pattern Baldness (Androgenetic Alopecia): What’s the Difference?
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Both men and women can experience androgenetic alopecia, which is better known as male or female pattern baldness.

But the condition can look different in men than in women, says John Browning, MD, a dermatologist with Texas Dermatology and Laser Specialists in Alamo Heights.

For starters, androgenetic alopecia affects different areas of the scalp in men than in women. It also tends to start at different ages. Here are six differences between male and female pattern baldness, plus how to treat it.

1. Hair Loss Can Happen to Men at a Younger Age Than Women

Men usually start to see hair loss in their thirties, says Dr. Browning, although he occasionally treats teenagers who have early onset androgenetic alopecia. With age, more men become affected. In fact, about half of men have some male pattern baldness by age 50, and about 4 in 5 men have it by age 70.

Women typically hold onto their locks a little longer — about 10 to 15 years after men typically start losing hair, says Browning. In women, alopecia usually occurs after menopause, largely because hormonal changes in the body — such as an increase in androgen and decrease in estrogen — also alter the hair follicles.

2. Hair Loss Affects Different Parts of the Scalp in Men vs. Women

Androgenetic alopecia does not affect every hair follicle on your scalp. Men tend to thin in the front and crown of the head, so they may appear to have a receding hairline or bald spot.

For women, hair thins on the top of the scalp, but not usually in the front of the head. “There is widening of the central part that progresses to more diffuse thinning,” says Shoshana Marmon, MD, PhD, an assistant professor of dermatology and the director of clinical research in the dermatology department at New York Medical College in Valhalla. Total baldness in females is rare, she adds.

What Are the Causes and Risk Factors of Androgenetic Alopecia?

Kristen Lo Sicco, MD, identifies some factors that could potentially put you at risk for developing androgenetic alopecia.
What Are the Causes and Risk Factors of Androgenetic Alopecia?

3. Hair Loss Is Linked to Different Health Conditions in Men and Women

Genetics — specifically, the androgen receptor gene — plays a major role in male and female hair loss. If you have a variation in this gene, your hair follicles are more sensitive to an androgen called dihydrotestosterone (DHT), which is a derivative of testosterone. Higher levels of DHT lead to thinner and shorter hair follicles (the tubelike structures that produce strands of hair), which may eventually stop growing hair altogether.

Androgen sensitivity, though, can be linked to different health conditions for men and women. Up to 67 percent of women with androgenetic alopecia, for example, also have polycystic ovary syndrome (PCOS), a hormone disorder that can cause hirsutism, or unwanted hair growth on the face, chest, and back.

Men who have androgenetic alopecia may have an increased risk of coronary artery disease, a type of heart disease in which the blood vessels that supply blood to the heart narrow and become blocked. In fact, one study suggested that androgenetic alopecia can be used as a screening method for coronary artery disease.

4. Going on Testosterone Replacement Therapy May Promote Hair Loss in Men

In recent decades, the use of testosterone replacement therapy (TRT) in men has increased in the United States.

TRT is used to address symptoms of low T in men, including erectile dysfunction, loss of muscle mass, loss of sex drive, and mood problems.

(While women, too, may receive testosterone replacement to improve sexual functioning or relieve symptoms of menopause, there is little evidence for doing so, so it is not widely prescribed.)

One potential side effect of TRT is hair loss on your head. “I often ask my patients who come into my office with androgenetic alopecia if they are taking any [supplemental] testosterone,” says Browning. Other signs may be the new development of acne or oilier-than-normal skin. The higher your testosterone levels, the more testosterone will be converted into DHT, which can cause the hair follicles to shrink and lead to hair loss.

If you are on TRT, make sure your T levels are monitored closely by a healthcare professional.

5. Men and Women May Receive Different Treatment Recommendations

For both men and women, one of the gold standards of androgenetic alopecia treatment is minoxidil.

 Minoxidil is commonly known by the brand name Rogaine, but it’s also used in other hair growth products. Men’s Rogaine is a topical solution that’s available in a 5 percent minoxidil strength. Women have the choice of 2 or 5 percent minoxidil products. Browning, though, advises women to use the 5 percent product, as the 2 percent is “just not that effective,” he says.

There are also oral options that may differ between men and women. Finasteride (Propecia) is approved by the U.S. Food and Drug Administration to treat hair loss in men,

 but because it may cause birth defects, it is not prescribed to women of reproductive age. It may be prescribed off label for postmenopausal women.

 Another option is an antiandrogen medication called spironolactone, which can also be prescribed off label. Spironolactone may improve hair growth when used alone or in combination with other treatments. (It may also be prescribed for women with PCOS, because they tend to make excess androgen.)

 Talk to your doctor about the treatment regimen that’s right for you.

6. Men’s and Women’s Experiences With Hair Loss Differ

Even though hair loss affects both men and women, women may deal with more stigma from it. “Androgenetic alopecia presents earlier in life for most men, compared to women,” says Kristen Lo Sicco, MD, a dermatologist at NYU Langone Dermatologic Associates in New York City. So, “Society often expects men to have hair loss at some point. ... As a result, many men experiencing hair loss may not receive unsolicited comments regarding their health.

That’s not to say hair loss doesn’t affect men’s confidence. It absolutely can, she says, and could take a toll on both their personal and professional lives. But hair loss can be more serious for women, who may be asked more personal questions, such as whether they have cancer.

The beauty of a woman can sometimes be defined by her hair, says Ken L. Williams Jr., DO, a surgeon and the founder of Orange County Hair Restoration in Irvine, California. He treats more women than men. When hair loss happens to a woman, it can be devastating, he says.

Whether you’re a man or a woman, it’s important to know who you are, says Dr. Williams. “We are not defined by our appearance but who we are emotionally and spiritually.”

The Takeaway

  • Androgenetic alopecia affects both men and women, but the causes, manifestations, and even treatments may differ.
  • Men generally start losing hair at least a decade earlier than women. In men, hair loss is most often seen on the frontal hairline, while women will see it as a widening of the part.
  • Minoxidil is a common treatment for both men and women, but there are two strengths available for women.
EDITORIAL SOURCES
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Resources
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  5. Hirsutism. Mayo Clinic. October 12, 2021.
  6. Wang Y-X et al. Association Between Androgenic Alopecia and Coronary Artery Disease: A Cross-Sectional Study of Han Chinese Male Population. International Journal of General Medicine. August 26, 2021.
  7. Mulhal JP et al. Evaluation and Management of Testosterone Deficiency (2024). American Urological Association. 2018.
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Dr. Sanober Pezad

Sanober Pezad Doctor, MD

Medical Reviewer

Dr. Sanober Pezad Doctor is a double board-certified dermatologist and internationally recognized leader in integrative and holistic dermatology. She is an anti-aging and regenerative medicine specialist and the founder of AGEnesis and Baby SkinWise.

She earned her MD in dermatology, venereology, and leprology and a diplomate of national board (DNB) in dermatology. She is board certified in anti-aging and regenerative medicine from the American Academy of Anti-Aging Medicine (A4M). She's also a trained clinical homeopath through the Center for Education and Development of Clinical Homeopathy (CEDH).

Sanober is the founder of AGEnesis: The Holistic Aging Blueprint, a science-backed, multidimensional protocol for healthy skin aging, and Baby SkinWise, the world’s first audiovisual skincare guide for parents. She also hosts the YouTube channel "Healthy Aging with Dr. Doctor," where she delivers educational content on evidence-based skincare, hair health, and integrative health practices.

Sanober is a medical school gold medalist and recipient of multiple national and international awards. She is also the chief dermatology medical advisor for emerging clinical research in integrative skin and hair health, with more than 50 published scientific articles.

Sanober is a proactive, compassionate medical practitioner with a thorough understanding of overall mind-body-spiritual wellness. She's also a key advocate for the healthy aging movement. She's a simple mommy to the core and strongly believes "prevention is better than cure." She's on a mission to make you and me into the healthiest version of ourselves.

Jessica Migala

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Jessica Migala is a freelance writer with over 15 years of experience, specializing in health, nutrition, fitness, and beauty. She has written extensively about vision care, diabetes, dermatology, gastrointestinal health, cardiovascular health, cancer, pregnancy, and gynecology. She was previously an assistant editor at Prevention where she wrote monthly science-based beauty news items and feature stories.

She has contributed to more than 40 print and digital publications, including Cosmopolitan, O:The Oprah Magazine, Real Simple, Woman’s Day, Women’s Health, Fitness, Family Circle, Health, Prevention, Self, VICE, and more. Migala lives in the Chicago suburbs with her husband, two young boys, rescue beagle, and 15 fish. When not reporting, she likes running, bike rides, and a glass of wine (in moderation, of course).