Hormonal Birth Control & Hair Loss: A Review Of The Evidence

The connection between hormonal birth control and hair loss has become a growing concern for many individuals. While contraceptives offer effective family planning, some users have reported experiencing hair thinning or shedding as a side effect. This issue has sparked interest in understanding how birth control methods, particularly those containing levonorgestrel, may influence hair growth patterns and potentially lead to hair loss.

This article aims to examine the evidence surrounding hormonal birth control and its impact on hair health. We’ll explore the science behind various contraceptive methods, including levonorgestrel-based options, and their potential effects on the hair growth cycle. Additionally, we’ll discuss different types of hair loss associated with birth control, compare high and low androgen index pills, and look into other hormonal contraceptives. The review will also cover the reversibility of birth control-induced hair loss and offer prevention strategies for those concerned about maintaining their hair health while using contraceptives.

The Science Behind Hormonal Birth Control

Hormonal birth control methods have revolutionized family planning, offering effective pregnancy prevention through various mechanisms. These contraceptives work by altering the body’s natural hormone levels, primarily affecting the reproductive system.

How Birth Control Pills Work

Birth control pills, the most common form of hormonal contraception, typically contain a combination of synthetic estrogen and progestin. These hormones work together to prevent pregnancy in several ways:

1. Ovulation Suppression: The primary mechanism is the inhibition of ovulation. The hormones in the pill suppress the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. This prevents the development and release of an egg from the ovaries.
2. Cervical Mucus Changes: Progestin thickens the cervical mucus, making it more difficult for sperm to penetrate and reach the egg.
3. Endometrial Changes: The hormones also thin the lining of the uterus, making it less receptive to implantation of a fertilized egg.

Types of Hormones Used

Hormonal contraceptives utilize various types and combinations of synthetic hormones:

1. Combined Hormonal Methods: These contain both estrogen and progestin. Examples include:
   • Combined oral contraceptive pills
   • Contraceptive patches
   • Vaginal rings
2. Progestin-Only Methods: These contain only progestin and are suitable for women who cannot tolerate estrogen. Examples include:
   • Progestin-only pills (mini-pills)
   • Contraceptive injections (e.g., Depo-Provera)
   • Hormonal intrauterine devices (IUDs)
   • Contraceptive implants

The choice of contraceptive method depends on individual factors, including health considerations and personal preferences. Each type has its own administration schedule and effectiveness rate.

It’s important to note that while hormonal birth control is highly effective at preventing pregnancy, it can have an impact on various aspects of a woman’s health, including potential side effects such as changes in hair growth patterns. The relationship between hormonal contraceptives and hair loss is complex and can vary among individuals. Understanding the science behind these methods can help women make informed decisions about their contraceptive choices and manage potential side effects effectively.

Hair Growth Cycle and Hormonal Influence

Understanding the hair growth cycle and the influence of hormones on hair follicles can help individuals comprehend common hair issues and potential causes of hair loss. This knowledge is essential for those seeking to maintain healthy hair or address concerns related to hair thinning or loss.

Normal Hair Growth Phases

The hair growth cycle consists of four distinct phases:

1. Anagen Phase (Growth Phase):
   • This is the longest phase, lasting 3-5 years on average.
   • Hair grows approximately half an inch per month, or about 6 inches per year.
   • Growth is typically faster in summer than in winter.
   • For some individuals, especially those of Asian descent, this phase can last up to 7 years, allowing hair to grow up to 3 feet long.
2. Catagen Phase (Transition Phase):
   • This short phase lasts about 10 days.
   • It signals the end of active hair growth.
   • Hair follicles shrink and separate from the blood supply.
3. Telogen Phase (Resting Phase):
   • This phase lasts around 3 months.
   • Approximately 10-15% of scalp hairs are in this phase at any given time.
   • Hair doesn’t grow or fall out during this phase.
   • New hairs begin to form in follicles that have released hairs during the catagen phase.
4. Exogen Phase (Shedding Phase):
   • This phase lasts about 2 to 5 months.
   • Old hairs are shed from the scalp, often during washing or brushing.
   • It’s normal to lose 50 to 100 hairs per day during this phase.
   • New hairs continue to grow in the follicles as old hairs fall out.

It’s important to note that each hair follicle goes through this cycle independently. This ensures that all hair doesn’t fall out simultaneously.

Impact of Hormones on Hair Follicles

Hormones play a crucial role in regulating the hair growth cycle and can have a significant impact on hair health. Here’s how various hormones influence hair growth:

1. Androgens:
   • Primary regulators of hair growth in humans.
   • Interact with androgen receptors in dermal papilla cells (DPCs).
   • Convert vellus hairs (thin, short, straight) into terminal hairs (darker, bigger, curlier) in sex-specific body areas.
2. Estrogen:
   • Necessary for pubic and axillary hair development in females.
   • Affects hair follicle changes through locally produced estrogen receptors.
   • Decline in estrogen during menopause can lead to hair thinning.
3. Growth Hormone:
   • Enhances androgen’s influence on sexual hair growth.
   • May affect the testosterone levels required for hair growth stimulation.
4. Insulin and Insulin-Like Growth Factor (IGF):
   • Stimulate hair development in conjunction with androgens.
   • Hyperinsulinemia may increase dihydrotestosterone production.
5. Prolactin:
   • Promotes hair shaft lengthening in the front-temporal region of the scalp in females.
   • May induce catagen in male occipital scalp hair follicles.
6. Thyroid Hormones:
   • Regulate the frequency of the hair cycle.
   • Imbalances can lead to diffuse hair loss across the scalp.
7. Cortisol:
   • Elevated levels due to stress can disrupt the hair growth cycle.
   • May lead to hair loss or thinning.

Understanding these hormonal influences can help individuals and healthcare providers identify potential causes of hair loss and develop appropriate treatment strategies. It’s essential to maintain hormonal balance through a healthy lifestyle and seek medical advice if experiencing significant hair loss or changes in hair growth patterns.

Types of Hair Loss Associated with Birth Control

Birth control methods, particularly hormonal contraceptives, can have an impact on hair growth patterns in some women. While these effects are not universal, it’s important to understand the potential types of hair loss that may occur. There are two primary forms of hair loss associated with birth control: telogen effluvium and female pattern hair loss.

Telogen Effluvium

Telogen effluvium is a type of hair shedding that occurs when there’s a disturbance or shock to the body’s system. This form of hair loss is often immediately noticeable and can be triggered by hormonal changes, including those caused by birth control pills. Here’s what you need to know about telogen effluvium:

1. Mechanism: Birth control pills can cause hair to move from the growing phase to the resting phase too soon and for too long. This disrupts the normal hair growth cycle.
2. Symptoms: Women may experience large amounts of hair falling out during this process. The shedding can be sudden and significant, with some women losing hair in clumps.
3. Timing: This type of hair loss can occur while on the pill or shortly after discontinuing it.
4. Severity: The extent of hair loss can vary. Some women may lose a little bit of hair, while others may experience substantial thinning.
5. Affected areas: Telogen effluvium typically causes diffuse hair loss across the scalp rather than in specific patterns.

Female Pattern Hair Loss

Female pattern hair loss, also known as androgenetic alopecia, is a genetic condition that can be influenced by hormonal factors, including those in birth control pills. This type of hair loss is characterized by gradual thinning over time. Here’s what you should understand about female pattern hair loss in relation to birth control:

1. Genetic predisposition: Women with a family history of hormone-related hair loss may be more susceptible to this type of hair thinning while using hormonal contraceptives.
2. Hormonal influence: Some birth control pills can trigger or worsen hair thinning due to their androgenic activity. Progestin, a synthetic form of progesterone found in many contraceptives, can produce effects similar to male hormones.
3. Gradual process: Unlike telogen effluvium, female pattern hair loss occurs gradually over time, leading to reduced hair volume and potentially making the scalp more visible.
4. Varying effects: The impact of birth control on hair thinning can differ among individuals. Some women may find that certain pills slow or stop the thinning process by increasing estrogen levels or diminishing testosterone levels. Others may experience worsening hair thinning.
5. Sensitivity factors: The effect of birth control on hair loss depends on how sensitive an individual’s hair follicles are to the hormones in the pill, as well as their body chemistry and metabolism of the drug.

It’s crucial to note that not all women will experience hair loss while using birth control. The likelihood of experiencing these effects is higher in women who are especially sensitive to hormonal changes or have a family history of hormone-related hair loss. Additionally, other hormonal birth control methods such as injections, skin patches, progestin implants, and vaginal rings can also potentially cause or exacerbate hair loss.

For those concerned about the potential for hair loss, it’s advisable to consult with a healthcare provider. They can discuss options for birth control pills with low androgenic activity or explore non-hormonal contraceptive methods. Remember, while hair loss can be distressing, there are often solutions available, and seeking professional advice is the best course of action.

Birth Control Pills with High vs. Low Androgen Index

The androgen index of birth control pills plays a crucial role in their potential impact on hair growth and loss. Androgens, including testosterone, are male sex hormones that are also present in females, albeit in smaller quantities. 

These hormones have a significant influence on hair growth patterns. Understanding the difference between high and low androgen index pills can help women make informed decisions about their contraceptive choices, especially if they have concerns about hair loss.

High Androgen Index Pills

Birth control pills with a high androgen index may contribute to hair loss in some women, particularly those with a genetic predisposition to hair thinning. These pills contain more androgens, which can have the following effects on hair:

1. Conversion to DHT: Testosterone converts to dihydrotestosterone (DHT), which can damage hair follicles.
2. Shortened anagen phase: Androgens may shorten the anagen phase of the hair growth cycle, which is when hair actively grows.
3. Prolonged exogen phase: The exogen phase, during which hair falls out, may be extended.

These combined effects can result in increased hair loss for some women. Pills with higher levels of androgens include:

• Triphasil/Tri-Levien
• Nordette
• Lo/Ovral
• Ovral
• Loestrin 1/20
• Loestrin 1.5/30
• Ovrette

Women who have a family history of hair loss or are particularly sensitive to hormonal changes may want to avoid these high androgen index pills if hair thinning is a concern.

Low Androgen Index Pills

On the other hand, birth control pills with a low androgen index are less likely to cause hair loss and may even help improve hair growth in some cases. 

These pills often contain more estrogen compared to progestin, which can have a positive effect on hair growth by:

1. Prolonging the anagen phase: Estrogen can keep hair in the growth phase for a longer period.
2. Counteracting androgen effects: Some progestins used in these pills have anti-androgenic properties.

Low androgen index pills that may be less likely to cause hair loss include:

• Desogen
• Ortho-Cept
• Ortho-Cyclen
• Ortho Tri-Cyclen
• Micronor
• Nor-Q D
• Ovcon-35
• Brevicon/Modicon

Some newer oral contraceptives have even lower androgenetic effects and can be particularly beneficial for women concerned about hair loss. These include:

• Yasmin
• Yaz
• Mircette

Yaz and Yasmin contain drospirenone, a progestin with anti-androgen properties, which can be especially helpful for women experiencing female pattern hair loss.

It’s important to note that the impact of birth control pills on hair growth can vary significantly among individuals. Factors such as genetic predisposition, overall health, and individual hormone sensitivity all play a role in how a woman’s body responds to different contraceptives.

For women who are particularly concerned about hair loss, consulting with a healthcare provider is crucial. They can help select a birth control option that balances contraceptive effectiveness with minimal risk of hair-related side effects.

 In some cases, birth control pills can even be prescribed specifically to address hair loss issues, especially for women with conditions like polycystic ovary syndrome (PCOS) that can contribute to hair thinning.

Remember, while the androgen index is an important factor to consider, it’s not the only aspect that determines the suitability of a birth control pill. Other factors such as overall health, medical history, and individual contraceptive needs should also be taken into account when choosing the most appropriate birth control method.

Other Hormonal Contraceptives and Hair Loss

While birth control pills are widely used, other hormonal contraceptives also have the potential to impact hair growth and loss. These alternative methods include injections, implants, patches, and rings. Each of these contraceptives has its unique mechanism of action and potential side effects on hair health.

Injections

The most common injectable contraceptive is Depo-Provera, which contains progestin. A study involving 536 individuals using this method revealed significant effects on skin and hair:

• After 3 months of use, 8% of new users reported acne or other skin problems.
• This percentage increased to 14% after 9 months of use.
• Hair loss was reported by up to 11% of users over the first 9 months.
• Up to 3% of users experienced facial hair growth as a side effect.

These statistics highlight the potential for Depo-Provera to have a noticeable impact on hair growth patterns and skin health.

Implants

Contraceptive implants, such as Nexplanon and Jadelle, are small devices inserted under the skin that release hormones over an extended period.

Nexplanon, which contains etonogestrel:

• In a study of 942 users over two years, 12% reported acne as a side effect.
• Only 1% discontinued use due to acne.
• Another study in Chile found that 13% of users reported new or worsening acne during the first two years of use.
• Interestingly, an equal number of users reported improved acne while using the implant.

Jadelle, which uses levonorgestrel:

• In a five-year study of 594 users:
  • Five individuals discontinued use due to acne.
  • Four stopped due to hair loss.
  • Two removed the implant because of hirsutism or coarse hair.
  • Four cited “other skin problems” as the reason for removal.

It’s important to note that these studies did not report the number of participants who experienced side effects but continued using the implant.

Patches and Rings

The contraceptive patch (e.g., Xulane) and vaginal ring (e.g., Nuvaring) are less studied in terms of their effects on hair and skin health.

Patches:

• Limited research exists on how patches affect skin and hair condition.
• A small study of adolescents with pre-existing acne showed that after 7 months of patch use:
  • 33% experienced improved acne.
  • 17% reported worsened acne.
  • 50% saw no change in their acne condition.

Rings:

• Research on the ring’s impact on hair health is also limited.
• An analysis of three studies found that people using the birth control ring for 3 to 13 months reported less acne compared to those using birth control pills.

It’s crucial to understand that these hormonal contraceptives can have varying effects on individuals. The androgenic effects of progestogens in these methods can lead to hair loss, acne, and hirsutism in some users. However, the impact can differ greatly from person to person.

For those concerned about potential hair loss or other side effects, it’s essential to consult with a healthcare provider. They can help weigh the benefits and risks of different contraceptive methods based on individual health profiles and concerns. Remember, while these side effects can be distressing, there are often alternative options available that may be more suitable for maintaining hair health while providing effective contraception.

Reversibility of Birth Control-Induced Hair Loss

The reversibility of hair loss induced by birth control is a common concern for many individuals. While the experience can be distressing, it’s important to understand that in most cases, this type of hair loss is temporary and reversible. The process of hair regrowth after discontinuing birth control can vary from person to person, depending on several factors.

Timeline for Hair Recovery

The timeline for hair recovery after stopping birth control can be divided into several phases:

1. Initial Shedding: Within 4-8 weeks after discontinuing birth control, many individuals may experience increased hair shedding. This is often due to telogen effluvium, a temporary condition triggered by hormonal changes.
2. Stabilization Period: For most people, the shedding phase begins to stabilize around 7-10 months after stopping birth control.
3. Return to Normal Density: In many cases, hair density returns to normal by around 12 months after discontinuing birth control.

It’s crucial to note that this timeline can vary significantly among individuals. Some may experience little to no noticeable change in their hair, while others may have a more prolonged recovery period.

Factors Affecting Regrowth

Several factors can influence the regrowth of hair after stopping birth control:

1. Underlying Genetic Predisposition: Individuals with a genetic predisposition to androgenetic alopecia (pattern hair loss) may experience different regrowth patterns. In some cases, stopping birth control might unmask or accelerate an underlying tendency towards hair loss.
2. Type of Birth Control Used: Different types of birth control can have varying effects on hair growth. Some formulations may have been helping to maintain hair density without the user’s knowledge.
3. Individual Hormone Sensitivity: The body’s response to hormonal changes can differ greatly from person to person. Some individuals may be more sensitive to the hormonal fluctuations that occur when stopping birth control.
4. Overall Health and Nutrition: General health status and nutritional factors can play a role in hair regrowth. A balanced diet and good overall health can support the hair recovery process.
5. Stress Levels: High stress levels can impact hair growth cycles and potentially prolong the recovery period.

It’s important to understand that while birth control-related hair loss is often reversible, the recovery process can take time. Patience is key, as it may take several months for noticeable improvements in hair density.

In some cases, individuals may find that their hair does not fully return to its pre-birth control state. This could be due to underlying factors that were previously masked by the hormonal effects of birth control. In such situations, it’s advisable to consult with a healthcare provider or a dermatologist specializing in hair loss.

For those experiencing persistent hair loss after stopping birth control, there are various treatment options available. These may include topical treatments, oral medications, or other hair restoration techniques. A healthcare professional can provide personalized advice based on individual circumstances and medical history.

Remember, while hair loss can be emotionally challenging, it’s often a temporary situation when related to birth control use. With time and proper care, many individuals see significant improvement in their hair growth and density after discontinuing hormonal contraceptives.

Prevention Strategies for Birth Control Users

For individuals concerned about hair loss while using birth control, there are several strategies to consider. These approaches focus on choosing the right contraceptive method and monitoring hair health to minimize potential adverse effects on hair growth.

Choosing the Right Contraceptive

The type of contraceptive and its hormonal composition play a crucial role in its potential impact on hair health. When selecting a birth control method, individuals should consider the following factors:

1. Progestin Type: The specific progestin used in birth control matters, as some have a more androgenic effect than others. Progestins with lower androgenic activity are less likely to cause hair-related side effects.
2. Androgen Index: Birth control pills with a lower androgen index are generally considered better for hair health. Some options with lower androgenic effects include:
   • Desogen
   • Ortho-Cept
   • Ortho-Cyclen
   • Ortho Tri-Cyclen
   • Micronor
   • Nor-Q D
   • Ovcon-35
   • Brevicon/Modicon
3. Estrogen-Progestin Balance: Pills containing a higher ratio of estrogen to progestin may be more beneficial for hair growth. Estrogen can help prolong the anagen (growth) phase of the hair cycle.
4. Anti-Androgenic Properties: Some newer oral contraceptives contain progestins with anti-androgenic properties. For example, Yaz and Yasmin contain drospirenone, which can be particularly helpful for women experiencing female pattern hair loss.
5. Consider Non-Hormonal Options: For those highly susceptible to hair loss, non-hormonal contraceptive methods such as copper IUDs or barrier methods may be worth considering.

It’s important to note that the effects of birth control on hair can vary significantly among individuals. What works well for one person may not be suitable for another. Consulting with a healthcare provider can help determine the most appropriate contraceptive option based on individual health history and concerns.

Monitoring Hair Health

Regular monitoring of hair health is crucial for early detection and management of any potential hair loss related to birth control use. Here are some strategies to consider:

1. Baseline Assessment: Before starting a new birth control method, it can be helpful to establish a baseline for hair health. This may include taking photos or noting any existing hair concerns.
2. Regular Check-ins: Schedule regular check-ins with a healthcare provider or dermatologist to assess hair health and discuss any concerns.
3. Track Changes: Keep a journal to document any changes in hair texture, density, or shedding patterns. This information can be valuable when discussing concerns with a healthcare provider.
4. Be Aware of Timing: Understand that hair changes may not be immediate. Telogen effluvium, a type of hair shedding, can occur when starting, switching, or discontinuing birth control pills. This typically happens within 4-8 weeks of the change.
5. Consider Scalp Health: Maintain good scalp health through proper hair care practices, as this can support overall hair health.
6. Nutritional Support: Ensure a balanced diet rich in vitamins and minerals essential for hair health, such as iron, biotin, and vitamin D.
7. Stress Management: As stress can exacerbate hair loss, implementing stress-reduction techniques may be beneficial.

It’s important to remember that while birth control can influence hair growth, it’s not always the sole cause of hair changes. Genetic predisposition, overall health, and other factors can also play significant roles.

 If persistent hair loss occurs, it’s crucial to consult with a healthcare provider or a trichologist for a comprehensive evaluation and personalized treatment plan.

By choosing an appropriate contraceptive method and actively monitoring hair health, many individuals can effectively manage their reproductive health while minimizing the risk of hair-related side effects. However, it’s essential to approach this process with patience, as it may take time to find the right balance and see improvements in hair health.

Conclusion

The exploration of hormonal birth control and its potential effects on hair health sheds light on a complex interplay between contraceptives and hair growth cycles. While some individuals may experience hair-related side effects, it’s crucial to remember that these effects are often temporary and reversible. Understanding the different types of birth control, their androgen indices, and how they interact with hair follicles empowers users to make informed decisions about their contraceptive choices.

For those concerned about hair health while using birth control, there are numerous strategies to consider, from selecting low androgen index pills to exploring non-hormonal options. Regular monitoring of hair health and open communication with healthcare providers are key to addressing any issues promptly. Our experts are available to assess your hair loss condition and provide you with a detailed plan tailored to your needs. To restore your confidence with our professional hair restoration services, get a Free Hair Analysis and Quote. Remember, while hair loss can be distressing, there are often solutions available, and seeking professional advice is the best course of action.

FAQs

Can hormonal birth control lead to hair loss?

Yes, some forms of hormonal birth control can lead to hair loss due to the androgenic activity of the progestin component. Different progestins vary in their level of androgenic activity. Individuals who are susceptible to hair loss might consider using a birth control pill with lower androgenic activity.

What can be done to reverse hair loss caused by birth control?

Typically, hair loss caused by birth control should cease after discontinuing the pill for some time. If hair loss persists and there is no regrowth, it is advisable to consult a doctor about using Minoxidil 2%, which is the only treatment for female hair loss approved by the U.S. Food & Drug Administration (FDA).

How can one regrow hair after hormonal hair loss?

Various treatments are available for managing female hair loss or female pattern baldness. These include topical medications like Rogaine, light therapy, hormone therapy, or even hair transplants in certain cases. Additionally, maintaining a nutritious diet and a healthy lifestyle can contribute to overall hair health.

Is Diane 35 effective in stopping hair loss?

Diane 35, which is used both as an oral contraceptive and for treating androgenic hormonal disorders such as hair loss, baldness, facial hair, and acne in women with PCOS, can help manage hair loss. However, it should not be used by women who are planning to conceive, are pregnant, or are breastfeeding.