As a younger man, you noticed your hair thinning on top. Then a little bald spot popped up. Congratulations, you have male pattern baldness! About half of men do, although in some, it happens decades earlier than in others. (Many women have a similar condition—more about that later.) You know your thinning hair affects your appearance, maybe your self-esteem. But can it be a predictor of your health?
The Testosterone Link
Male pattern balding (MPB)’s medical name is androgenic alopecia. Androgens are “male” hormones, although women have them in smaller amounts, just as men have small amounts of estrogen. The most well-known androgen is testosterone. But a small portion of testosterone is converted into an even stronger androgen called dihydrotestosterone—DHT.
MPB is a genetic condition—it runs in families—marked by increased production of DHT. “Men with male pattern baldness produce higher levels of the enzyme that converts testosterone to DHT,” says Southern Illinois School of Medicine urology professor Kevin T. McVary, M.D., FACS. “DHT is the hormone that causes you to grow hair on your back—and lose it on your head. It also causes your prostate to grow.”
Benign Enlarged Prostate
Men who have male pattern baldness are more likely to experience symptoms of benign prostatic hyperplasia (BPH), aka enlarged prostate, says Dr. McVary. “In one Italian study, men with male pattern baldness were more likely to experience symptoms such as getting up at night, and urination urgency and frequency.” That’s why MPB is “potentially a way to identify men at risk for symptoms of BPH.”
If your pate is shiny, should you get checked? Not neccessarily. “Just because you’re bald doesn’t mean you need to see your doctor,” says Dr. McVary. “But if you have symptoms, bring it to your doctor’s attention.”
Of course, that’s good advice for every man, even those with lion's manes.
There is a link between getting bald early and getting prostate cancer. Several, but not all, studies show it. “Our study showed increased odds of prostate cancer with baldness by age 30,” says Charnita M. Zeigler-Johnson, Ph.D., an epidemiologist at the Perelman School of Medicine at the University of Pennsylvania. Men getting bald in the front by age 30 were more likely to get “clinically significant” prostate cancer before age 60, she found. Another study found the frontal link, but others have found a link with hair thinning in the middle of your head or vertex (the bald spot). While the cause isn’t specifically known, DHT is a suspect.
Time to call the doc? Not yet. It’s still just a statistical link, not a risk factor. More studies need to confirm the connection. “We hope that upon such confirmation, we may be able to use early baldness as a clinical indicator of risk for prostate cancer,” says Zeigler-Johnson. If you’re worried, you may want to reinforce lifestyle changes that can lower your risk, such as eating a plant-based diet with no more than a pound of red meat a week (and little or no processed meats). “If you want to improve your prostate health, either for preventing cancer or BPH, follow the same guidelines for a healthy heart,” says Dr. McVary: “Exercise, eat a low animal-fat diet, and try to keep thin.”
A recent Japanese meta-analysis of six studies, involving 40,000 men, showed a statistical link between MPB and heart disease. Men with severe baldness were about a third more likely to develop heart disease than men with a full head of hair. In this case, the link was to vertex baldness — the bald spot — not a receding hairline. “These studies found an association,” says cardiologist Nieca Golberg, M.D., a clinical associate professor at the NYU School of Medicine. “but it’s far from an established risk factor, such as high blood pressure or high cholesterol.”
If you’re concerned about possible increased cardiovascular disease risk, by all means take charge now. “There are important steps we can take to reduce risk,” says Dr. Goldberg. “Regular exercise, quitting smoking, getting cholesterol checked (and taking meds if you need them), lowering blood pressure—these all lower the risk of heart disease.”
What About Women?
While male pattern baldness is a guy thing, women after menopause often experience a related condition called “female pattern hair loss” (FPHL). It’s characterized not by receding hairline or a bald spot but by a gradual thinning over the crown of the head. It affects as many as 38 percent of women by age 70. Unlike the situation with men, FPHL isn’t tightly linked with excess androgens. Many women with the condition have no excess androgens, although it’s possible that their hair follicles may exhibit some hormonal imbalance. If your doctor does find high circulating androgen levels, though, he or she may want to check into other related conditions such as adult acne or obesity. Although not as well studied as in men, there are some associations between female pattern hair loss and heart disease, especially if it starts early, before age 55. If your hair is thinning, your doctor may want to check you for metabolic and cardiovascular risk. If you have thinning hair, it's also important to check your iron status, since iron deficiency can cause hair loss. As with men, there are medications such as Minoxidil (Rogaine) that may help restore hair growth or reduce hair loss such as Minoxidil (Rogaine). Click here to read more about products that can help women with thinning here.
Other Kinds of Hair Loss
Male pattern, and female pattern, hair loss are the two most common causes of hair loss. But they are far from the only ones. Many factors—diseases such as diabetes, medications, chemotherapy, high fever, poor diet, hair dyes and more—can cause hair to thin or fall out. If you experience unusual hair changes, see your doc. As for treatment, there are a couple of medications approved by the FDA to treat male pattern baldness: Minoxidil (Rogaine), a solution you apply to your scalp, and finasteride (Propecia, Proscar), a pill that blocks certain androgens. Otherwise, the treatment for both men and women is hair transplantation.
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