Can Birth Control Pills Cause Hair Loss?

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Note: I’m not a doctor and this article shouldn’t in any circumstance be taken as a diagnosis. I am telling my experience, through the gathering of data and scientific information and writing my personal opinion, which happened to be sustained by the scientific sources and studies I have found regarding this subject.


Hint: Yes, some of them can.

It was in the beginning of this year that I started to notice not only a thinning of all my hair, but a lack of density in certain areas such as the top of the head. Little did we know that 2020 was already destined to be a total flop. This was just the beginning of my journey in understanding what was going on in my body.

It’s important to say that I’ve had beautiful, long, strong hair all my life since I was a little girl. Even through puberty, my hair was one of my proudest assets. Until… you guessed it: I started using the birth control pill as a contraceptive method.

The Problem

Now, if you’re wondering, I’m not one of those people who hates medicine. In fact, I’m quite fascinated by the way doctors and drugs are able to save lives — I’m the biggest House M.D fan. What appalls me, especially in female reproductive health is how doctors, in general, still hide scientific facts and crucial information from women for matters of… convenience? And how far behind western medicine is from a real understanding of many female diseases.

It may seem easier to conceal every women’s health issue by prescribing birth control pills, but is it really the best thing? Do doctors really believe they’re doing the best they can? Ignoring the fact that conditions such as Endometriosis or PCOS aren’t “cured” with the pill?

According to the American Hair Loss Association “Millions of women are prescribed the pill each year in this country, but very few are aware that oral contraceptives are a common trigger of hair loss for many who use them.”

This is where the problem lies. I was prescribed a pill with a high potential of side effects and I wasn’t even aware of that. I took it for four years, convinced it was a very good thing. Turns out something called alopecia was silently developing, my nails were weaker than ever and my libido was lost in the Sahara desert. While these aren’t matters of life or death, they sure matter. And I wished I would have been told things like these could happen.

Hair Loss: An Epidemic

If we take some time to think about it, it’s a pertinent discussion and it makes the most sense to reflect on why it’s happening. Twenty years ago, female hair loss was something women suffered occasionally with childbirth or illness. Now, it’s so common doctors see it every day.

I have researched extensively on this subject and amid much noise, I found Dr. Lara Briden. She’s a Bachelor of Science in Biology from the University of Calgary, and Doctor of Naturopathic Medicine (ND) from the Canadian College of Naturopathic Medicine and specializes in female reproductive health. According to Dr. Briden, “Young women are suffering an epidemic of hair loss, and it’s time for some straight-talk about why it’s happening.” She says, “My patients are losing piles of hair — they see it on their brushes, and they see it all over the floor, they’re not imagining things.”

Come on, it’s impossible our genes have changed in two decades. Previous generations of young women had the same genes and they also suffered iron deficiency, thyroid disease, PCOS and they dieted. None of that is new, yet previous generations did not suffer the epidemic of female hair loss we’re seeing now. “The thing that has changed,” Dr. Briden is relentless, “is that more women today use more hormonal birth control, and they’ve started it at a younger age.”

And frankly, she’s not the only one who thinks so. The American Hair Loss Association (AHLA) has also warned about the impact of hormonal birth control on hair. In a 2010 statement, the AHLA said that “it is imperative for all women especially for those who have a history of hair loss in their family to be made aware of the potentially devastating effects of birth control pills on normal hair growth.”

What Contraceptives Can Cause Hair Loss?

To understand the science behind what causes hair loss, it’s helpful to understand the science behind how contraceptives work.

“Birth control causes hair loss if it contains a progestin, a synthetic version of progesterone, with a high androgen index,” Dr. Briden explains.

Progestins with a high androgen index include medroxyprogesterone, norgestrel, etonogestrel and levonorgestrel. One solution for women struggling with a high androgen index contraceptive could be to switch to a progestin with a lower androgen index such as drospirenone and cyproterone, which have in fact anti-androgenic effects, but unfortunately those progestins also carry a higher stroke risk. In my case, these were absolutely not an option because I have heart and circulatory disease risks running in the family.

Take a look at the molecular structure images below.

Can you spot the difference? Levonorgestrel is actually more similar to testosterone than it is to progesterone, which is why it can cause hair loss.

This is what I mean by “show me the evidence”. As Dr. Briden explains, “Progestins with a high androgen index act like testosterone in the body, shrinking hair follicles and thinning hair much like testosterone does in men.”

According to the Journal of the American Academy of Physician Assistants, “Contraceptives with androgenic effects, especially first and second-generation progestins1, can induce androgenic alopecia and chronic telogen effluvium, and can worsen the effects for women who already have androgenic alopecia.”

This is proof that some contraceptives can lead to an increase in the testosterone metabolite DHT, which leads to hair loss by shortening the hair growth cycle.

Conclusion

So, yes. It’s reasonable to assume that your birth control pill or hormonal contraceptive is the cause of your shredding, thinning hair if:

  • You take a progestin with a high-androgen index
  • You’ve been on it for at least three months
  • Your hair is becoming finer
  • Your hair is thinning on top
  • Your part is widening
  • You have no other explanation for hair loss such as thyroid disease

I wonder why more doctors and health practitioners don’t take the approach of telling patients what hormonal contraceptives can potentially do to their bodies. Which could help those who have experienced or are concerned about hair loss feel more comfortable about shifting to another birth control pill or even a non-hormonal method.

On a deeper level, I would love to see more efforts being taken by science towards developing efficient, painless, non-hormonal contraception. As always, it’s been a woman’s burden to carry but it’s not exclusively our responsibility.

1 First-generation progestins: estranes such as norethisterone. Second-generation progestins: norgestrel and levonorgestrel.