Female Pattern Hair Loss

Question
QUESTION: Dear Dr. Thank you for always answering my questions. I appreciate your time. I am trying very hard to trust my Endo's advice but my hair loss progresses and makes me vulnerable to trying anything.

After my last labs, he called and said he wants me to take two drops of TESTOSTERONE transdermally. He says my testosterone is so low it is "undetectable" and that this could be making my hair loss worse. Everything Ive read says DO NOT take testosterone if you have AGA.

Currently taking 2mg.Estrace,100 Prometrium (3 mos).

And 150 mg. Spironolactone and 5% Rogaine (5 yrs)

Would you advise me to add this testosterone if I was your patient?

I'm worried he is more focused on my "balance" than my hair loss.(Between Ludwig Stage II and III)

Appreciate your opinion.



ANSWER: I would not advise Testosterone in a woman losing hair. You may have other causes but I would not add to the problem. The main reason women take supplemental testosterone is to make them feel more peppy, more libido, less depression. If you have no problems with these issues I can not see why it needs to be a bone of contention or a test of wills. It may be that the small dose will have no effect on your hair but if you do not need it for other well defined reasons then why take it.



---------- FOLLOW-UP ----------



QUESTION: Thanks again. Just to follow up, I am having issues with unusual fatigue and depression and my testosterone level was so low it was "virtually unreadable".  He is a very well-respected, highly recommended Endo in our state BUT..I thought a 2nd opinion wouldn't hurt. All of my  issues with fatigue and depression are a direct result of this AGA diagnosis.

He assures me that such low testosterone levels can be causing my hair loss and I can continue taking spiro to conteract any bad effects.

Sounds good, but would you agree?

Thanks Again. Beth


Answer
It sounds good but I am not convinced. In any case you could try it for a short time and if the small amount of testosterone improves your mood and doesn't increase a shed it will turn out to be the right decision. 150mg of spironolactone is good enough to block most androgens in most women. I would be interested in a follow up email in three months.