TESTOSTERONE AND HAIR LOSS: How to Get Ahead

The simple fact is that most men are concerned about their looks; for the bodybuilder and fitness enthusiast, appearance is a strong factor in one’s satisfaction. It is undeniable that testosterone (T) directly impacts the physical health, function, and appearance of a man; as well, one’s mental health and cognitive abilities. In the chronology of life, testosterone’s effects produce milestones that easily identify the stages of life: the ultrasound’s shadow of a penis during pregnancy; a wispy mustache during adolescence; a deep voice during adulthood; and with its decline late in life, the loss of muscle, and erectile dysfunction.

- Dan Gwartney

Many men also see hair changes related to testosterone. Regional hair overgrowth can result in scary-looking eyebrows, or furry ears. However, the greatest concern is hair loss. There are numerous causes for hair loss, but this article deals primarily with testosterone-related hair loss, called androgenetic alopecia (AA). AA commonly results in loss of hair in an ever-growing patch, typically from the crown of the head. About half of all men (and a fair number of women) will develop “male pattern balding.” For some, this may start in their early 20s, while others will be spared any noticeable hair loss until their mid-50s.

Bodybuilders and other athletes who have used anabolic-androgenic steroids (AAS) and are predisposed to hair loss often see an acceleration during AAS cycles. Testosterone is an androgen, but in the body it can be converted into a more androgenic form called DHT via an enzyme called 5-alpha reductase (5AR); conversely, it can be metabolized into an estrogen via a separate enzyme group called aromatase. During natural testosterone production, an epimer called epitestosterone is produced in near-equivalent amounts. Epitestosterone has anti-androgenic properties, so it probably balances out the effects of testosterone. AAS users suppress natural testosterone production (and thus epitestosterone production), so they lose that protective “check and balance.” The AAS that cause the most pronounced hair loss are those based upon the DHT structure or those that do not aromatize easily; Winstrol and Anadrol 50 are notorious for this effect.