Hair loss is a sensitive subject for many individuals, particularly men who often associate a full head of hair with youth, vitality, and self-confidence. There are numerous reasons why men may experience thinning hair or baldness, ranging from genetic predisposition to hormonal imbalances. One hormone often under the spotlight when it comes to hair loss is testosterone. For men in the UK—Manchester included—understanding the relationship between testosterone and hair growth can help in deciding the most appropriate course of action, whether this means visiting a local hair clinic, seeking medical advice, or making lifestyle adjustments.

We will explore whether low testosterone truly causes hair loss, what the medical literature and clinical studies indicate, and how men in Manchester and the rest of the UK can address any concerns. We will discuss the role of testosterone and its derivative, dihydrotestosterone (DHT), in hair loss; how to identify and manage low testosterone; and the various treatment options available, including medical therapies and potential surgical interventions.

Understanding Testosterone and Its Role in the Body

Testosterone is a steroid hormone primarily produced in the testes in men, with a small amount also produced by the adrenal glands. It plays a significant role in the development of male sexual characteristics, influencing factors such as muscle mass, bone density, and libido. Testosterone levels generally peak in early adulthood and gradually decline with age. While this decline is normal, some men experience levels that are lower than what is considered optimal.

According to research found on the National Center for Biotechnology Information (NCBI), normal total testosterone levels in adult men are typically between approximately 300 and 1000 ng/dL, though exact reference ranges may vary slightly from one laboratory to another. Men at the lower end of this spectrum might exhibit various symptoms associated with low testosterone, often referred to as hypogonadism. Such symptoms can include reduced libido, fatigue, loss of muscle mass, mood changes, and in some cases, an altered pattern of hair growth.

The Hair Growth Cycle and Key Hormones Involved

To understand the potential link between low testosterone and hair loss, it is helpful to first appreciate how hair grows. Each strand of hair on our scalp goes through a growth cycle composed of three phases:

1. Anagen Phase (Growth Phase): This is the longest phase, lasting anywhere from two to seven years. During anagen, the hair follicle is actively growing, and the hair shaft becomes longer.

2. Catagen Phase (Transition Phase): This short phase, lasting about two weeks, involves the follicle shrinking and detaching from the blood supply.

3. Telogen Phase (Resting Phase): Lasting around three months, the follicle lies dormant, and the hair eventually falls out, making way for a new hair to begin its cycle in the follicle.

In a healthy scalp, around 90% of hairs are in the growth phase at any given time. Hormones, genetics, and overall health each influence the duration of these phases and the quality of the hair produced.

The Role of DHT in Male Pattern Baldness

When discussing hair loss, particularly male pattern baldness (androgenetic alopecia), the hormone dihydrotestosterone (DHT) often takes centre stage. DHT is created from testosterone through the action of an enzyme called 5-alpha reductase. Although testosterone itself is important, it is actually DHT that is strongly implicated in male pattern baldness. DHT binds to receptors in hair follicles on the scalp, causing them to shrink over time. This process, known as follicular miniaturisation, leads to thinner hairs that grow more slowly and eventually stop growing altogether.

Interestingly, it is not high testosterone per se that causes this, but rather the sensitivity of the follicles to DHT. Genetics play a substantial role here, as certain individuals have hair follicles more susceptible to DHT’s effects. Thus, male pattern baldness can occur even in men with completely normal testosterone levels.

Does Low Testosterone Cause Hair Loss?

The relationship between testosterone levels and hair loss is somewhat paradoxical. On one hand, DHT, a more potent androgen derived from testosterone, plays a key role in male pattern baldness. On the other hand, you might wonder if having too little testosterone might prevent hair loss or whether low testosterone itself could lead to thinning hair.

Generally, low testosterone is not directly associated with the classic pattern of male baldness. Men who have low testosterone levels sometimes experience changes in body and facial hair patterns, potentially resulting in sparser body hair. However, research suggests that low testosterone is not a primary cause of androgenetic alopecia. In fact, some men with low testosterone may still experience male pattern hair loss, because their follicles are genetically sensitive to even small amounts of DHT. Moreover, those with normal or even high testosterone might not lose their hair if their follicles are not genetically predisposed to DHT sensitivity.

It’s also crucial to note that testosterone affects the hair on different parts of the body in different ways. While DHT may cause scalp follicles to shrink, it tends to stimulate hair growth on the face and body. Therefore, low testosterone could mean less robust facial hair growth, but not necessarily a complete safeguard against scalp hair loss.

Signs and Symptoms of Low Testosterone

If you are concerned about low testosterone and its potential impact on your hair, it’s worth evaluating whether you have other signs of this hormone deficiency. Symptoms of low testosterone can include:

• Reduced libido and sexual performance issues

• Fatigue or decreased energy levels

• Loss of muscle mass or difficulty gaining muscle despite exercise

• Increased body fat or difficulty maintaining a healthy weight

• Mood changes such as irritability, depression, or low motivation

• Reduced bone density over time

• Changes in hair growth patterns on the body

If you suspect you may have low testosterone, it’s advisable to see a GP or a specialist for proper evaluation. At CLNQ Manchester, we have specialists who will measure your testosterone levels through a blood test and explore potential underlying causes.

Other Factors Influencing Hair Loss

While the role of hormones is crucial, it’s important to remember that hair loss is multifactorial. Other elements that might contribute to thinning hair or baldness include:

• Genetics: The biggest predictor of male pattern baldness is family history.

• Age: Hair follicles may become less active over time, making hair loss more common with ageing.

• Lifestyle Factors: Poor nutrition, lack of exercise, excessive stress, and inadequate sleep can all impair hair health.

• Medical Conditions: Thyroid disorders, autoimmune diseases, and scalp infections can also lead to hair loss.

• Medications: Some medications, including those used to treat high blood pressure, depression, or certain cancers, can cause hair shedding as a side effect.

Considering these factors, it’s essential not to focus solely on testosterone levels when addressing hair loss. A comprehensive approach often provides the best outcome.

Diagnosing Low Testosterone and Hair Loss Conditions

If you’re concerned about hair loss and suspect hormonal imbalances, a medical professional can help guide you. The diagnostic process typically involves:

1. Medical History and Examination: A doctor will ask about your symptoms, family history of hair loss, medication use, and any underlying health conditions.

2. Blood Tests: A simple blood test can measure your levels of testosterone, free testosterone, DHT, and other hormones. Additional tests may assess thyroid function or detect anaemia.

3. Scalp Examination: A dermatologist or hair specialist may inspect your scalp, possibly using a dermoscope to evaluate the health of the follicles.

4. Biopsy (Rarely Needed): In some complex cases, a small scalp biopsy might be performed to rule out other conditions.

Manchester, as a large city, has reputable clinics specialising in hormone therapy and hair restoration. Consulting with a local specialist will allow you to obtain tailored advice and treatment options relevant to your situation.

Treating Low Testosterone-Related Hair Changes

If tests confirm that you have low testosterone and you are experiencing changes in hair growth, what treatments are available? While low testosterone is not usually the primary cause of male pattern baldness, optimising your hormone levels might help improve overall well-being, potentially supporting healthier hair growth indirectly.

1. Testosterone Replacement Therapy (TRT):

TRT involves administering testosterone through gels, patches, injections, or implants to bring levels into a normal range. Studies indicate that restoring testosterone levels can improve libido, energy, and mood. There is no solid evidence that TRT will halt classic male pattern baldness because DHT sensitivity is a separate issue. However, men with low testosterone might notice improved hair quality if their deficiency was contributing to poor overall health.

Before starting TRT, it’s essential to discuss potential risks and benefits with a doctor. TRT should be carefully monitored due to potential side effects such as increased red blood cell count, sleep apnoea, or effects on the prostate. At CLNQ, we have specialists in bioidentical hormone replacement therapy.

2. Finasteride (Propecia):

Finasteride is a medication that reduces the conversion of testosterone to DHT by inhibiting 5-alpha reductase. By lowering DHT levels around the hair follicles, finasteride can slow down or even partially reverse follicular miniaturisation in androgenetic alopecia. It’s important to note that finasteride does not increase testosterone levels; instead, it affects the hormone’s pathway to DHT. Some men experience stabilisation of hair loss and moderate regrowth with this treatment.

3. Minoxidil (Regaine):

Minoxidil is a topical treatment applied directly to the scalp. It increases blood flow to hair follicles and can prolong the growth phase, thus supporting hair retention and, in some cases, minor regrowth. Although it doesn’t affect testosterone or DHT, it can be beneficial as part of a broader hair loss management plan.

4. Lifestyle and Nutritional Interventions:

While these measures might not single-handedly reverse advanced hair loss, they are excellent supporting strategies. A balanced diet rich in protein, vitamins, and minerals is crucial for hair health. Foods containing zinc, iron, biotin, and omega-3 fatty acids support hair quality. Adequate exercise and sleep can help maintain optimal hormone balance and reduce stress levels, both of which benefit hair growth.

Reducing lifestyle stress, whether through yoga, meditation, or simply spending time outdoors in a Manchester park, can also help limit stress-induced hair shedding (telogen effluvium).

Non-Surgical Alternatives and Scalp Treatments

Aside from medications and lifestyle modifications, a range of non-surgical treatments may help improve hair quality and slow the progression of hair loss:

• Platelet-Rich Plasma (PRP):

PRP therapy involves drawing a patient’s own blood, processing it to concentrate the platelets, and injecting it into the scalp. Platelets contain growth factors that may stimulate hair follicles and improve hair density. Some studies suggest PRP can be helpful for those with thinning hair.

• Low-Level Laser Therapy (LLLT):

Low-level laser devices, such as laser combs or helmets, use light energy to stimulate hair follicles and improve blood circulation in the scalp. While evidence is mixed, some men report thicker, healthier-looking hair after consistent use.

• Microneedling:

Microneedling creates tiny punctures in the scalp, encouraging wound healing processes that may lead to improved hair growth. It can also help topical treatments like minoxidil penetrate more effectively.

Surgical Options: Hair Transplantation

For men experiencing more advanced hair loss, especially those in Manchester who have sought medical advice and identified no improvement with medical or hormonal treatments, hair transplantation may be a worthwhile consideration. Modern techniques like Follicular Unit Extraction (FUE) and Follicular Unit Transplantation (FUT) have advanced significantly, providing natural-looking results.

During a hair transplant, healthy hair follicles are taken from the back or sides of the scalp (areas resistant to DHT) and transplanted into thinning or balding areas. While it doesn’t change hormone levels, a hair transplant can provide a permanent solution if ongoing treatment stabilises further loss.

This is not usually the first-line treatment for hair loss influenced by hormones, as addressing the underlying hormonal or metabolic factors first is important. However, it remains a definitive option for those seeking a more permanent cosmetic improvement.

Preventative Measures and Maintenance

While it may be challenging to prevent hair loss entirely, several strategies can help delay its progression or maintain existing hair:

• Early Intervention: The sooner you address hair loss, the better your chances of maintaining the hair you still have.

• Compliance with Treatment Plans: Whether you’re using finasteride, minoxidil, or following a recommended lifestyle regimen, adherence is key.

• Regular Check-ups: Keep in touch with a healthcare professional or hair specialist. Regular monitoring ensures you catch changes early and adjust your treatment as needed.

• Reduce Scalp Irritants: Using gentle shampoos, avoiding harsh hair products, and limiting heat styling can keep the scalp environment as healthy as possible.

When to Seek Help in Manchester

If you’re a man living in Manchester and concerned about hair loss, particularly if you suspect low testosterone or other hormonal imbalances, it’s worth seeking professional advice. Our GP can provide initial blood tests for hormone levels and refer you to specialised care if required. Manchester is home to reputable hair clinics and medical centres that offer a range of services, from advanced diagnostic tools to cutting-edge treatments.

Whether you opt to see a private specialist or choose care through the NHS, it’s crucial to be well-informed and proactive. Consider preparing a list of questions before your appointment:

• Do I have low testosterone or another hormonal imbalance?

• What treatments are most suitable for my type of hair loss?

• Could medication like finasteride or minoxidil help in my case?

• Are there lifestyle changes that could optimise my overall health and indirectly benefit my hair?

The Bottom Line: Low Testosterone and Hair Loss

Despite common misconceptions, low testosterone is not generally the direct cause of male pattern baldness. Instead, the key player in genetic hair loss is DHT, which is influenced by both testosterone and the enzyme that converts it. Men with low testosterone may experience other changes in body and facial hair, reduced libido, or fatigue, but classic scalp hair loss is more strongly tied to genetic factors and how hair follicles respond to DHT rather than to the absolute level of testosterone.

Nevertheless, maintaining healthy testosterone levels is beneficial for overall health, vitality, and possibly for maintaining good quality hair, especially if low hormone levels are associated with general health issues. Addressing low testosterone—where indicated—through lifestyle changes or medical interventions can have positive knock-on effects, improving mood, energy, and well-being, all of which support a healthier scalp environment.

If you are experiencing hair loss and are concerned about low testosterone, consulting a medical professional in Manchester is a great first step. A thorough evaluation by our team can help identify or rule out hormonal imbalances, nutrient deficiencies, or other contributing factors. From there, a tailored approach involving possible hormone optimisation, medications like finasteride or minoxidil, lifestyle modifications, or advanced treatments like PRP or hair transplantation can be considered.

Ultimately, there are many paths to managing hair loss, and being informed is the first step in regaining confidence and control over your appearance. While low testosterone on its own is unlikely to be the culprit in most cases of male pattern baldness, understanding this hormone’s role in your body can empower you to seek the right help and make decisions that best serve your individual needs.