Can Birth Control Cause Hair Loss? What Women Should Know
If you have recently started, stopped or changed birth control and suddenly seem to be finding more hair in the shower, on your brush or on your clothes, it is understandable to wonder whether the two are connected. The answer is that a change in hormonal birth control can sometimes be associated with increased hair shedding, but that does not necessarily mean the medication has permanently damaged your hair or that birth control is the only explanation for what you are seeing.
Hair loss in women can be particularly confusing because there is not always one obvious cause. Hormonal changes, genetics, illness, stress, childbirth, medications and other factors can affect the hair in different ways. Sometimes the increased shedding is temporary. Other times, what initially appears to be a temporary change can bring attention to underlying female pattern hair loss that was already developing gradually.
That is why, if your hair suddenly seems different, the most useful question may not simply be, “Is my birth control causing this?” It is, “What is happening to my hair, and why?”
Your Hair Has Its Own Biological Clock
To understand why a hormonal change today might affect your hair months from now, it helps to understand that every hair on your scalp is moving through a biological cycle.
Most scalp hairs are normally in the anagen, or active growth, phase. Eventually a follicle leaves that growth phase, passes through a short transitional phase and enters the telogen, or resting, phase. At the end of that process, the old hair is shed and a new growth cycle can begin. Your follicles do not all move through these stages together, which is why you normally lose some hairs every day without suddenly looking as though you have less hair.
A significant change in the body can temporarily disrupt that balance. More follicles than usual may shift from the growth phase toward the resting phase around the same time. Because those hairs do not immediately fall out, you may not notice increased shedding until weeks or months after the original trigger.
This type of shedding is known as telogen effluvium. Hormonal changes can be among the triggers, which is why some women may notice increased shedding after a change involving birth control.
The delay is important. If you stopped birth control and your hair seemed perfectly normal for a while, only to begin shedding later, you may not immediately connect the two events. Looking back at what was happening several months before the shedding began can therefore be an important part of understanding the bigger picture.
Birth Control and Your Hair Are More Complicated Than “Good” or “Bad”
Not all birth control pills are the same, and hormones do not affect every woman’s hair in exactly the same way. Different contraceptives contain different types and amounts of hormones, and your individual response depends on considerably more than the name on a prescription bottle.
The biology of female hair loss itself is also complex. Hormones can play a role, but scientists do not completely understand the hormonal mechanisms behind female pattern hair loss, and many women who develop it do not have abnormal hormone levels. Genetics and other biological factors can also contribute to the way follicles behave over time.
For that reason, we would be cautious about telling you that a particular birth control pill is simply “good for hair” or “bad for hair.” We would also be cautious about assuming that birth control is responsible simply because your hair loss began while you happened to be taking it.
If you believe a prescription medication is affecting your hair, you should discuss that concern with the healthcare professional who prescribed it rather than stopping or changing the medication on your own.
What you can do, however, is pay attention to the timing and to exactly how your hair is changing. Those details can be very useful when someone evaluates your hair loss.
The Difference Between Losing Hairs and Losing Density
This is one of the most important distinctions to understand.
When you are experiencing telogen effluvium, the change you notice may be increased shedding. You might suddenly see considerably more hair when shampooing, brushing or styling your hair. Because many follicles were pushed through the cycle at approximately the same time, the amount of shedding can feel dramatic.
Female pattern hair loss behaves differently.
With female pattern hair loss, individual follicles gradually become smaller through a process called miniaturization. A follicle that once produced a thicker, longer terminal hair can begin producing a finer and shorter hair. The active growth phase can also become shorter. As this process continues across affected areas of the scalp, the overall density gradually decreases and more scalp may become visible.
For you, the difference may show up as a part that seems wider than it used to be, less coverage through the top of your scalp, more difficulty styling your hair or photographs in which your scalp seems increasingly visible.
And this is where things can become confusing: you can potentially experience increased shedding and progressive thinning at the same time.
A hormonal change might produce noticeable shedding that finally causes you to look closely at hair that had actually been becoming less dense for some time. In that situation, blaming everything on birth control could cause you to overlook another process that deserves attention.
Your Old Photos May Tell You More Than Your Shower Drain
When women become concerned about hair loss, it is natural to start watching every hair that comes out. You may find yourself looking at the shower drain, checking your brush or wondering whether the amount of hair on your clothing is normal.
That can quickly become frustrating because the number of hairs you notice on any particular day does not necessarily tell you what is happening to the overall density of your hair.
Instead, take a broader look.
Pull up photographs of yourself from six months ago, a year ago and several years ago. Try to find pictures with similar lighting and angles. Look at the width of your part, the amount of scalp visible through the top and the overall coverage of your hair. Ask yourself whether you are simply shedding more right now or whether your hair actually looks different than it used to.
This is also why we recently wrote about how to tell if your hair is thinning. When you see yourself every day, gradual changes can be surprisingly difficult to recognize. Comparing yourself with yourself over time can sometimes give you a much clearer picture.
What Happens If the Shedding Doesn’t Stop?
If the shedding was triggered by a temporary disruption to the hair cycle, the expectation is different from what we would have with progressive female pattern hair loss. Once the triggering event has passed, the follicles can return toward their normal cycling pattern, although hair recovery takes time because hair itself grows slowly.
What deserves a closer look is shedding that continues, density that does not seem to recover, or thinning that appears to be progressively getting worse.
You may notice that your part continues to widen even after the heavy shedding has slowed. You may feel that your ponytail is not as full as it used to be. You may see more scalp through the top of your hair than you did a year ago. Or you may simply have the feeling that your hair never returned to what was normal for you.
Those observations do not automatically mean you have female pattern hair loss, but they are reasonable reasons to have the change evaluated rather than continuing to assume that birth control is responsible.
Sometimes There Is More Than One Explanation
One of the biggest mistakes you can make with hair loss is feeling that you need to identify one event and make it responsible for everything that followed.
Human biology is rarely that convenient.
You could have a temporary period of shedding after a hormonal change and still have a genetic predisposition to female pattern hair loss. You could notice thinning around the same time you changed medications even though the two are unrelated. Another medical issue could also be contributing to the change.
This is why Dr. Matthew Lopresti looks at the larger picture when evaluating women with hair loss at Leonard Hair Transplant Associates. The pattern of the thinning, when it began, whether it has progressed, your medical and family history and other relevant factors can all help determine what may be happening.
That distinction matters because treatment should follow the diagnosis, not the other way around.
For some women, the appropriate next step may simply be giving temporary shedding time to resolve. For others with progressive hair loss, a non surgical hair loss treatment may be worth discussing. And for selected women with an appropriate pattern of permanent hair loss and adequate donor hair, hair transplant surgery may eventually be an option.
The important part is not deciding on a treatment before you understand the problem.
If You’re Worried About Your Hair, You Don’t Have to Guess
Hair loss can affect women differently than it affects men, but that does not make the concern any less significant. When your hair has always been an important part of how you see yourself, noticing more scalp or feeling that your hair is suddenly less full can be upsetting. It can also leave you wondering whether you are imagining a change that other people may not even notice yet.
You do not have to wait until your hair loss becomes obvious to everyone else before asking about it.
If your hair began shedding after starting, stopping or changing birth control, that timing is useful information. If the shedding has continued, your density has changed or you simply cannot tell whether what you are experiencing is temporary, an evaluation can help put those pieces together.
At Leonard Hair Transplant Associates, Dr. Matthew Lopresti evaluates women experiencing hair loss throughout Boston and New England. Complimentary consultations are available in person and by Telehealth.
The goal of that first conversation is not to assume that you need treatment. It is to understand what has changed, what may be causing it and what, if anything, makes sense for you.
And if birth control is the first thing that made you start paying attention to your hair, that may be an important part of the story. It just may not be the whole story.