Androgenic Alopecia. Female pattern hair loss. FPHL. Whatever name your doctor threw at you, or didn’t, because let’s be honest a lot of GPs are not exactly falling over themselves to help with this one, it’s the same condition. And it affects way more women than anyone talks about.
I’ve had it for years. Finding decent, honest information when I was first trying to figure out what was happening to my hair was genuinely hard. So this is the post I wish existed back then.
What Actually Is It?
Androgenic Alopecia is a genetic form of hair loss that comes down to how sensitive your follicles are to androgens, a group of hormones that includes testosterone. In women it usually shows up as gradual, diffuse thinning across the top and crown of the scalp, with the hairline mostly staying put. That’s the key difference from male pattern baldness, which tends to recede from the front. Women’s AGA is more of an all-over thinning on top situation.
What’s actually happening is that a byproduct of testosterone called DHT causes the affected follicles to miniaturise over time, producing finer and shorter hairs until eventually they might stop altogether. It’s a slow process usually, which sounds reassuring but also means it can creep up on you without you realising until suddenly you’re looking at a photo from a wedding and thinking… oh.
That was me, by the way. That’s genuinely how I found out how far things had progressed.
How Common Is It?
Really common. Like, an estimated 40% of women by age 50 common. It can start as early as your teens or twenties. And yet it’s still treated like this unusual, slightly shameful thing that doesn’t get talked about. It’s not unusual. It’s incredibly widespread. I just think people suffer quietly because nobody’s telling them they’re not alone in it.
What Does It Look Like?
For me it started as a widening parting. Then I noticed my hair felt less dense overall, more see-through in certain lights. More hair in the shower than felt normal. More on my pillow.
The sides and back of the head are usually spared, at least early on, which is actually why toppers work so well for AGA. There’s typically enough hair around the edges to anchor clips and blend naturally. It’s one of the few silver linings really.
Getting a Diagnosis
Please don’t skip this part even if you’re pretty sure you know what’s going on. Other conditions like thyroid issues, nutritional deficiencies and alopecia areata can look really similar but need completely different treatment. A proper diagnosis matters.
Ideally you want a dermatologist or trichologist rather than relying solely on your GP. In the UK you can ask for an NHS referral to a dermatologist, or go privately to a trichologist. My UK Hair Loss Resources page has links to organisations who can point you in the right direction.
What Actually Helps?
There’s no cure. I know that’s not what anyone wants to read but it’s true, and I’d rather be upfront about it. What there is, is things that can slow it down and in some cases encourage some regrowth.
Minoxidil is the big one. Topical treatment, available over the counter, and the most widely used option out there. It works by improving blood flow to follicles and extending the growth phase. Results vary a lot between people and you have to keep using it to maintain any benefit, stopping means losing what you gained.
Anti-androgen medications like spironolactone can help and are prescribed by a doctor. They work by blocking androgen activity at the follicle level.
Scalp treatments and supplements are a whole minefield. There’s a lot of noise and a lot of products that promise the world. Some people find them helpful as part of a broader routine, I’ve tried a few myself including Monpure London which I wrote about. Results are really individual though.
Alternative hair (toppers, wigs) won’t reverse or stop the loss but they can genuinely change your day to day life in a massive way. That’s most of what I write about on here because it’s where my personal experience is deepest.
The Bit Nobody Really Talks About
Hair loss is technically a medical condition but it doesn’t stay in a medical box. It seeps into everything. How you feel getting dressed in the morning. Whether you’ll sit in a certain seat at a restaurant because of the lighting. Whether you want to go swimming. It’s exhausting to manage and genuinely hard on your mental health, and I think it’s important to just say that out loud.
If you’re newly diagnosed or just starting to piece together what’s happening, you are not alone. There is a whole community of people going through exactly the same thing and they are the kindest, most supportive people I’ve come across online. This post on supporting someone with alopecia is a good one to share with people in your life who want to understand but don’t quite know how.
And if you’re ready to look into alternative hair, start with my Hair Topper vs Wig guide. You don’t have to figure it out alone.
