Testosterone Replacement Therapy (TRT) is a very popular treatment for men with low testosterone levels. It helps to restore energy, muscle mass, sex drive, and overall well-being. But some men worry that TRT might contribute to hair loss. Testosterone itself is not a direct cause of hair loss, but TRT can play a role with some men that have the genetics to grow bald.
How Testosterone replacement therapy affects hair loss
Hair loss in combination with TRT is mainly linked with dihydrostasterone (DHT), a more powerful form of testosterone. The body transforms part of testosterone into DHT through an enzyme called 5-alpha reductase. DHT attaches to the hair follicle and shrinks it over time. That leads to a condition known as androgenic alopecia (male alopecia).
Factors that affect TRT hair loss
- Genetic predisposition: If you have a family history baldness, TRT can speed up this process. This is because increased testosterone levels can lead to higher DHT levels and that can speed up the shrinking of hair follicles.
- DHT levels and sensitivity: Even if DHT levels are increased, not all men will receive hair loss with TRT. One major thing to consider is how sensitive the hair follicles are to DHT. Some men have more durable DHT hair follicles and have not undergone a big reduction of the hair but others can see a quicker hair removal.
- Dosage and TRT Administration Method: High doses of testosterone can cause an increase in DHT change and that can potentially speed up hair loss. Next to that: the administration method (e.g., injection, gel, or spotted) can affect the amount of testosterone changed to DHT. Some men may see changes in the TRT method help reduce the effects of hair loss.
- Existing age and hair loss: If you already feel your hair getting thinner before starting TRT, treatment can speed up the process. However, if you don’t have family that is bald, TRT is unlikely to cause big hair loss.
Can I prevent hair removal from TRT?
If you are worried about hair loss during TRT, there are several ways to reduce the effect.
- DHT Blockers: Drugs such as finasteride (Propecia) and dutasteride (AVODART) can suppress 5-alpha reductase, lower DHT levels, and slow hair loss. However, these medications can have side effects, such as reduced sex drive or erectile dysfunction. So it is important to talk to your doctor before use.
- Topical Treatments: Minoxidil (Rogaine) is a external solution that helps stimulate hair growth and may slow thinning of the hair caused by DHT.
- Lowering TRT dosage: If hair loss is a serious problem then adjusting the TRT dose can reduce DHT conversion.
- Alternative TRT methods: The transition from injection to transdermal methods (e.g. gel) can reduce DHT overvoltage in some people.
- Life and nutrition: a diet that has a lot of vitamins, such as biotin, zinc and vitamin D, can help maintain hair health.
Conclusion of hair loss on TRT
The TRT itself does not cause direct hair loss, but it can speed up male baldness in men that have a family that has baldness. If you are interested in stopping the slimming of your hair during TRT, watching your DHT levels, changing your dose, or using a DHT blocker can help you deal with the effects. Taling with a healthcare service provider is the best way to balance the benefits of TRT in minimizing side effects.