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You might have heard people say that birth control can cause hair loss. While it’s not common, hair loss is a possible side effect.
Let’s take a look at the link between birth control and hair loss––and how to prevent it from happening.
Birth control and hair loss
Although this may make you nervous about trying birth control, there are some hormonal methods less likely to cause hair loss than others. Interestingly, it’s worth pointing out that some birth control pills are actually prescribed for hair loss (Williams, 2021).
Not all contraceptives are hormonal and not all trigger hair loss. Two types of hormonal birth control that can cause hair loss are combined hormonal methods and progesterone-only pills.
How birth control works
To understand why some contraceptives cause hair loss, we have to look at how different birth controls work.
Non-hormonal methods include the copper IUD (intrauterine device), which prevents sperm from swimming to the egg. Condoms and diaphragms are natural birth control options that block sperm from getting to the egg. There are also fertility awareness methods where you track your ovulation (fertile period) and avoid unprotected sex on those days.
Hormonal methods work differently. As the name suggests, combined hormonal birth control contains a mix of the hormones estrogen and progestin. Examples of combined options include the pill and hormonal IUD.
Other hormonal methods that only contain progestin and protect you from pregnancy include:
- Birth control shot (Depo-Provera)
- Nexplanon arm implant
- Progestin-only pill
Side effects of birth control
Like any medication, birth control has a risk of side effects. Not all women experience them, but the most common ones include (FDA, 2020):
- Mood swings
- Changes in menstrual bleeding patterns
- Breast tenderness
What side effects you may or may not experience depends on how your body responds to hormones. For people who are sensitive to certain hormones, hair loss is a possible (though less common) side effect (Graves, 2018).
How can birth control cause hair loss?
However, everyone responds to hormones differently, especially sex hormones called androgens. Hair health and growth are linked to androgens, and sensitivities to changes in these hormones could impact hair. Medication, medical issues, stress, and the postpartum period following childbirth can also affect androgen levels (Gordon, 2011; Hoover, 2021).
Okay, but how does this relate to birth control? Progestin, an ingredient in most hormonal contraceptives, acts similarly to androgens. Birth control with high androgen indexes is more likely to cause hair loss in people already susceptible (Graves, 2018; Nassar, 2022).
Genetics also plays a role. Having a family history of hair loss (specifically, androgenic alopecia) or medical conditions like PCOS makes it more likely for birth control to cause hair thinning or shedding (Graves, 2018).
What types of birth control cause hair loss?
Any hormonal birth control that contains progestin could theoretically cause you to lose hair. These include (Graves, 2018; Williams, 2021):
- Combined oral contraceptives (aka the pill)
- Progestin-only pills (the minipill)
- Birth control shot (Depo-Provera)
- Contraceptive implant (Jadelle)
Progestin-only methods are even more likely to trigger androgenic alopecia if you have a family history of it. These birth controls include (Graves, 2018):
Not all types of hormonal birth control have ingredients with high androgen indexes. If hair loss is something you’re concerned about, check the ingredient list before starting it.
Risk factors for hair loss
Most people don’t experience hair loss when using birth control. If you’re taking a high-androgen birth control, the following makes it more likely for you to experience hair loss:
- Family history of alopecia
- During pregnancy and the postpartum period
- Stress and illness
- Health conditions that cause hormonal imbalances like PCOS or thyroid disorders
- Certain medications
- Severe nutritional deficiencies
Treatment and prevention
Losing your hair can be a devastating experience. Fortunately, there are many ways to treat hair loss, slow it down, or prevent it from happening in the first place. Here are some common treatment methods:
- Rogaine (minoxidil): Minoxidil is a topical over-the-counter treatment that stimulates hair growth and prevents shedding on the top and back of your head. It’s applied twice daily. Minoxidil is the only medication approved to treat hair loss in women.
- Eat a healthy diet: Eating a nourishing diet and getting plenty of rest will help your body heal and replenish itself so you can regain emotional and hormonal balance.
- Dietary supplements: The role of vitamins and minerals in hair loss is contested, and there is very little evidence supporting the effectiveness of skin, hair, and nail supplements. That said, micronutrients are essential for healthy hair growth and if you have a nutritional deficiency, it may contribute to hair loss (Almohanna, 2019).
- Stress management: Ongoing, intense stress is a well-known cause of hair loss, and experiencing shedding can certainly cause even more stress (Al Aboud, 2021). The good news is there are many easy, accessible stress management techniques you can from home. Examples include talk therapy (especially cognitive behavioral therapy), mindfulness, meditation, spending time in nature, and medication.
- Promote self-care after childbirth or illness: The stress and hormonal shifts of childbirth and illness can both contribute to hair loss. Make sure you’re gentle with yourself during recovery and practice self-care.
- Hair transplantation: This is a surgical method of transplanting hair follicles from a part of your scalp with healthier growth to the areas thinning.
Preventing hair loss
If you are concerned about hair loss, you can speak with your healthcare provider about non-hormonal forms of birth control, or taking a pill that has low androgenic activity.
Birth control that contains progestins but has low androgen activity can actually help prevent hair loss if you’re predisposed to it. Here are the options currently available (Graves, 2018):
- Desogestrel (Desogen, Reclipsen)
- Norethindrone (Ovcon-35, Brevicon, Modicon, Ortho Novum 7/7/7, Tri-Norinyl)
- Norgestimate (Ortho-Cyclen, Ortho Tri-Cyclen)
- Drospirenone (Nikki, Ocella)
- Etonogestrel (Nexplanon implant)
You can also try using the copper IUD (Paragard), which is effective, hormone-free, and doesn’t cause hair loss.
- Al Aboud, A. M. & Zito, P. M. (2021). Alopecia. StatPearls. Retrieved on April 27, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK538178/
- Almohanna, H. M., Ahmed, A. A., Tsatalis, J. P., & Tosti, A. (2019). The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatology and Therapy, 9(1), 51–70. doi:10.1007/s13555-018-0278-6. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380979/
- Egger, A., Resnik, S. R., Aickara, D., et. al. (2020). Examining the safety and efficacy of low-level laser therapy for male and female pattern hair loss: a review of the literature. Skin Appendage Disorders, 6(5), 259-267. doi:10.1159/000509001. Retrieved from https://www.karger.com/Article/FullText/509001
- Gordon, K. A. & Tosti, A. (2011). Alopecia: evaluation and treatment. Clinical, Cosmetic and Investigational Dermatology, 4, 101–106. doi:10.2147/CCID.S10182. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149477/
- Graves, K., Smith, B., & Nuccio, B. (2018). Alopecia due to high androgen index contraceptives. JAAPA, 31(8), 20-24. doi:10.1097/01.JAA.0000541476.24116.c4. Retrieved from https://journals.lww.com/jaapa/Fulltext/2018/08000/Alopecia_due_to_high_androgen_index_contraceptives.3.aspx
- Gupta, A. K., Quinlan, E. M., Venkataraman, M., & Bamimore, M. A. (2022). Microneedling for Hair Loss. Journal of Cosmetic Dermatology, 21(1), 108-117. doi:10.1111/jocd.14525. Retrieved from https://pubmed.ncbi.nlm.nih.gov/34714971/
- Hoover, E., Alhajj, M., & Flores, J. L. (2021). Physiology, hair. StatPearls. Retrieved on April 27, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK499948/
- Nassar, G. N. & Leslie, S. W. (2022). Physiology, testosterone. StatPearls. Retrieved on April 27, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK526128/
- Polaneczky, M. & Liblanc, M. (1998). Long-term depot medroxyprogesterone acetate (Depo-Provera) use in inner-city adolescents. Journal of Adolescent Health, 23(2), 81-8. doi:10.1016/s1054-139x(98)00014-7. Retrieved from https://pubmed.ncbi.nlm.nih.gov/9714170/
- Sivin, I., Alvarez, F., Mishell, D. R. Jr., et. al. (1998). Contraception with two levonorgestrel rod implants. A 5-year study in the United States and Dominican Republic. Contraception, 58(5), 275-82. doi:10.1016/s0010-7824(98)00112-7. Retrieved from https://www.contraceptionjournal.org/article/S0010-7824(98)00112-7/fulltext
- U.S. Food and Drug Administration (FDA). (2020). Birth control. Retrieved on April 27, 2022 from https://www.fda.gov/consumers/free-publications-women/birth-control
- Williams, N. M., Randolph, M., Rajabi-Estarabadi, A., et al. (2021). Hormonal contraceptives and dermatology. American Journal of Clinical Dermatology, 22(1), 69-80. doi:10.1007/s40257-020-00557-5. Retrieved from https://link.springer.com/article/10.1007/s40257-020-00557-5
Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.