Alopecia Due to High Androgen Index Contraceptives

August 2018 in “ JAAPA ”

Katelyn Y. Graves, Benjamin J. Smith, Brigitta C Nuccio

androgenic alopecia high androgen index progestins low androgen index progestins PCOS thyroid disorders topical minoxidil corticosteroids nonhormonal contraceptives progestin-only contraceptives Rogaine

TLDR Some birth control pills can cause hair loss, and switching to ones with less androgen should help.

The document from August 2018 explains that certain hormonal contraceptives with high androgen index progestins can cause alopecia, particularly androgenic alopecia, in women. It advises that if alopecia occurs and persists for 6 months after starting such contraceptives, patients should switch to a low androgen index option. The article stresses the importance of primary care providers in conducting initial evaluations and laboratory work to exclude other causes of hair loss, such as PCOS or thyroid disorders. It also discusses the varying androgenic effects of different generations of progestins, recommending that patients with ongoing hair loss after switching contraceptives should be referred to a dermatologist and may consider treatment with topical minoxidil or corticosteroids. Nonhormonal or less-androgenic progestin-only contraceptives are suggested as alternatives for those sensitive to estrogen.

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