Alopecia in Female Athletes Using Androgenic and Anabolic Steroids: Pathophysiology and Management

This review compiled and evaluated numerous studies on alopecia treatments, highlighting promising pharmacological strategies like JAK inhibitors for alopecia areata and advancements in regenerative medicine for androgenetic alopecia, while also stressing the importance of personalized, mechanism-targeted approaches for improved outcomes across different alopecia subtypes.

Low-dose oral minoxidil alone is effective for treating hair loss, but combining it with dutasteride or finasteride may offer better results.

This letter to the editor discusses blood pressure changes in patients taking low-dose oral minoxidil but reports no new research findings.

This review highlights significant health risks associated with anabolic-androgenic steroid use in women and reports no new research results, emphasizing the need for further understanding of their effects on female physiology.

This study examines the link between testosterone use and hair health in males, stressing the importance of developing guidelines for safe usage due to associated health risks like liver toxicity, gynecomastia, and hair loss.

In this randomized clinical trial, oral minoxidil was not superior to topical minoxidil in increasing hair density in men with androgenetic alopecia over 24 weeks, though photographic analysis suggested oral minoxidil may work better on the vertex area of the scalp.

The abstract notes that while telogen effluvium—a condition causing diffuse hair loss—is triggered by stressors like significant weight loss, there is limited literature specifically exploring the connection between telogen effluvium and weight loss.

This study concluded that while both 5% topical and 1 mg oral minoxidil significantly improved hair diameter in androgenetic alopecia patients, there was no significant difference in overall effectiveness or patient satisfaction between the treatments.

This study highlights the complex clinical issues associated with using low dose oral minoxidil for alopecia, emphasizing the need for careful cardiology-dermatology collaboration due to rare but serious cardiovascular risks, especially in patients with existing cardiorenal or cardiovascular concerns.

This study found a significant negative correlation between serum SHBG levels and androgenetic alopecia severity in women, but not in men, while no significant correlation was observed for testosterone, estradiol, dehydroepiandrosterone sulfate, and vitamin D levels with hair loss severity across genders.

In a systematic review and meta-analysis, this study reported that oral spironolactone showed a 56.60% overall improvement in female pattern hair loss, with better results in combination therapy, but emphasized the need for more research due to varied treatment responses and adverse event rates.

This study evaluated low dose oral minoxidil as a treatment for female pattern hair loss but reports no new clinical results.

This review discusses the degenerative effects of anabolic-androgenic steroids on the nervous system and reports no new experimental results, aiming to increase public awareness of their health risks.

This study found that women with Female Pattern Hair Loss had lower serum BDNF levels, which correlated with higher stress and depression, suggesting BDNF as a potential marker for psychological impacts in these patients.

This study found that female patients in Finnish specialized health care with a history of doping use exhibited high rates of psychiatric and substance use disorder morbidity, with less than half of those using anabolic androgenic steroids showing atypical red blood cell parameters.

This study concluded that both oral and topical spironolactone effectively treat androgenetic alopecia, with topical administration being safer and suitable for any gender, especially when combined with minoxidil.

This review discusses the potential of low-dose oral minoxidil as a safe and effective treatment for certain hair disorders, including alopecia, but reports no new clinical results.

In this study, the authors reported that oral dutasteride at 0.5 mg/day showed a probable greater efficacy in treating male androgenetic alopecia compared to finasteride and minoxidil, but it may cause sexual dysfunction and neuropsychiatric side effects.

In this South Korean retrospective study, dutasteride improved hair growth more effectively than finasteride in men with androgenic alopecia, and had a similar or possibly lower rate of adverse events, suggesting it as a viable treatment option.

This review discusses the psychological impacts of androgenetic alopecia on body image and the importance of addressing these issues in hair transplantation patients, without reporting new clinical findings.

This meta-analysis reported that finasteride 1 mg/day significantly increased hair count in male androgenetic alopecia compared to placebo, but highlighted persistent sexual side effects and associated depression risk.

This review discusses the use of platelet-rich plasma for treating female androgenetic alopecia, reporting that it shows high patient satisfaction and improved quality of life in affected women.

In this study, low-dose oral minoxidil for hair loss was associated with infrequent systemic adverse effects, and only 1.7% of patients discontinued treatment due to these effects.

This review indicates that low-level laser therapy may stimulate hair growth in both men and women with androgenetic alopecia, showing similar efficacy to minoxidil in some studies, but requires more robust evidence.

This review discusses the relationship between SHBG, NAFLD, and PCOS and reports no new clinical results; the authors highlight low hepatic SHBG production as potentially significant in PCOS pathogenesis.

In this study, nearly half of the female patients with androgenetic alopecia reported symptoms of hormonal disorders, but hormone test results did not show significant abnormalities.

This review discusses the effects of hormonal changes on hair follicles, concluding that hormones like androgens and estradiol significantly influence hair growth and cycle, while the roles of other hormones are still being researched.

This review discusses the use of platelet-rich plasma for treating various types of alopecia, reporting promising preliminary hair regrowth results but noting a lack of quantitative evidence from well-designed clinical trials.

This systematic review suggests that topical ketoconazole may improve hair regrowth and thickness in both animal and human studies for androgenetic alopecia, but further randomized controlled trials are needed.

This study observed that low-dose oral minoxidil and topical minoxidil 5% solution both improved hair density in women with female-pattern hair loss, but oral minoxidil may offer advantages in reducing hair shedding.

This review offers evidence-based recommendations for diagnosing and treating female pattern hair loss, emphasizing clinical assessment and starting treatment with minoxidil, while noting that measurement of certain hormones and vitamins is optional.

This review discusses the role of androgens in women's skin-related conditions like acne, hirsutism, and female pattern hair loss, noting the lack of dermatology guidelines for when to pursue endocrinologic evaluation.

This article discusses treatments for female pattern hair loss, highlighting that oral antiandrogens and topical minoxidil can effectively arrest progression and reverse miniaturization in many patients with mild-to-moderate cases, but it reports no new clinical results.

This review discusses the causes and diagnosis of traction alopecia, emphasizing education for high-risk populations as there is currently no cure, and presents no new clinical findings.

This systematic review and meta-analysis found that minoxidil, finasteride, and low-level laser light therapy significantly improve hair growth in men with androgenetic alopecia, while minoxidil is also effective for women, compared to placebo.

This study found that vitamin D, ferritin, and zinc deficiencies are prevalent among patients with telogen effluvium in the greater Pittsburgh area, suggesting these should be included in initial evaluations.

This review discusses the adverse events associated with 5-alpha reductase inhibitors, finding them generally well-tolerated but noting potential risks like sexual side effects and psychological effects in men, and sparse data on use in women.

Hormones and genetics play key roles in male and female baldness, which can affect mental health and may be linked to other health issues.

This study found that adding microneedling to minoxidil treatment significantly improved hair growth in men with androgenetic alopecia compared to minoxidil alone across all assessed measures.

This review discusses the roles of androgens and androgen receptors in skin-related disorders and suggests that targeting androgen receptors may be a more effective treatment strategy.

This study found that long-term flutamide treatment reduced hair loss in women with female pattern hair loss, but liver-related dropouts were minimized at a very low dose of 62.5 mg/day.

This review explores the current understanding of genetic and hormonal influences on male androgenetic alopecia and female pattern hair loss, providing guidance for clinicians but reports no new results.

This paper proposes a theory explaining how the normal anabolic effects of androgens lead to structural changes and hair follicle miniaturization, contributing to androgenic alopecia.

This study observed that women with female pattern hair loss had a significantly lower ratio of estradiol to free testosterone compared to healthy controls, suggesting a potential hormonal trigger for hair loss.

This review discusses the use of anti-hormonal therapies for female androgenetic alopecia and notes that while some treatments show promise, larger controlled studies are needed to define their roles and effectiveness.

This review explores the hormonal regulation of hair growth and changes with season, age, and sexual development, and calls for improved treatments for hair disorders.

This review discusses the roles of androgens and estrogens in skin functions and disorders, and highlights the use of estrogen-progestin treatments and anti-androgens in managing hirsutism and acne, without reporting new results.

This article reviews the historical developments in understanding and treating male pattern hair loss, emphasizing the role of dihydrotestosterone and 5α-reductase inhibitors, but reports no new clinical findings.

This study suggests that stress negatively affects hair growth by inducing inflammation and early hair cycle transitions in mice, which might inform strategies for managing stress-related hair loss in humans.

In this 48-week trial, 5% topical minoxidil was more effective than both 2% minoxidil and placebo in promoting hair growth in women with female pattern hair loss, with notable improvements in nonvellus hair count and hair growth assessments.

Minoxidil works better for female hair loss, but cyproterone reduces scalp oiliness and causes menstrual issues.

This article discusses the shifting role of physicians in addressing performance-enhancing drug use in sports and highlights that the same benefits may be achieved through dietary and training advice, but it reports no new results.

This case report describes a young woman with hypopituitarism who experienced hair loss typical of female androgenetic alopecia without detectable androgens, suggesting this hair loss pattern may not always be androgen dependent.

Androgens can cause hair growth in some areas and hair loss on the scalp.

This study found that androgenetic alopecia causes significant psychological distress, particularly in women, who exhibit a more negative body image and less adaptive functioning compared to controls.

This study suggests spironolactone, particularly when combined with an oral contraceptive or dexamethasone, may reduce hair symptoms in women with hirsutism, but it should be avoided during pregnancy and in women with a family history of breast cancer.