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Can
birth control pills promote androgenetic alopecia in women
Yes sometimes. There are some forms of synthetic progesterone in
drugs that may promote androgenetic alopecia for a few women. Some
synthetic progesterone derivatives have a chemical structure that
looks a lot like a natural steroid hormone.
Enzymes made by our bodies are not particularly fussy about what
they try to convert so long as the molecule they latch on to looks
approximately like the molecule they are looking for. Some synthetic
progesterones can be converted by enzymes in the steroid pathway.
These can directly or indirectly be converted to testosterone. Some
synthetic progesterones may artifically increase a woman's testosterone
levels and this may lead to an increase in dihydrotestosterone production
and pattern baldness.
Some pill formulations contain synthetic versions of progesterone
that have androgenic properties. It may be that these progestins
with androgenic properties can exacerbate female pattern baldness.
Newer contraceptive pill formulations have non-androgenic progestins
in them and are probably most appropriate for women with baldness.
Some examples of non-steroidal synthetic progesterone drugs include
norgestimate and promegestone. If you suspect your pattern alopecia
developed as a result of using birth control pills, check the packaging
to see what progesterone derivatives were used in the forumulation
and consult with your doctor. The problem may be resolved by a simple
switch to a different type of birth control pill.
Barbara Reed did an excellent review in Fitzpatrick's Journal Sept/Oct
94 on "The Pill". She listed the brand names in order
of less androgenicity to more androgenicity as: Desogen, Ortho-Cept,
Ortho-Cyclen, Ortho Tri-Cyclen, Micronor, Nor-Q D, Ovcon-35, Brevicon/Modicon,
Ortho Norvum 7/7/7, Ortho Novum 10-11, Tri-Norinyl, Norinyl and
Ortho 1/35, Demulen 1/35, Triphasil/Tri-Levien, Nordette, Lo/Ovral,
Ovrette, Ovral, Loestrin1/20, Loestrin 1.5/30.
She listed these as the best birth control pills for acne, alopecia,
and hirsuitism: Desogen, Ortho-Cept, Ortho-Cyclen, Ortho-Tri-Cyclen,
Brevicon, Modicon, Ovcon-35, and Demulen-35.
Also note that stopping birth control pill use can cause a telogen
effluvium type hair loss unrelated to androgenetic alopecia.
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