There is much argument on whether oral contraceptives can promote
hair loss. Some dermatologists claim that at least a small minority
of women develop a telogen effluvium type of hair loss when using
oral contraceptives. The hair loss may begin at almost any time
after starting oral contraceptive use. Hair loss onset has been
reported anywhere between one month to two years after starting
contraceptive pill use. Telogen effluvium from oral contraceptives
can be temporary with recovery while the individual is still using
the contraceptives. Sometimes the hair loss may persist for as
long as the contraceptives are used.
When oral contraceptives are suspected as a cause of telogen
effluvium the individual may be switched to a different contraceptive
pill formulation to see if the hair loss is brand specific or
alternatively complete avoidance of contraceptive pill use is
suggested by dermatologists.
Temporary hair loss can occasionally develop up to one month
after discontinuing use of contraceptive pills even though the
individual had no hair loss symptoms while using the pill. It
is assumed the sudden withdrawal of hormones from pill use is
a disruption the body has to adjust to. Oral contraceptives suppress
natural hormone production. After withdrawal of oral contraceptives
the body must begin to produce estrogen and progesterone according
to the natural cycle. Potentially, it may take time for the body
to adjust and begin normal hormone production during which hormone
levels may be a concentrations that adversely affect hair follicles.
Some older oral contraceptive pill formulations contain synthetic
progestin derivatives that have androgenic abilities. A few women
using these pills experience exacerbation of (androgenetic alopecia)
rather than telogen effluvium type hair loss. New oral contraceptive
pill formulations are made with progestin derivatives with low
or no androgenic potential that should not promote androgenetic
alopecia. Natural progesterone and some of its derivatives (Nestorone,
nomegestrol acetate, trimegestone, norgestimate, desogestrel),
do not bind to the androgen receptor and, hence, do not exert
androgenic side effects. Newly synthesized progesterone-like molecules
such as drospirenone or dienogest have no androgenic effect and
have a partial antiandrogenic effect. Drospirenone derives from
spironolactone and binds to the mineralocorticoid receptor. The
type of synthetic progestin used in a brand oral contraceptives
should be listed on the information sheet that comes with the
package.
Finally, note that sometimes oral contraceptives can actually
promote excess hair growth. See birth
control pill hirsutism for details.
