Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: bear on December 02, 2019, 02:43:19 PM
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Hi girls, (special hello to Sammiejane)
This is a recent article on the interaction between human scalp hair and hormones, particularly oestrogens.
Human scalp hair: Modulation by various factors and hormones, do estrogens inhibit or stimulate — A perplexing perspective
Edwin D. Lephart PhD
First published: 15 February 2019 https://doi.org/10.1111/jocd.12888
Sammie, if you'd like to read the article, I have a 48-hour access and will be glad to send you the important bits.
BeaR.
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hi bear
loverly to hear from you yes please that would be excellent !
you could email me if it’s easier
thank you
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Hia BeaR
The link wouldn't load for me :(
Could you or SJ please put the bullet points in this thread as my scalp is really interested in what Edwin has to say ;)
TD
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Hi girls,
Sammie, I have sent you the article. I think you should delete or edit your post so your email address won't be disclosed to the world wide web! ;) I had sent you a PM, but I guess you haven't read it.
Turkish delight, try this other link https://www.ncbi.nlm.nih.gov/pubmed/30770632 Anyway, it's just an abstract.
I will post the bullet points later on, I must dash!
BeaR.
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I'm very interested too. Thanks, BeaR
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Hi girls,
You're welcome! I'm still reading the important articles quoted in this mini review, in the meantime I came across another recent article (full text available) that is very interesting and easy to understand.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419033/
My life is a bit chaotic ::) atm but I promise I will come back with some interesting thoughts on this subject.
BeaR.
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Thanks bear - being naturally curious, the first study I got a copy from the author through an organisation I belong to. For anyone interested it is VERY technical! Also showing that some of the apparently conflicting results were due to the use of rat and mouse models and that you can't extrapolate these findings to humans. I can't pretend to follow it all as you would need to be a specialist really and it is very complex - and would be very time-consuming! However here is the conclusion:
"The topics in this brief summary cover the known and potentially knowable components of how 17β‐estradiol influences human scalp hair growth. Of course, the differences and similarities between human and murine hair biology remain and it would be much easier to demonstrate a clear‐cut role of 17β‐estradiol in human hair
growth; unfortunately, this is still not possible due to the complex number of interactions in the cellular/molecular signaling cascades that are involved in the cycling and growth of human hair."
It is clear there is still much to understand and although very interesting from a biological point of view will not actually enable anyone to decide what is the cause of their particular hair loss - and like other members have said on other threads - there are so many factors and interactions that HRT per se cannot be blamed, but will depend on a woman's particular circumstances - very difficult and frustrating!
However one thing did stand out and that was the role of cortisol - which the study said was incorporated into the hair follicle and that some studies show that cortisol inhibits hair growth. As we know cortisol is a stress hormone and this does stand to reason - we've heard anecdotally of people who's hair has "fallen out with shock". Therefore just knowing this - it seems to me one positive thing that anyone could do irrespective of whatever else is going on - is to try to stop worrying and reduce stress - so that excess cortisol can be lowered? Probably too simplistic maybe this would help? At least it would have other beneficial effects on your health - reducing stress and worry....
I would suggest bear that the second reference is also very technical and not easy to understand unless you have knowledge and understanding of the biological processes - it is not a "lay" paper!!
It does go through drug treatment of certain types of hair loss. In fact it reminds me I started looking into this a while ago and dug out some refs and articles on hair loss. The treatment recommended for women ( Finasteride) is only licesned at low dose for younger men with the early stages of hair loss (androgenetic alopecia), and at higher doses for prostate problems!
If you have any interesting thoughts that will help women who are suffering from this problem to overcome it, this would be very useful.
Hurdity x
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I am very interested, as i have been suffering hair loss for the last year at least
The dermatologist i saw put it down to stress, but last a lot in a very short ime,
Lost even more when put on Evoral Conti, so could be a mix of stress and hormones
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Hi girls,
Jaycee, I'm sorry you're also struggling with this, it's very distressing, My scalp hair loss is mainly in the vertex, but I had been on HRT for only 3 months. You're absolutely right it's a mix of stress, hormones and other things as well that I will be discussing soon. Lots of love.
As I said before I don't have time to discuss the articles now, but I will certainly do it later on.
Regarding smoking, I have been chatting with Sammie by email and this topic has been extensively covered ;)
BeaR.
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Hi girls,
Jaycee, I'm sorry you're also struggling with this, it's very distressing, My scalp hair loss is mainly in the vertex, but I had been on HRT for only 3 months. You're absolutely right it's a mix of stress, hormones and other things as well that I will be discussing soon. Lots of love.
As I said before I don't have time to discuss the articles now, but I will certainly do it later on.
Regarding smoking, I have been chatting with Sammie by email and this topic has been extensively covered ;)
BeaR.
May I respectfully suggest that any discussion about private messages or conversations is kept private. It is (probably unwritten!) protocol not to mention whether you're in touch with anyone by pm or e-mail because this is a private matter - usually what members say if they refer to any such exchange is "I've sent you a pm" or just send it! This is a public open forum and as such all the information on here is for public consumption and for all members to post. It gets a bit awkward referring to private convos (especially with a knowing wink) on an open thread. Sometimes members might not want others to know if they have been in touch with other members and who they are and the content of their convos. So - the smoking and hair loss issues are of interest to all. I only mention this bear because you also referred to a private convo on another thread a couple of weeks ago and I brought it up then - so just thought I would mention it in a bit more detail!
If anyone thinks this is too outspoken - well I certainly would not want the content of any of my pms or e-mail discussions aired on the open forum, nor it be known whom I was in contact with - and I am sure there are others who might think the same and perhpas be worried about sending pms etc - so just putting it out there. ::)
Happy days :)
Hurdity x
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Hi girls,
May I respectfully disagree? Sammie has mentioned that she's a smoker on 9 posts (you just have to do an advanced search). I have been sending her many PM's (one with my email address) but she didn't answer, maybe she's too stressed right now and that's why I posted on this thread that if she needed any support I'd be glad to help her via email. I just don't like sending long PM's because I have to login on the forum and I don't have much spare time right now. She has kindly provided her email address which I promptly told her to delete from this thread. I don't see anything wrong with that. Many members have been offering advice regarding types and dosages of prescription drugs (HRT). I don't think mentioning smoking is a problem. Nothing that we've been chatting is new to this forum and everyone interested can post and ask whatever they like on this thread and I'll be glad to reply if I can be of any help.
BeaR
PS. The winking smiley was intended to mean 'I know she smokes and we have been addressing this issue' to Lola50 who was the one that has mentioned smoking, not me.
PSS. I don't have time to discuss these sort of thing, I want to help and be helped by people on this forum, if my posts have anything that might be an issue for you or anyone else, just report it to the Admin or maybe you could apply for moderator?
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Gosh, I hope I didnt start a furore by mentioning the smoking thing. I just think it's very important as it really does affect hormone balance which many find so hard to achieve especially after ovaries are removed.
I'm new here, so apologies if this has been covered before on other threads and posts. I have no knowledge of 'advanced searches'. Just trying to help out BeaR, I didn't realise that you were in touch with Sammiejane privately and obviously couldn't have known that, so felt like I was being 'slapped down' a bit. I'm sure that wasn't your intention though and realise that you're a much more seasoned member than me.
Hi Lola50,
Not at all, I just want to make clear I was referring to hurdity's post, although you 'agree with her totally'... ;D
Back to the thread... I will post my final thoughts on the scalp hair loss tonight.
BeaR.
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BeaR, I'm sure the moderators can step in if they consider it necessary, although I can't see why they would in this instance.
Personally I really appreciate the time and effort you take in posting all the info you do so thank you.
Hi sparkle,
Thank you :) I think I have already mentioned on the HRT & Cancer Lancet study thread that I don't mind talking to myself, it's good for the brain ;D
BeaR.
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Woah steady on girls! No-one mentioned anything that would criticise anyone for providing any information on this forum - far from it!! Certainly not me because that's also what I like to do!!
PSS. I don't have time to discuss these sort of thing, I want to help and be helped by people on this forum, if my posts have anything that might be an issue for you or anyone else, just report it to the Admin or maybe you could apply for moderator?
Exactly - as I do. However I do get a bit twitchy at the mention of any mention of pms and who is in touch with whom. I have been around a long time and without going into details things have happened in the past as a result of this, so it was nothing to do with the smoking thing per se, I just wanted to point out the general principle/protocol of not disclosing this sort of thing.
BeaR, I'm sure the moderators can step in if they consider it necessary, although I can't see why they would in this instance.
re the moderators - a few months ago Emma posted to say we were all moderators - every single one of us. In other words the forum is far too big for her to read all the posts and many things do not warrant reporting when we can point things out ourselves - to help each other in terms of how things work on the forum. OK?
I agree with that totally, Hurdity. 💜
I'm glad you agree Lola50!
Getting back to the thread - I had a very thick head of hair for most of my life but it is way way thinner now than it used to be - still have plenty but nothing compared to old times when younger. Thinning hair happens with age - which may be down to dramatic oestrogen decline, and testosterone too, and possible also the tipping of the balance in favour of T over oestrogen - ie T becoming more dominant while both hormones are declining. I don't think either oestrogen replacement nor Testosterone replacement fully compensates for this because we cannot hope to have the levels we had when fertile.
I did find a lot of articles about it - maybe I'll post them because I haven't done up until now. It will be very long so perhaps a separate thread if members would find it helpful...
Hurdity x
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hi ladies
i would like to say as my smoking as been raised !
please remember i had my operation 5 yrs ago throughout which my ovaries removed i smoke all through those years will no hairloss my hairloss has happened since starting hrt it maybe different for natural menopause as your own hormones compensate but surgical is completely different ! after my operation my hair did the opposite of thin it grew fast and mega thick to the point i had to go to the hairdresser to have it thinned it's was a horses main since being on estrogen i have lost 50 % in a year , in my case stress causes no effect on my hair nor does smoking i never smoke throughout 3 pregnancies made no difference to my hair ! and the same if low estrogen causes so much hairloss then the 4 plus years not being on hrt i would be virtually bold so yes hrt in my opinion causes hairloss so many women i know on here and celebrity's have suffered hairloss whe initiating hrt and again it isn't always progesterone i'm proof of that as i take only estrogen every women is different how they respond to hormones !
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Hi girls,
Sorry I'm a bit late, but here goes. Sentences in bold are mine.
Necessary background:
1 g = 1,000 mg = 100,000 µg = 100,000,000 ng = 1,000,000,000 pg.
‘17β‐estradiol' has been substituted by estradiol in the main text. Greek letters have been substituted by alpha, beta and gamma or left out when not needed. '5α‐DHT' has been substituted by DHT.
The purposes of this review:
‘(a) the hair follicle in mammals vs humans for growth and cycle control;
(b) the 5α‐reductase enzyme and the impact of 5α‐dihydrotestosterone (5α‐DHT) on the human hair follicle;
(c) steroids, in general, and estrogens specifically (ie,17β‐estradiol) on their influence of the human hair follicle that may be inhibitory or stimulatory;
(d) estrogen receptors (ER) alpha (α) and beta (β), G protein‐coupled estrogen receptors (GPR30 or GPER), and even the orphan receptor, estrogen‐related receptor (ERR) gamma (γ), as potential mediators of estrogen hormone actions in hair follicles; and
(e) steroidogenesis by aromatase and 5α‐reductase expression and their enzyme activities.
Hair follicle is a dynamic mini-organ influenced by multiple factors:
‘(…) numerous growth factors, immune molecules, neuropeptides, inflammatory molecules, and hormones.'
Some in vitro studies have used fetal calf serum containing steroids… but recent studies have addressed this issue by substituting it.
Estradiol and progesterone dose response show inverted U-shape curves, meaning more is not necessarily better, intermediate doses may be more effective:
‘(…) 1 nmol/L of progesterone inhibited DHT synthesis by 75% and 100 nmol/L and 1 µmol/L levels of progesterone inhibited DHT formation by 99% and 96%, respectively.
The intermediate estrogen dose of 10 nmol/L appeared to be the most effective in stimulating hair shaft elongation from the Conrad report. This dose.response inverted U-shape curve has been reported for estrogen effects in brain activity (hippocampal neurons) in young women where physiological estradiol concentrations stimulate brain activity, whereas supraphysiological estradiol ranges (as seen during pregnancy) display inhibitory effects. Such findings may not be surprising since the overall “tone†of the brain and heart is inhibitory in order to maintain homeostasis.
Additionally, in the report by Conrad et al they showed that hair shaft elongation was significantly stimulated by 1‐100 nmol/L estradiol from a healthy man. Notably, from this report, the 1 nmol/L and 100 nmol/L estradiol results were very similar, while the 10 nmol/L level of estradiol displayed the greatest stimulatory effect on hair shaft elongation.'
Scalp hair follicles respond differently from body hair follicles.
Human hair follicles respond differently from other mammals hair follicles.
‘Much of our understanding of hair biology has been based upon research in rodents since human and murine hair follicles share similar organizational (cellular) and functional components in the repetitive cycling of the anagen, catagen, and telogen phases.
Early reports from mammals suggested that estrogens (estradiol) usually inhibited hair follicle growth.
Conrad et al. addressed this perplexing topic citing human data for both the inhibition and stimulation of hair growth by estradiol.
However, Oh et al in 2016 noted that while both human and murine hair follicles are very responsive to hormonal stimulation via estrogens and prolactin, these hormones inhibited murine hair follicle growth and cycling, conversely, both hormones prolonged the anagen phase in human female temporofrontal scalp hair follicles.'
Conclusions:
‘Much more is known about the expression and molecular mechanisms of the human estrogen receptors (ER alpha and ER beta) in the hair follicle, which have revealed:
(a) differential expression of ERs from the vertex and occipital scalp in humans,
(b) the distribution pattern of ER beta and TGF-beta 2 (a negative hair growth modulator) is different between males and females and there are substantial sex-dependent differences in the response in fronto-temporal human scalp hair follicles to estradiol,
(c) from murine studies,ER alpha vs ER beta have selective roles in the complexity of hair growth and regulating the hair cycle, and
(d) hormonal activation via dexamethasone in human hair follicles significantly reduced ER alpha expression by 38%, while ER beta levels were unaffected.
Oestrogen, Progesterone & Testostesterone actions on hair follicle are intertwined depending on affinity for receptors and enzymes
'The inhibitory actions of androgens on hair follicle cycling are undisputed, where DHT is more potent than the principal circulating androgen, testosterone, due to its greater affinity (2.5‐5 times) and stability for androgen receptors.
They found that 1 nmol/L of progesterone inhibited DHT synthesis by 75% and 100 nmol/L and 1 µmol/L levels of progesterone inhibited DHT formation by 99% and 96%, respectively.
This "inhibition"of DHT may be misleading since it is known, in general, that the 5 alpha-reductase enzyme has a higher affinity for progesterone as a substrate compared to testosterone, thus possibly reflecting more conversion to 5 alpha-progesterone compared to DHT among the progesterone levels tested.
Kondo et al showed that the growth curves of human scalp hair follicles in organ culture were inhibited by the addition of testosterone or estradiol.
Nelson showed that estradiol inhibits female scalp hair shaft elongation along with the phytochemical, genistein, which selectively binds ER beta.
(…) in human skin and scalp tissue, the expression levels of aromatase and steroidogenic acute regulatory protein (StAR) were positively correlated with estrogens and testosterone concentrations respectively. StAR has been demonstrated to play an important role in the production of steroid hormones by the transfer of cholesterol from the outer mitochondrial membrane to the inner membrane in steroidogenic tissue sites.'
Hormones, Pregnancy & Hair
‘The stimulatory action of estrogens during pregnancy on hair growth has shown that after parturition, the follicles enter the resting phase with associated hair shedding and thinning. However, there is a dramatic decline in progesterone and estrogen levels by approximately 98% (with the delivery of the placenta). This may result in estrogen dominance due to the ng/mL vs pg/mL declination of progesterone and estradiol, respectively, along with the fact that estradiol is the more potent hormone. Also, the rapid decline of progesterone may alter DHT formation since progesterone is a preferred substrate for the 5 alpha-reductase enzyme that could alter the estrogen/androgen ratio resulting in hair shedding and thinning after parturition.'
Other factors influence hair follicle:
Dexamethasone and other steroids
‘Additionally, dexamethasone treatment stimulated the expression of aromatase mRNA levels by ninefold with a corresponding increase in aromatase activity in both frontal scalp and beard hair follicles. These reports suggest selective estradiol and other hormone actions via ERs that may involve systemic and/or locally synthesized steroid hormone, or other signaling mechanisms that remain to be elucidated.
Other oestrogen receptors
Finally, the discovery in human skin of the orphan receptor that is a member of the nuclear receptor superfamily, namely estrogen related receptor gamma (ERR gamma) displays strong sequence homology estradiol with ER alpha but does not bind estradiol and information on GPR30 or GPER in hair follicles is lacking especially in light of the well.known beneficial effects this receptor has in inhibiting breast cancer.
Enzyme levels variability
'More recently, Sanchez et al showed that aromatase mRNA levels in plucked hair follicles were significantly lower in women with female pattern hair loss (FPHL). Additionally, the mRNA levels of all three 5 alpha-reductase enzymes were increased in some women with FPHL, but not in others, which may explain the lack of effectiveness of 5 alpha-reductase inhibitors in some FPHL women.'
Dietary soy isoflavones
‘The dietary derived polyphenol, equol, is present in the circulation of humans at various concentrations regardless of age, race, gender, or geographical location in the world. In this case, equol is a selective ER beta agonist, is known to bind ERR gamma which it is thought to protect against neoplastic growth. Other phytochemicals such as genistein have been shown to alter human scalp hair shaft elongation.
Estrone
‘Substantial rates of estrogen formation from estrone sulfate (via steroid sulfatase) were found in anagen hair follicles where estrone accounted for 97% and estradiol 3% of the formed estrogens. A selective decrease in estradiol was observed in telogen compared to anagen hair follicles suggesting an impaired formation of estradiol in the presence of high estrone levels. The authors concluded that the resulting loss of estradiol may cause the transformation from anagen to telogen hair, since the principal hormone action of estradiol is to prolong the anagen phase of human scalp hair and to decrease the length of the telogen phase.'
The bulletproof reality:
‘It is still rather unclear what exactly estradiol administration does to human scalp hair growth.'
“It is no longer justifiable to portray telogen as the resting stage of the human follicle cycle…. It is a master switch stage in the control of human follicle cyclingâ€.'
BeaR.
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Hi Lola50,
Ask away!
BeaR.
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hi bear
thanks for all that info
could you break it down in simple terms for me so is estradiol good for the hair ?
is progesterone good for the hair ?
does progesterone inhibit dht ?
i presume inhibit means to stop ?
stimulate means to grow in hair terms ?
thanks again bear
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Hi Sammie,
Bottom line: No one knows!
Sorry, but that's reality. There is 'human data for both the inhibition and stimulation of hair growth by estradiol.'
What is certain is that DHT inhibits scalp hair growth. 'The inhibitory actions of androgens on hair follicle cycling are undisputed, where DHT is more potent than the principal circulating androgen, testosterone, due to its greater affinity (2.5‐5 times) and stability for androgen receptors.'
Progesterone can inhibit DHT and potentially help hair growth, but the 'inhibition' may not be a true inhibition, more likely a competition between progesterone and testosterone for the alpha reductase enzyme. Whatever mechanism is at play, YES, progesterone would help hair growth by competing with testosterone in the scalp tissue and preventing the formation of DHT.
Inhibit is not the same as stop in this case, it's more like competition as I have explained above.
Yes, 'stimulate' as in stimulating hair growth.
You're welcome!
BeaR.
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hi birdy
that's an idea or maybe my body just needs all 3 hormones so they can work together !
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hi birdy
sorry being thick i don't understand what u mean? is is because my testosterone is low there isnt much DHT ? i thought low levels of testosterone can cause DHT to rise as can to much testosterone ?
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Thanks BeaR, progesterone didn't do my hair any good, when i was on one with Norethisterone my hair fell out a lot within 4 weeks, so did my daughters.and i have read a lot of womem had hair loss on this HRT
Sorry if i have read it wrong,it is all a bit too complex for me ::)
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Reading with interest as I started using Androfeme about 2 months ago, and I'm sure my hair has gotten finer and that's there's less of it since, especially around the front. This 'could' be due to the testosterone converting to DHT, right? If I used Saw Palmetto, this 'might' stop the conversion and thus the hair loss? I really want to nip this in the bud before it gets bad. 🙁
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There is insufficient evidence whether Saw Palmetto works for hairloss;
https://examine.com/supplements/saw-palmetto/
https://selfhacked.com/blog/benefits-saw-palmetto/#comments
https://www.medicalnewstoday.com/articles/326927.php
It can have side-effects and most studies are done with males.
Also:
Saw Palmetto may reduce the effectiveness of birth control pills by lowering estrogen levels
https://www.ncbi.nlm.nih.gov/pubmed/18700016
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Thank you Alicess. I think I'm just going to stop using the Androfeme for now and see if things get any better or at least stop getting worse. I guess it could be the oestrogel causing the hair loss/thinning, but I don't feel I can live without that!
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sheanie
like u, i take estrogel to but only this and my hair is considerable thinner , i've actually stopped it 3 days now to see if shedding stops if it does then i know it's that !
but i think for me if it continues to shed then i will take all 3 hormones together as have had hysterectomy because estrogen on its own wasn't enough causing to much mood fluctuation x
so just using ovestin vaginally for time being see how i go as i've lost 50 percent and is noticeably thinner colour has changed to bear my roots and as all bloods are fine and no deficiencies in anything it must be hrt as has only shed since starting !
hope that helps thing is to stop on thing at a time .
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Thanks Bear, but for me it raises more questions. Hairloss can be caused by so many factors. It is not only DHT that causes it. Some men and women lost hair on DHT blockers.
I've been on a very potent anti- androgenic BCP (ethinylestradiol/ cyproteronacetaat) which is also a highly progestogenic progestin. I started to loose my hair and I grew hair on my nippels, tummy and chin.
Progesterone also has a anti-estrogenic effect so with already low estrogen levels I doubt it will do much good
Alicess.
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Thanks Sammiejane. I was on Estrogel and Utrogestan for about 8 months, and I don't think. had hair loss. I really feel the last two months since I've been on Androfeme the hairs of gone finer and have split and also I seem to have less hair. I'm stopping the Androfeme as I can live with it. The Estrogel is a life saver for me though, so if it's that, I'll have to live with the hair loss somehow.
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hi sheanie
well stop as you said the androfemme i assume this is a testosterone ?
i've been 6 days now no estrogel and think my shedding maybe haulting ! like yourself though, estrogel has helped with vaginal dryness for me so this is starting to show now but going to go till monday of it as that's been a full week then and then when i restart i'm going to add in progesterone to see if this helps as it may of been unopposed estrogen causing exessive shedding ! if it goes back to shedding i will look at another hrt maybe sandrena gel or patch !