This is a bit of a personal matter, but I’ve always been quite grateful to those who have shared answers on blogs and forums whenever I was in search of something.  Therefore, I’m sharing this personal matter in hopes that it will help someone in turn.

For the past 3 years or so, my hair has been thinning.  It’s gotten much worse in the past year.  A lot of it comes out whenever I brush, and every time I shower I end up surprised that I have any hair left because of the amount that ends up at my feet.

At first, I thought it was because of the damage I had inflicted upon my hair.  I use to color and bleach my hair quite often.  My natural hair color is black and I was blond for several years - I can’t even begin to explain how damaging this is!  Logically, I attributed my hair loss to all the trauma I’ve put my hair through, but I haven’t colored my hair in over a year and I have been losing more hair than ever.  Additionally, damage hair tends to break and split.  My hair isn’t breaking but falling out at the root.  These two factors made me realize that my hair loss wasn’t from my history with hair dye.

I then thought that maybe it was because of my diet.  Was I not getting enough vitamins and minerals? Was I low in iron?  I had been anemic in the past, about 7 years ago, but since then I have been eating pretty well and I eat a lot of iron-rich foods such as beef, shrimp, eggs and greens.  Still, I became convinced that I wasn’t getting enough nutrients for the health of my hair and started taking supplements such as GNC’s Ultra Nourishair and biotin pills.  These did nothing to stop the constant shedding of my hair.

It has gotten so much worse in the past couple months.  My part is becoming wider and the contrast between my ever sparse black hair and light scalp is growing more visible.  I reached the point where I thought about trying women’s Rogaine.  I had ruled out hair damage and vitamin deficiency so I was left with thinking that maybe my hair loss was hereditary.  Was it all in my genes?  However, my parents don’t have thinning hair and neither do any of my sisters.  What was going on?

A few days ago, as my mind often works, a random thought hit me:  was it hormones?  I know hormones can affect almost every system in your body.  Could a hormone imbalance be causing my hair to fall out?  But why would my hormones be out of whack and then I made the connection: birth control pill!

I started the birth control pill a little over 3 years ago to help with my skin.   I had pretty oily and acne-prone skin before I went on the pill, but a few months after starting it, my skin was clear and much less oily!   I didn’t experience any of the other well-known side effects associated with the pill such as weight gain, depression, water retention and loss of sex drive.  All I knew was that my skin was finally clear and I was thrilled about it!

During that time, it never once occurred to me that my oral contraceptive was causing me to lose my hair.  As I just detailed, I had a couple more plausible reasons that jumped out at me first.  Plus, it was never mentioned by any of my doctors that hair loss was a potential side effect of the pill.

Well, a few days after my realization and a lot of online research later, I have learned that scalp hair loss is a potential side effect for pretty much all forms of hormonal birth control.  This is due to how hormonal birth control works which is by the introduction of unnatural levels of estrogen and progestin (progestin is the name for the artificial form of progesterone, another kind of female hormone).  All birth control pills have estrogen plus a progestin.  There are about 8 different kinds of progestin and their selection and dosage is what makes birth control pills different from brand to brand.

Some birth control brands have a high level of estrogen and a low level of progestin.  Others are the opposite with low estrogen and high progestin.  The type of and amount of progestin has an effect on the way the estrogen works on your body (estrogenic effects).  The progestin also has its own influences called progestational effects and androgenic effects.  Progestational effects deal with ovulation and menstrual bleeding.  Androgenic effects deal with influences on the hormone androgen.  Androgen is a key ingredient in making estrogen but androgen by itself is a pretty masculine hormone.

I have learned that hair loss from the birth control pill is an androgenic effect which makes sense since baldness is more usually a male thing.  What happens is that your hair growth is accelerated.  For the women who are affected by this, it may seem at first that your hair is growing faster and maybe even seem longer, thicker or fuller.  However, what this also means is that your hair will reach its “death” sooner and will shed itself much earlier than usual.  All birth control pills have the potential for scalp hair loss, but those with a formula containing a progestin with higher androgenic activity have an increased likelihood of scalp hair loss.  Also, some women are more sensitive to androgen-induced hair loss (androgen alopecia) than others.

It seems that I am one of those women! I wasn’t even using a brand with high progestin let alone one with an androgenic type of progestin.  For the past three years, I had been on Trinessa, which is the generic version of OrthoTriCyclen.  The specfic progestin in OrthoTriCyclen is a chemical called norgestimate.  Norgestimate has a pretty low androgenic effects rating compared to others. Two months ago I switched to Loette, which is also known by the brand name Alesse and Levlite.  The progestin in Loette is called levonorgestrel and to my astonishment, its androgenic effects rating is about 4.37 times more potent than OrthoTriCyclen! No wonder my hair loss has been accelerated, but that’s not the only culprit.  Any time you start a new hormonal birth control, switch brands, or stop taking the pill all together, your hormones go through an adjustment period and you can expect all sorts of stuff such as weight gain or weight loss, moodiness, depression, hair loss or even hair growth (face, back)!  You just need to remember that your hormones, which are basically the regulators of your body’s systems, are thrown out of whack and will need time to find balance.  It could be 4 months, it could be 2 years!

After realizing that my birth control pill was the root cause of my hair loss, I briefly considered switching back to the lower androgenic brand, OrthoTriCyclen.  However, I was on OrthoTriCyclen for 3 years and was steadily losing my hair during that time.  Though the likelihood for hair loss with such a low androgenic brand was slim, it seems that I am more sensitive than most.  I also thought about finding a brand with an even lower androgenic effects rating, but that would mean going to a high estrogen/low progestin pill and after even more research I didn’t want that either.  Instead, I’ve decided to go off the pill completely.  Though I am worried about my acne coming back, what I have read the past few days makes me more worried about what the introduction of artificial hormones is doing to my body.

Before I elaborate on that further, I want to explain one more thing about birth control pills: the reason why there are so many different kinds out there.

Every woman’s body will respond differently to different hormones and different levels of those hormones and how those hormones work together.  There are a few potential effects though that seem to be common:

Estrogenic effects (from the estrogen in the pill, influenced by and affects the progestin in the pill): Helps with acne, can cause weight gain, water retention, breast soreness, headaches

Progestational effects (from the progestin in the pill, influenced by and affects the estrogen in the pill): Depression, more regular menstrual cycles, breast soreness, headaches, moodiness and irritability, less painful menstrual cramps

Androgenic effects (from the progestin in the pill, influenced by and affects the estrogen in the pill): Unwanted hair growth (such as facial hair, hairy legs, back, etc.), scalp hair loss, acne

As you can see, they all have their pros and cons and it really is a science when it comes to finding the right balance. Though it may not look like there are any beneficial androgenic effects, a big plus of adrogenic activity is that it helps tone down estrogenic effects.  Women who experience weight gain or moodiness on their current high estrogen birth control pill may switch to something with more androgenic potency to tone down the estrogenic effects.  This could mean a pill with a bigger dose of progestin or one with a more androgenic kind of progestin.  There are benefits to both high and low androgenic effects.

The charts on this page [link] are very helpful in comparing the different brands of birth control pills.  The brand is listed along with its type of progestin and the dosage.  The bottom chart, in order to be able to compare among the brands, uses one of the progestin (norethindrone) as a baseline.  It’s like comparing fractions: you can’t really see the difference between ⁴?₉ and ⁵?₆ until you create a basis of comparison (¹⁶?₃₆ to ³⁰?₃₆).  When looking at the chart and trying to determine the potency of your progestational or androgenic effects, don’t forget to convert the activity value listed, which is for a 1mg dosage, to the actual dosage in the pill.  For example, OrthTriCyclen, whose progestin is norgestimate, has an androgenic value of 1.9 while Alesse, with the progestin known as levonorgestrel, has an androgenic value of 8.3.  However, OrthoTriCyclen has on average .205 mg progestin per pill while Alesse has .10 mg progestin.  Multiply this dose by the values and you get a better basis of comparison: 0.39 versus 0.83.  You need to do this for all the brands you’re comparing.  Just because a particular progestin has a higher androgenic effect value does not necessary mean the pill that uses that progestin is highly androgenic. The dosage is very important.

Okay, that’s a lot of information! I want to wrap this up by saying that I am not a doctor, nothing I write should be taken as medical advice, and if anything on this page is wrong, please let me know so I can correct it. I just hope that this helps someone who happens to be in the same boat as I am.  My doctors never told me about any of this and I think it’s all very important! So much is hidden behind medical jargon and fine print. In my research, I’ve found people who have said that the birth control pill can not cause hair loss when in fact it is listed as a potential side effect in the literature for many of the major brands. It’s in tiny print of course but it’s there.  I’m also not saying that everyone will experience hair loss on the pill,  I just know that I am.  I have decided to go off the pill completely since I am reactive to both high and low androgenic formulas.  I know it will take my body a few months to adjust, and during that time I expect my hair to keep falling out and perhaps other unpleasant side effects as my body tries to find its balance again. I am worried about my acne coming back but I will cross that bridge if and when I get there.  I just hope that after all is said and done, my hair will stop falling out and (fingers crossed) it will start growing in and staying in as normal again!

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