For other women, the problem with estrogen dominance is that they’re also experiencing lower levels of progesterone relative to estrogen—and progesterone helps protect hair follicles from the hair-thinning effects of testosterone, DHT, and estrogen. Evidence suggests that progesterone may act as an aromatase inhibitor and other research suggests that the genes involved in aromatase activity are implicated in female hair loss. 

Several skin conditions, including psoriasis, eczema, and seborrheic dermatitis, don't directly lead to hair loss, but cause inflammation (a symptom of these conditions) near the brow that may be to blame. The urge to scratch and rub the inflamed area can indirectly cause eyebrow hairs to fall out. Loss that occurs in this manner is usually patchy, but as it is generally non-scarring (the hair follicle is intact), eyebrows can and often do grow back.
Despite the name androgenetic alopecia, the exact role of hormones is uncertain. It is well known that androgens affect the growth of the scalp and body hair and even Hippocrates observed 2,400 years ago that eunuchs did not experience baldness (Yip et al., 2011). However, hyperandrogenism cannot be the only pathophysiologic mechanism for FPHL because the majority of women with FPHL neither have abnormal androgen levels nor do they demonstrate signs or symptoms of androgen excess (Atanaskova Mesinkovska and Bergfeld, 2013, Schmidt and Shinkai, 2015, Yip et al., 2011). Furthermore, cases have been reported in which FPHL developed in patients with complete androgen insensitivity syndrome or hypopituitarism with no detectable androgen levels (Cousen and Messenger, 2010, Orme et al., 1999). 

In an article on menopause, the University of Maryland Medical Center states, “Estrogen loss can contribute to slackness and dryness in the skin and wrinkles. Many women experience thinning of their hair and some have temporary hair loss.” Meanwhile, this study reports, “It has long been known that estrogens also profoundly alter hair follicle growth … the time has come to pay estrogen-mediated signaling the full attention it deserves in future endocrinological therapy of common hair growth disorders.”
When compared with no treatment, patients who received ethinyl estradiol 50 μg and cyproterone acetate 2 mg with cyproterone acetate 20 mg on days 5 to 20 of the menstrual cycle for 1 year had a significant increase in their percentage of anagen hairs with trends toward a larger shaft diameter of full anagen hairs and a decreased number of hairs that were less than 40 microns (Peereboom-Wynia et al., 1989). A 12-month randomized control trial of 66 women compared treatment with topical minoxidil 2% plus an oral contraceptive (ethinyl estradiol 30 μg + gestodene 75 μg) with treatment with cyproterone acetate 50 mg plus an oral contraceptive (ethinyl estradiol 35 μg + cyproterone acetate 2 mg) and demonstrated that treatment with cyproterone was more effective in hyderandrogenic patients but otherwise less effective (Vexiau et al., 2002). Side effects of cyproterone acetate include weight gain, breast tenderness, and a decreased libido (Kelly et al., 2016). Hepatotoxicity and development of multiple meningiomas may occur when doses exceed 25 mg daily (Medicines and Healthcare products Regulatory Agency, 2009). Cyproterone acetate is used widely in Europe and Canada, either in an isolated form or in combination with ethinyl estradiol, but it is only available in the United States as an orphan drug for the treatment of hirsutism (Carmina and Lobo, 2003, Jurzyk et al., 1992, Kelly et al., 2016). Cyproterone acetate is classified as pregnancy category X.
In your quest for perfectly maintained brows, you probably keep regular maintenance appointments on your calendar. Instead, you might want to embrace a more natural, hands-off approach. “The trauma inflicted on hair follicles during waxing, tweezing, and threading can lead to permanent follicular damage,” explains Dr. Umar. “Women who grew up in the height of the ’90s overplucked, pencil-thin brow trend have begun to notice the difficulty in growing thicker eyebrows after years of this habit.”
Some cancer chemotherapy drugs cause temporary hair loss, which affects all body hair. Along with the loss of scalp hair, people undergoing chemotherapy also commonly lose their eyebrows and eyelashes. Chemotherapy drugs that frequently cause hair loss include paclitaxel, 5-fluorouracil, carboplatin, cisplatin, actinomycin-D, bleomycin, vincristine, cyclophosphamide, altretamine, etoposide, docetaxel and doxorubicin. Hair loss typically begins 2 to 3 weeks after the start of chemotherapy. Lost eyebrow hair regrows in the weeks to months following completion of treatment.
Although it’s generally only prescribed as a last resort for menopausal symptoms, hormone replacement therapy is a common and very effective hair loss treatment for some women — as long as they are menopausal or post-menopausal and are not at higher risk for adverse effects from HRT. It's most often prescribed for women who have androgenetic alopecia, also called pattern baldness. Hormone replacement therapy has a number of benefits for both general health and symptom management, but also a number of side effects — which range from unpleasant to dangerous.
Eyebrows frame your face and play an important role in your facial appearance and expressions. If the hair in your eyebrows starts falling out, you are sure to see a difference in your appearance, which you may want to rectify. Many conditions can cause eyebrow loss.[1] However, you can usually take steps to reverse the effects, such as eating a healthy diet and adjusting your beauty routine or lifestyle to account for the natural aging process.
Estrogen and combined oral contraceptive (COC) drugs with estrogen or progestogen have been reported as effective, but data are limited (Adenuga et al., 2012, Raudrant and Rabe, 2003, Scheinfeld, 2008). They are thought to function through several mechanisms. Both components of COC drugs increase the levels of sex-hormone-binding globulin (Schindler, 2013). They also send negative feedback signals that suppress the hypothalamic secretion of gonadotropin and releases the hormone and pituitary secretion of the luteinizing and follicle-stimulating hormones, which results in a decreased androgen production (Gilman et al., 1990, Varothai and Bergfeld, 2014). These actions decrease androgen secretion from the ovary and the quantity of free, biologically active androgens, which reduces their effects on the hair follicles (Schindler, 2013). Our practice when prescribing COC drugs is a combination of ethinyl estradiol 20 mcg plus drospirenone 3 mg. Drospirenone is an analogue of spironolactone. This treatment combination is approved by the FDA for the treatment of acne but not alopecia.
“…a beauty editor told me she had been using Viviscal... Since beauty editors see truckloads of products every week, I was immediately convinced when she said it worked – so I bought it myself. I started taking it twice a day for the first six months and saw dramatic results within three to four months. My hair was less thinned out …and it was also less brittle. I’ve gone to the same hairdresser since I was 19, and he was the first to comment on how full and strong my hair looked…”
What she doesn’t mention is how to regrow your brows after chemo-related brow loss! If you have recently undergone chemotherapy, your brows may be a bit wonky in the beginning, but you still want them, right? They are the frame for your beautiful face. Every October we host a “Buy One Give One for the Cure” campaign, where for every bottle of WINK  sold, we donate one to a cancer survivor. If that’s you, shoot us an email so we can get you hooked up. 

Toxic alopecia occurs when there is a disruption of hair growth in the anagen phase. This usually occurs following chemotherapy and radiotherapy.[94] Radiotherapy for various types of ocular tumors, eyelid and choroidal tumors have been reported to produce madarosis.[95–97] Hair loss due to radiation is usually reversible, but may be permanent when the dose of radiation is in the range of 50 to 60 Gy.[94]

Madarosis is a terminology that refers to loss of eyebrows or eyelashes. This clinical sign occurs in various diseases ranging from local dermatological disorders to complex systemic diseases. Madarosis can be scarring or non-scarring depending upon the etiology. Appropriate diagnosis is essential for management. Follicular unit transplantation has been found to be a useful method of treating scarring madarosis and the procedure relevant to eyebrow and eyelash reconstruction has been discussed. A useful clinical approach to madarosis has also been included for bedside diagnosis. The literature search was conducted with Pubmed, Medline, and Google scholar using the keywords madarosis, eyebrow loss, and eyelash loss for articles from 1960 to September 2011. Relevant material was also searched in textbooks and used wherever appropriate.
If, however, you aren’t so sure that any of the causes listed above are a problem for you, then a good place to start may be to talk with your healthcare provider about testing. It is important to learn the root cause – especially if dealing with infertility – because that which is causing hair thinning and shedding may also be contributing to your inability to conceive.
Toxic alopecia occurs when there is a disruption of hair growth in the anagen phase. This usually occurs following chemotherapy and radiotherapy.[94] Radiotherapy for various types of ocular tumors, eyelid and choroidal tumors have been reported to produce madarosis.[95–97] Hair loss due to radiation is usually reversible, but may be permanent when the dose of radiation is in the range of 50 to 60 Gy.[94]
Also new is the HairMax Laser Comb. It's a red light therapy hairbrush-like device that increases circulation and the biological march that makes hair. It's only approved in men (though some women are using it) and in my experience, is not as good as minoxidil. But in one study, 45% of users reported improvement after eight weeks, and 90% saw improvement after 16 weeks.
Androgenic alopecia, hair loss when androgen levels are not too high, is an indicator of inflammation. Hair loss is just one sign of inflammatory issues like Celiac disease or gluten intolerance. Naturopathic Doctor Lara Bridden says, “Inflammation hyper-sensitizes your hair follicles to a normal amount of androgen. Reduce inflammation by avoiding food sensitivities such as wheat and/or dairy, and by correcting intestinal permeability.”

Try out new hairstyles to disguise your thinning hair whilst you recover your hormonal balance. You may also want to consider a hair piece or clip-in extensions if your hair loss is very bad, but these should be used with care in order to prevent traction alopecia. You may also like to try using rollers or a hair volumizer, to add lift to your locks, or instantly hide thin patches with a good hair loss concealer.
The eyebrows are two-arched eminences of skin situated above the orbital regions.[3,4] The hairs of the eyebrows are short, thick. and stiff and are set obliquely. The diameter of eyebrow hair is normally thinner than scalp hair in Asians, and the scalp hair in thinner in Caucasians.[5] The eyebrows can be roughly divided into three parts. The medial third is usually below the orbital margin with the hairs in this region oriented vertically. The middle third lies along the orbital margin with hairs oriented obliquely or horizontally. The lateral third usually lies above the orbital margin.[3] Eyebrow hair normally tends to be less dense laterally than medially; thus, hair loss from any cause is apt to be more obvious in the lateral portion.[6]
While these factors contribute to hair loss for any woman, it’s particularly dicey for those of us with PCOS because when the follicle is exposed to our elevated androgens such as DHT (di-hydro testosterone, an active metabolite of testosterone) it gets damaged. Whenever a cell is damaged it generates oxidative stress which further alters the androgen receptor in the follicle perpetuating the issue.
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