Hormonal Influences on Hair Restoration in Leeds

Hormonal activity underlies many patterns of hair loss and remains central to the success of restoration strategies. In clinical practice across Leeds, we often assess endocrine contributors before advising surgical or pharmacological intervention. Addressing the hormonal environment of the scalp can significantly alter hair density outcomes, especially in those considering hair transplantation.

Androgens and Hair Loss

Androgenetic alopecia (AGA) is the most common form of hair loss, affecting both men and women. Its progression is closely linked to the conversion of testosterone to dihydrotestosterone (DHT) via the enzyme 5α-reductase. DHT binds to androgen receptors in genetically predisposed follicles, triggering follicular miniaturisation, reducing the anagen phase, and eventually leading to hair shaft thinning and dormancy.

Inhibitors of 5α-reductase such as finasteride have shown consistent benefit. Finasteride 1 mg daily has been reported to reduce scalp DHT by approximately 64%, slowing hair loss and promoting partial regrowth in responsive individuals. Dutasteride, though not currently licensed for hair loss in the UK, is a dual 5α-reductase inhibitor with even greater potency. A randomised controlled trial showed dutasteride was significantly more effective than finasteride at increasing hair count over 24 weeks.

Importantly, not all patients are candidates for these medications. Long-term hormonal suppression may cause side effects such as decreased libido or mood changes, which must be discussed during consultation. For those proceeding with hair transplantation in Leeds, managing DHT pre- and post-operatively can help stabilise surrounding native hairs and preserve results.

Oestrogen's Protective Role

Oestrogen has a complex but generally protective role in hair physiology. It extends the anagen phase and suppresses the effects of androgens in the follicle. Women often notice thicker hair during pregnancy due to increased oestrogen levels, followed by diffuse shedding in the postpartum period as oestrogen falls.

Postmenopausal women may experience hair thinning attributed to declining oestrogen. Hormone replacement therapy (HRT) can partly reverse this process. Transdermal oestradiol combined with progesterone has been observed to improve hair volume and density in select postmenopausal patients. It's important to consider the cardiovascular and oncological risks before initiating HRT, but for some women with female-pattern hair loss, hormonal support may delay or reduce the need for surgery.

Thyroid Function and Hair Health

Thyroid disorders are common and often overlooked causes of diffuse hair loss. Hypothyroidism, in particular, is associated with coarse, brittle hair and increased shedding. The mechanism is linked to a slowed hair cycle and reduced basal metabolic support to follicles.

In hyperthyroidism, hair may become fine and fragile, with increased telogen shedding. Restoration of normal thyroid function—through levothyroxine for underactivity or antithyroid drugs for overactivity—often results in hair regrowth over several months. A detailed thyroid function panel (TSH, FT4, FT3) is routinely requested when assessing unexplained hair loss in both sexes (PubMed PMID: 37692605).

Polycystic Ovary Syndrome (PCOS)

PCOS is a hormonal disorder affecting up to 10% of women of reproductive age. It is marked by elevated circulating androgens, insulin resistance, and irregular menstruation. Hair loss in PCOS is typically seen in a frontal pattern similar to male AGA.

Management includes weight optimisation, metformin, and anti-androgens like spironolactone or cyproterone acetate. These treatments can reduce further loss but rarely achieve full regrowth without additional therapy. For patients in Leeds with PCOS-related thinning, hair transplant surgery can restore the hairline if hormonal levels are well controlled.

Hair Transplantation in Leeds

Hair restoration surgery using Follicular Unit Extraction (FUE) is available in Leeds through several private clinics. Prices vary according to graft number. A typical range is £4,000–£8,000 depending on whether 1,000 or 3,500 grafts are required. At My Hair UK, prices start from £2,899 for up to 1,000 grafts and rise to £4,899 for 3,500 grafts. These are fixed rates inclusive of the full treatment day and post-operative care.

While surgery offers a permanent solution for androgen-sensitive areas, the hormonal drivers must be addressed concurrently. Transplanted follicles are generally resistant to DHT, but native surrounding hair can continue to miniaturise if not protected.

Importance of Medical Evaluation

Before undergoing any hair loss treatment or surgery, a full medical assessment is essential. Hormonal causes must be identified and treated early. This may involve blood tests, medication reviews, and a scalp examination.

Your local NHS GP can guide you through this process. In Leeds, three recommended practices include:

• Leeds City Medical Practice, 123 Cemetery Road, LS11 8LH

• The Light Surgery, Balcony Level, The Headrow, LS1 8TL

• North Leeds Medical Practice, 355 Harrogate Road, LS17 6PZ

Your GP can refer you for specialist endocrine or dermatology input if needed. They can also ensure you're fit for minor surgery and provide follow-up for any long-term treatments started.

Understanding the interplay between hormones and hair is essential. Addressing the endocrine background before, during, and after a transplant can dramatically influence success rates and patient satisfaction.