The role of hormones in female androgenetic alopecia: focus on menopause

Female androgenetic alopecia (FAGA) is the most common cause of hair loss in women. Even though its prevalence differs between populations, studies show consistent evidence that the incidence increases with age. This can be attributed to hormonal changes during the menopausal transition - a decrease of estrogen levels leading to the state of relative hyperandrogenism. Nonetheless, the pathogenesis of the disease remains unclear, as up-to-date studies have failed to prove the correlation between total and free testosterone concentrations and the prevalence of FAGA. This article provides a literature review on the impact of hormones on the hair cycle and their role in postmenopausal women. In particular, the article focuses on the role of androgens, estrogens, progesterone, stress hormones and hormones released from the adipose tissue in the context of AGA. Furthermore, the article reviews the risk factors of FAGA in postmenopausal women, such as insulin resistance, high body mass index and metabolic syndrome, and elucidates their possible role in the pathogenesis of the disease.