Hormone blocking medications in women receiving hair transplants:

Do we ever prescribe?

To keep hair looking full in the long term you need to think about the long term. A hair transplant provides a source of permanent hair, but you also need to be focusing on doing everything you can to keep the existing hairs on the scalp. That’s where minoxidil, hormone blockers and even other strategies come to be very important. Of course, I’m happy when my patients are pleased with their hair at the end of year 1, but the real focus needs to be on helping keep your hair full 5, 10 and 15 years down the road as well
— Dr. Donovan

An important issue for all women undergoing hair transplants is how to reduce the chance of losing the 'existing' hair on the scalp. Although transplanted hair help provide a permanent improvement in hair density,  the existing hair that is "already" there could be lost in future years.  At Donovan Medical, women undergoing hair transplantation are counselled on the use of medications that are scientifically proven to either help stop hair loss or improve hair growth. This includes the use of minoxidil and sometimes hormone blocking medications such as spironolactone, cyproterone acetone, flutamide and finasteride.  Like any medications, the use of these medications requires through discussion and all hair restoration patients develop a thorough understanding of these medications. 53 % of our female hair transplant patients  use minoxidil around the time of their transplant, 37 % use minoxidil long term. 18 % use one of the hormone blocking medications.   

 

Hormone blocking medications 

These include spironolactone, flutamide, cyproterone acetate and finasteride. The most important issue for women using hormone blocking medications to be aware of is that the medications must never be used during pregnancy or by women trying to conceive. These medications could block hormones in a developing baby and cause harm to the fetus. The decision to start these medications requires thorough discussion and Dr. Donovan reviews all details with patients. Premenopausal hair transplant patients who decide to start these medications are often started on a birth control pill as well. 

 

Do these medications help women with genetic hair loss? 

- Yes. These medications help 60 % of women. 

- About 30 % of women will notice an improvement in their hair after 1 year of use

- About 30 % of women will notice that they are no longer losing any more hair

 

How long does the drug need to be used? 

- The medications work only while they taken. If  stopped, any benefits that a patient received will be lost in 6-9 months. Hair density will return to the way it was before starting the drug.

 

What are the side effects of hormone blockers? 

It's important to be aware that most women that use the medications don't have any side effects. These medications are usually start one month post transplant. 

The most important issue for women using hormone blocking medications to be aware of is that they must never be used during pregnancy or by women trying to conceive. These medications could block hormones in a developing baby and cause harm to the fetus. The decision to start these medications requires thorough discussion and Dr. Donovan reviews details with patients. Premenopausal hair transplant patients who decide to start these medications are often started on a birth control pill as well. 

 

However the following may occur in a low proportion of users:

- Mood changes (lowered mood, depression & anxiety) in 1:100 women

- Sexual dysfunction. Decreased libido (sex drive)  occur in a small proportion of women using these medications.

- Enlargement of breast tissue and breast tenderness  

- Irregular periods. Pre menopausal women using these medications may develop irregular period while on the drug. 

 

 

Common Questions 

 

1.  How long will it take to see benefits from these drugs?

Benefits will be seen between 4-9 months. Generally, results peak around one year. 

 

2. Can hormone blocking medications be used with minoxidil?

Yes, the two can be used together and studies suggest the combination works even better than the use of either alone.

 

3. Can women using these drugs stop them and have a healthy pregnancy in the future? 

Yes. Although these drugs are not to be used during pregnancy or while trying to get pregnant, women can stop these medications and have healthy pregnancies.  

 

4. Do hormone blocking medications cause breast cancer?

At present, there is no evidence that finasteride causes breast cancer in women. It is generally recommended that women  perform routine self exams to check for lumps, pain.   However, there is no evidence that these medications cause cancer. 

 

5. Can patients taking hormone blocking medications donate blood?

Patients taking these pills should not donate blood. If a woman who was pregnant received a blood transfusion and it contained these medications, the developing baby could be harmed. Patients should tell their blood donor clinic if they use any medications. 

 

 

 

 




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