Testosterone Replacement Therapy (TRT) is a medical treatment used to address low testosterone levels in men, a condition known as hypogonadism. TRT aims to restore normal testosterone levels, improving symptoms such as low energy, decreased libido, and mood changes. However, one of the potential side effects of TRT is hair loss, especially in individuals predisposed to male-pattern baldness.

When testosterone levels are increased through TRT, a portion of the hormone is converted into dihydrotestosterone (DHT) by the enzyme 5-alpha reductase.

• DHT is known to shrink hair follicles, leading to a condition called androgenic alopecia (male-pattern baldness).
• Individuals with a genetic sensitivity to DHT are more likely to experience hair thinning or receding hairlines during TRT.

TRT can sometimes cause fluctuations in hormone levels, potentially triggering telogen effluvium, a temporary condition where hair enters the resting phase prematurely, resulting in diffuse shedding.

• Genetic Predisposition: If you have a family history of androgenic alopecia, you are more likely to experience hair loss on TRT.
• High DHT Levels: Individuals with naturally high DHT levels or increased sensitivity to the hormone are at greater risk.
• Prolonged Use: Long-term TRT may amplify the effects of DHT on hair follicles.

Hair loss caused by TRT is generally related to androgenic alopecia, which is permanent if untreated. However, hair shedding due to telogen effluvium is typically temporary and resolves once hormonal levels stabilize.

• Finasteride (Propecia): A prescription medication that inhibits the conversion of testosterone to DHT, helping to prevent hair follicle miniaturization.
• DHT-Blocking Shampoos: Over-the-counter shampoos with ingredients like ketoconazole may reduce scalp DHT levels.

• Minoxidil (Rogaine): A topical treatment that promotes hair regrowth and improves follicle health.
• PRP Therapy: Platelet-rich plasma injections can rejuvenate damaged hair follicles and stimulate growth.

Work closely with your healthcare provider to find a TRT dosage that balances testosterone levels without significantly increasing DHT production.

• Maintain a diet rich in vitamins and minerals such as biotin, zinc, and iron to support hair health.
• Reduce stress levels through relaxation techniques like yoga or meditation, as stress can exacerbate hair loss.

If hair loss is a major concern, consider discussing alternative treatments with your doctor, such as:

• Clomiphene Citrate: A medication that stimulates the body’s natural testosterone production.
• Lifestyle Changes: Regular exercise, weight management, and balanced nutrition can naturally boost testosterone levels.

If you notice significant hair thinning or shedding while on TRT, consult a trichologist or dermatologist for tailored treatment options. They can assess the cause and recommend therapies to minimize hair loss.