The classical image that pops in our heads when thinking of baldness is the balding man.

And with much reason, since as much as 85 per cent of men report experiencing some form of hair loss before age 40.

The understanding of the mechanism that leads to permanent balding helps us to fight it better. Hormonal hair loss directs most permanent baldness in males and, as the name implies, hormones cause it.

Causes of Hormonal Hair Loss in Men

The male body’s endocrine system produces much more testosterone than the female body. A male has, on average, sixteen times more testosterone in the body along with less prolactin and estrogen than females.

Testosterone, the male hormone, comes in many forms depending on the part of the body it is acting. ‘Free testosterone’ is the state of it where it is not yet bound to any receptor fulfilling a specific function.

This testosterone transforms into dihydrotestosterone (DHT) via an enzyme called ‘Alpha 5 reductase’. DHT fulfils critical functions in the health of the prostate; it also is the main hormone causing hair loss.

DHT can bind itself to a hormonal receptor located in your scalp. There, its effects cause hair follicles to shrink, thinning the hair and eventually ceasing its growth. Moreover, it effectively makes DHT the culprit of hormonal hair loss.

Genetic Factors of Hormonal Hair Loss in Men

The genetic structure of each man plays a decisive role in their ultimate chances of experiencing hormonal hair loss. If there are a considerable number of balding men in your family, it means you are likely to experience hormonal hair loss yourself as well.

This is due to enhanced sensitivity to DHT in the hair follicles at a genetic level. Due to this, these people are much more sensitive to reacting to even reduced quantities of DHT and triggering hair loss.

Hormonal Male Hair Loss Means Higher Testosterone?

A common myth that persists to this day is that men that present male pattern baldness has large reserves of testosterone. This is widely inaccurate since the genetic level of sensitivity to DHT determines if your hair ultimately falls or not. There can be the cases in which the body has more 5-alpha reductase enzymes working in creating DHT out of available testosterone.

So, the levels of testosterone of balding men might pretty much be the same as non-balding men; they can even be much lower. It is the DHT sensitivity of their hair follicles which ultimately determines hair loss. The level of perceived virility of balding men is not likely hormonally caused and down to other factors.

Treating Hormonal Hair Loss in Men

Minoxidil can grow back fallen hair. The prescripted drug Propecia can slow down hair loss and even grow new hair sometimes though it has certain side effects. 

Also, a hair transplant can harvest healthy hair follicles that remain elsewhere in the scalp. After the doctor extracts them, he grafts them in the desired area via incisions and leaves them to grow. Modern techniques, like DHI and FUE,  allow very natural-looking results.