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Hormones, genes, and age mainly cause male pattern baldness or hair loss. It’s important to remember that the exact reason for hair loss may vary across each TRT patient.

The relationship between testosterone and hair loss is very intricate. Testosterone is one of the most crucial elements in the body of any man. It can keep the male body healthy in various ways, and that extends to hair growth, bone strength, muscle mass, motivation, focus, mental state, and other factors.

Without the optimal level of testosterone, many of these things can suffer. So, it ensures that without a precise amount of testosterone, a male may experience hair loss. Androgenic Alopecia causes more than 90% of all hair loss cases, including male baldness and thinning hair in women. Testosterone and dihydrotestosterone (DHT) are responsible for Androgenic Alopecia.


Androgenic Alopecia is a genetic condition that affects both men and women. Men with this condition called male pattern baldness (MPB).
Testosterone is converted to DHT with the help of a particular enzyme, 5-α reductase. It can also be made from DHEA, a hormone present/found in women. DHT is five times more effective than testosterone. The body primarily uses DHT in the prostate, skin, and hair follicles.

Increased DHT levels, or high sensitivity to DHT’s consequences, start to miniaturize the hair follicle, consequent hair loss, and a shortened anagen phase of the hair cycle.

TRT and Hair Loss

From clinical studies, men on Testosterone Replacement Therapy who are at risk of undergoing Androgenic Alopecia will present with hair loss most frequently after the first year of being on TRT.

During the first year of TRT, developing hair loss was found minimum, even in males who had preexisting male pattern baldness.

TRT may not affect hair loss in men who are not genetically susceptive to Androgenic Alopecia. Some hairs are resistant to DHT or testosterone, which explains why some men present with baldness, and others do not. For men who are genetically inclined to have male pattern baldness (MPB), taking TRT may quicken hair loss by boosting the amount of circulating DHT. Testosterone has been shown to improve body and facial hair growth, so men on TRT may accelerate Androgenic Alopecia.
Moreover, studies unveiled that the duration of testosterone supplementation may associate with hair loss. More prolonged exposures to exogenous testosterone improve the risk of male pattern baldness. There is no exception in the type of testosterone used (injection, gel, pellet) and hair loss.

It’s your genes

If you have any record of male pattern baldness in your family, then you may suffer from baldness as you age. It’s hard to accept, but there is nothing we can do to prevent genetics. If your genetics decide that you will have balding hair early, there is hardly much that can be done about it, as genetics is one of the most potent forces in nature.

Some artificial treatments may help, but testosterone generally will not affect this situation.

Sometimes, your hair follicles’ sensitivity may be the cause of your baldness, not testosterone or DHT. Your genetics defines sensitivity. When your receptors are especially sensitive, they are more easily activated by even small amounts of DHT, and
hair loss occurs more efficiently as a result. Other genes may also play a role.

Bottom Line

Women may also undergo hair loss due to Androgenetic Alopecia. Although women produce a minimal amount of testosterone than men, there is enough to cause androgenetic hair loss too likely.

But women may experience a different pattern of hair loss. In the beginning, thinning occurs over the scalp’s top, but the front hairline doesn’t fall. Female pattern hair loss is also due to the actions of DHT on hair follicles.

Age, stress, and other factors may impact your hair loss. But especially genes play a vital role, and men who have a history of family pattern baldness have a much higher risk of developing MPB themselves.