Does Testosterone Cause Hair Loss in Men?

The simple answer to this question is no. Men with low testosterone can still lose their hair if they have the right genes, while men with high testosterone may keep their thick hair into old age.

Testosterone does not directly cause hair loss. The real problem is DHT, which your body makes from testosterone. For people who are genetically sensitive to DHT, this hormone can shrink hair follicles and stop hair growth.

In this blog, we will discuss the latest research on testosterone and how it relates to hair loss. You will also find various prevention strategies and hair products designed to address this common issue.

What Recent Studies Show

Research on testosterone and hair loss has increased a lot in recent years. A 2024 review in Frontiers in Endocrinology examined the complex relationship between androgens and hair follicle biology. The study confirmed that DHT remains the primary driver of male pattern baldness. But individual variations in enzyme activity and receptor sensitivity explain why men with similar hormone levels can have completely different hair outcomes.

Clinical trials on finasteride show clear evidence of the role of DHT.  Studies show that blocking 5-alpha-reductase enzyme reduces DHT levels by about 70% and slows hair loss in roughly 90% of men. This confirms that DHT, not testosterone itself, causes the balding process.

Recent genetic research has identified multiple genes involved in male pattern baldness. The androgen receptor gene on the X chromosome plays a major role, but scientists have found over 250 genetic variants that influence hair loss risk. This explains why predicting hair loss based on family history alone can be tricky.

A 2025 study published in PMC looked at DHT levels in men with and without male pattern baldness. They found that scalp DHT concentrations matter more than blood DHT levels. Some men have normal blood DHT but high scalp enzyme activity, leading to localized hair loss.

Most studies focus on men of European ancestry. To fully understand the issue, we need more research on how testosterone affects hair loss in different ethnic groups. Other hair loss factors, like stress, diet, and different hormones, may also play a role in the relationship between testosterone and hair loss. Scientists are still learning about more factors related to this issue.

What Men on Forums Say

Reading through Reddit's r/tressless and other hair loss forums reveals mixed experiences with testosterone and hair loss. Some men report rapid thinning after starting TRT or using anabolic steroids. 

For example, one user who always had thick hair without signs of balding noticed hair shedding after taking TRT. 

Other forum members share different stories. Men with strong family histories of baldness sometimes report that TRT didn't seem to change their hair timeline much. As one poster noted, he didn’t have hair loss, or even thinning, despite being in his 40s and being on TRT for over 7 months. 

People who use high doses of testosterone or other androgens frequently discuss hair loss as a known side effect. The general consensus seems to be that if you're going to go bald anyway, steroids will speed up the process significantly.

Keep in mind that reports from online forums can show bias. Men who are losing their hair are more likely to share their experiences than those who are not. The stories you find online might not show the full impact of testosterone on hair.

How Male Pattern Baldness Actually Works

Genetics decides if DHT affects your hair follicles, not just your testosterone levels. Your body converts testosterone into DHT using an enzyme called 5-alpha-reductase. This happens in your hair follicles, skin, and prostate. DHT is a stronger form of testosterone. It’s about five times more effective when it attaches to androgen receptors.

Here's where genetics comes in. Some men inherit hair follicles that are sensitive to DHT. When DHT attaches to these follicles, it causes them to shrink. This process is called miniaturization. The follicles produce thinner and shorter hairs over time until they eventually stop growing.

This explains the classic male pattern baldness. We often see receding hairlines and crown thinning. These areas have the most androgen receptors, making them vulnerable to DHT. The back and sides of your head typically have fewer receptors. This is why hair transplant surgeons can move follicles from these "safe zones" to balding areas.

Your genes control both the enzyme activity and how sensitive your follicles are to DHT. Some people are lucky to get both low enzyme activity and resistant follicles.

Does Having More Testosterone Mean More Hair Loss?

Not really. High testosterone levels don't guarantee baldness any more than low levels protect you from it. What matters is how much DHT your body produces and whether your follicles react to it.

Bodybuilders who use testosterone often report hair loss, but plenty of men with naturally high testosterone have great hair. The difference comes down to individual genetics and how much of 5-alpha-reductase enzyme activity they have.

Men with very low testosterone can still develop male pattern baldness if their follicles are sensitive to whatever small amounts of DHT their bodies produce. Men who are destined to go bald will likely experience it regardless of their testosterone levels. The timing might vary, but genetic programming usually wins. 

Does TRT Cause Hair Loss?

TRT can speed up hair loss in men who are already likely to develop male pattern baldness. When you increase testosterone through replacement therapy, you're also potentially increasing DHT production. This can trigger or speed up the hair loss process.

Not everyone on TRT will lose hair. Men without genetic sensitivity to DHT can often use testosterone replacement without any side effects. The challenge is that many men don't know their genetic risk until they start losing hair.

Some TRT specialists recommend getting baseline hair photos and DHT levels before starting treatment. This helps track any changes early on. If you notice increased shedding after starting TRT, your doctor might suggest some adjustments.

Men often notice hair changes within 6-12 months of starting TRT. Catching it early gives you more treatment options. Some men choose to continue TRT while using finasteride to block DHT production. Others prefer to lower their testosterone dose or switch to different delivery methods.

How to Tell if Your Hair Loss Is Caused by DHT

Male pattern baldness follows predictable patterns. Look for thinning at the temples, crown, or both. The hair often becomes finer and shorter before it disappears completely. Check your family history. Both sides matter, but maternal genetics play a bigger role.

Blood tests can provide useful information. Ask your doctor to check total testosterone, free testosterone, and DHT. Some men have normal testosterone but elevated DHT due to high enzyme activity. 

SHBG (sex hormone-binding globulin) levels also affect how much active hormone circulates in your system.

A dermatologist or trichologist can examine your scalp using specialized tools like dermoscopy. They can identify miniaturized hairs and assess follicle health. 

Pay attention to the timing and pattern of your hair loss. Hormone-driven baldness usually progresses gradually over months or years. Patchy hair loss or rapid thinning might indicate other causes that need different treatments.

Hair Loss Treatment Options

Finasteride remains the gold standard for treating male pattern baldness. This medicine works by blocking the enzyme called 5-alpha-reductase, which lowers DHT production. The main issue to consider is the possibility of sexual side effects, which affect 2-5% of users.

Other treatment options are:

• Topical minoxidil helps hair growth by increasing blood flow to hair follicles and extending the growth phase of hair. It's available over-the-counter and generally well-tolerated. Many men take finasteride and minoxidil together to get better results.

• Low-level laser therapy devices that are approved by the FDA to treat hair loss. These caps or combs use specific light wavelengths to stimulate follicles. Some men notice improvements, especially when this treatment is combined with others, but the evidence is not strong.

• Making changes to your lifestyle can help improve hair health, but they won’t stop male pattern baldness. You can quit smoking, manage your stress, and eat enough protein. Some men try natural DHT blockers like saw palmetto or pumpkin seed oil.

Bottom Line

When it comes to hair loss, testosterone isn’t the main villain here. DHT and your genetics are what really drive hair loss. If you notice more hair falling out or your hairline moving back, see a doctor as soon as you can. If you’re considering starting testosterone replacement therapy (TRT), talk to your doctor about the risks to your hair. It might also be helpful to get some initial lab tests to understand your current hair situation.

Acting early can make a big difference. When you lose a lot of hair density, it’s harder to recover. If you're already dealing with thinning, try Spartan’s Root Activator line. 

The Root Activator Shampoo, Root Activator Conditioner, and Root Activator Spray use ingredients like saw palmetto and caffeine to support your hair and scalp. They can be used alongside medical treatments or on their own if your hair loss is still on the mild side.

FAQs

Is hair loss from testosterone permanent?

It depends on how far things have progressed. If the follicles are completely inactive, they’re tough to revive. But if you step in early, you can usually keep the hair that you still have.

Will raising my testosterone make me go bald?

Not automatically. Your genetics are really the deciding factor here. If you're already prone to male pattern baldness, higher testosterone can bump up DHT levels, which may speed things along. If not, you’re probably fine.

Can lowering DHT help regrow my hair?

It can help, but only to a point. Once a follicle shrinks too far, getting it back is hard. DHT blockers like finasteride help protect your existing hair and can sometimes help regrow a little more.

Do steroids cause hair loss faster than TRT?

Usually, yes. Steroid cycles typically use higher doses than medical TRT. And, some compounds convert to DHT more easily. That combo can speed up shedding if you're sensitive to it.