Women Lose Their Hair Too—and It Can Wreak Havoc on Their Mental Health: Advice from a Dermatologist

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As a practicing dermatologist, I treat a lot of patients with various skin concerns—rashes, growths, etc. But, I also see many patients, both men and women, with hair loss, known as alopecia.

Male hair loss or male pattern baldness is well-known, as are its treatments (think Rogaine)). Female hair loss or female pattern hair loss is much less talked about but is in fact very common. Two out of 5 women will experience hair loss by age 60, but female hair loss can start as early as in your 20s. We just don’t hear a lot about it. That’s unfortunate for several reasons, including the fact that it can have a profound impact on mental health.

Hair Loss, Anxiety and Depression

Alopecia has been linked to both anxiety and depression. A recent systematic review of 17 studies found that hair loss undeniably impacts one’s quality of life, and it showed that alopecia is heavily associated with major depression and anxiety (Note: stress and other mental health factors are also linked to hair loss).

I have a few female patients with hair loss whose mental health symptoms are very severe. They’re incredibly preoccupied and distressed with their hair loss, so much so that they feel it’s ruining their lives. But there are things that can be done to help.

(RelatedHow Much Hair Do You Lose in a Day?)

Patients With Hair Loss

Many women with hair loss do not end up in my office at all. While thinning hair can be distressing, many women don’t know that female pattern hair loss is common nor that there are safe and effective treatments available. Many end up suffering alone. Even my hairdresser was unaware of medical treatments for female hair loss, yet clients often come to her seeking hairstyles to camouflage thinning hair or advice about supplements.

When women with hair loss do make it to my practice, they may have already tried over-the-counter products unsuccessfully, stopping when they didn’t see immediate results. Many of them have experimented with various unproven treatments that just don’t work. Some are desperate for help. I also commonly see women struggling with anxiety or depression or both as a result of their hair loss. Their hair loss may even be wreaking havoc on their mental health.

I had one recent patient who appeared to have fairly normal hair density but who reported she had lost over half of her hair volume in the last year. She had an overwhelming sense of loss of self and identity because she no longer had her previously very thick hair, and she had terrible anxiety about losing even more hair.

I had another patient with a history of breast cancer who had hair loss induced by chemotherapy. But she had continued severe thinning over a year after her chemotherapy treatment. Chemotherapy can cause total hair loss, but it can also unmask an underlying genetic predisposition to female pattern hair loss and hair may not grow back to its previous density. 

This hair loss was very distressing to her, and in a lot of ways was more salient to her than her breast cancer diagnosis. I started her on hair loss medications and she was absolutely thrilled with her improvement, even though her regrowth was somewhat subtle. Her experience is not unique. For some women with a cancer diagnosis and scheduled chemotherapy, the possibility of chemotherapy-induced alopecia is their greatest concern. Women with breast cancer reported the loss of hair associated with chemo as more psychologically difficult than losing a breast to surgical treatment.

Hair and Identity

In a 2004 book called Rapunzel’s Daughters: What Women’s Hair Tells Us About Women’s Livesthe author wrote “There is an important link between hair and identity, especially for women.” 

Current developments in women’s hair emphasize this connection. There’s the natural hair movement, which encouraged black women to embrace their hair; pandemic gray hair, where many women stopped dyeing their hair; and changing hair trends, where a new style might be tied to significant life events.

Because hair is closely tied to women’s identity, hair loss can have a profound effect on self-esteem and body image. Furthermore, hair loss can affect how women cope with their surrounding world. 

One study found about 4 out of 10 women with alopecia reported relationship issues and over 6 out of 10 had work-related problems. In another study of women seeking treatment for alopecia, almost 9 out of 10 reported a negative impact on their day-to-day lives and half of them were worried or fearful in social situations.

(RelatedHow to Prevent Hair Loss in Women)

Effective Treatments and Psychological Support for Females with Hair Loss

As with many of my patients, treatment can improve satisfaction and quality of life. There are safe and effective treatments for alopecia in women. I use several medications, including topical and oral minoxidil in my practice. Many patients are initially wary of side effects. I reassure them that these medications are actually quite safe and I find most of my patients tolerate them well.

But for my highly anxious female hair loss patients, they often need something more than just medications. Some do not give treatments enough time to work and switch gears too soon; they are impatient or fearful of worsening hair loss. 

I tell them, they need to trust the process—it’s a marathon, not a sprint. While hair growth can occur sooner, improvement is often only appreciated in about 6 months, with continued improvement over the next 1-2 years. 

Women have one disadvantage compared to men when it comes to identifying improvement. Men may have a bald spot that fills in after several months of treatment. Since men typically have short hair and get haircuts frequently, this improvement is often easily noticed. For women with longer hair, improvement may be harder to appreciate as hair grows at the roots but the ends still feel thin. 

I communicate the idea of the slow progress of treatments with follow-up visits every 6 to 12 months. I often suggest that they focus on a special event—a holiday or vacation 6 or 12 months in the future—at which point they can gauge whether hair loss has improved. It gives them a more realistic and positive way to think about hair regrowth.

Since improvement is so distant, I encourage women to focus on things outside of their hair loss to help them cope with challenging emotions. I encourage them to focus on their sense of self outside of their hair identity—their strengths, what makes them happy and so on—while trusting the process and their treatment. 

What’s most important here? Hair loss in women is real and there is help for it.

This article originally appeared on Forhers.com and was syndicated by MediaFeed.org.

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Weight Loss Medications: Are They Actually Effective?

Weight Loss Medications: Are They Actually Effective?

It’s common knowledge that managing your weight keeps you healthy now and as you get older. In fact, obesity contributes to several health conditions, including heart disease, stroke, type 2 diabetes and certain types of cancer.

Not only was the prevalence of obesity in U.S. adults nearly 42 percent in 2017, but the estimated medical costs for adults with obesity were almost $2,000 more each year than for adults who do not have obesity .

Those who have a body mass index (BMI, or the measurement of fat based on height and weight) between 25 and 30 are considered overweight, while those with a BMI over 30 are considered to have obesity.

You’ve probably heard of a few weight loss medications, or at least their brand names, like Ozempic® and Wegovy®. However, there are several other prescription drugs available that are approved by the U.S. Food and Drug Administration (FDA) and frequently prescribed off-label for weight loss.

Healthcare providers may prescribe these medications to someone who has obesity or is overweight with a weight-related health problem like high blood pressure, high cholesterol or diabetes.

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You’re probably familiar with one of semaglutide’s brand names, Ozempic — other brand names for this drug include Wegovy and Rybelsus®.

Ozempic is approved by the FDA to treat type 2 diabetes and may be prescribed off-label for weight loss, in combination with lifestyle changes like diet and exercise or with other diabetes medications like insulin or metformin.

Wegovy, meanwhile, is a prescription medication approved for use for weight loss in people who have obesity or who are overweight.

Ozempic and Wegovy are in a class of medication called GLP-1 receptor agonists, which mimic the hormone glucagon-like peptide-1 and target areas of the brain that regulate appetite.

Ozempic was approved by the FDA in 2017, while Wegovy was granted approval to pharmaceutical company Novo Nordisk more recently, in 2021.

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Although only approved by the FDA to treat diabetes, metformin is often used off-label for weight loss, as well as gestational diabetes (a type of diabetes that develops during pregnancy) and polycystic ovary syndrome (PCOS).

It isn’t exactly clear how metformin helps people lose weight, but researchers think the drug works as an appetite suppressant. Similarly to Ozempic, metformin may increase how much GLP-1 hormone your body makes. This can send a signal to your brain that you’re full, which means you eat fewer calories.

Read our blog to learn about Ozempic vs. Metformin for weight loss.


(Related: Metformin For Weight Loss: Does It Work?)

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If you’ve dealt with depression or looked into medication to quit smoking, bupropion may sound familiar to you.

For weight loss, it can be combined with the drug naltrexone, which is used to treat alcohol and drug dependence, to curb your hunger or make you feel fuller sooner. Together, these medications work on two areas of the brain, the hunger center and the reward system, to reduce appetite and help control cravings.

Along with a reduced calorie diet and exercise plan, naltrexone-bupropion can also help keep excess weight off.

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Phentermine-topiramate is actually two separate medications that are combined in Qsymia, but are offered separately in other applications. 

While phentermine is considered an anorectic and topiramate is an anticonvulsant, both help with appetite suppression.

Topiramate offers the added benefit of helping you feel fuller longer after you eat.

When used specifically with a healthy exercise regimen and a reduced calorie diet, these medications — either together or separately — have been shown to help people lose weight and keep it off.

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Orlistat, which belongs to a class of medications known as lipase inhibitors, reduces the amount of fat your body absorbs from the food you eat.

Orlistat is used for weight loss in conjunction with exercise and a reduced-calorie diet, as well as after weight loss to help people keep from gaining back that weight.

While the brand name Xenical requires a prescription, another brand called Alli is available in a lower dosage without one.

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Like Ozempic and Wegovy, liraglutide is an injected weight loss medication. It works as a GLP-1 receptor agonist to suppress appetite, similarly to semaglutide.

Also available under the brand name Victoza at a lower dose, this drug is FDA-approved to treat type 2 diabetes.

(Related: Weight Loss Injections: Are They Safe?)

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These weight loss drugs are all available with a prescription from a healthcare professional, but how effective are they really?

  • One study found that when people without diabetes took a weekly semaglutide injection they had a higher average weight loss — almost a 15 percent average decrease in weight — than people who took a placebo.

  • Metformin has also demonstrated clinically significant weight loss. A 2020 meta-analysis of 21 trials testing metformin found the drug had a modest impact on lowering BMI, especially for those who are considered to have obesity.

  • smaller study on metformin also found that the average amount of weight lost in 154 patients was between 5.6 and 7 kgs (that’s roughly between 13 and 15 pounds).

It’s also worth mentioning cost here — if you can’t afford the drug you need to take, it’s effectiveness essentially drops to zero percent. That said, there’s some wide price disparity between weight loss drugs. 

For instance, injectibals like Ozempic and Wegovy are generally more expensive than orals like metformin — namely because metformin is a generic medication that’s been around for decades, and Ozempic and Wegovy are newer. 

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Because everyone’s weight loss journey is different, weight loss medications may work slowly for some people and faster for others.

How long you need to take a weight loss prescription drug depends on various factors such as what side effects you experience, how much weight you need to lose, whether the drug helps keep the weight off and more.

Generally, as found in the studies noted above and clinical trials, weight loss will occur within the first few months of using the medication.

Sometimes your health care professional may recommend long-term use of the medication, while other people may be advised to stop the drug if they don’t lose a certain amount of weight after 12 weeks.

If you’re taking a weight loss medication, your healthcare provider will likely suggest that you also increase your physical activity and make healthy lifestyle changes like eating lots of protein and fiber and getting enough sleep. These medications are the most effective when combined with healthy habits.

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Just like any medication, weight loss drugs also come with the possibility of side effects.

When it comes to injectibal drugs like Ozempic and Wegovy, there are some broad side effects that apply to all injectibals — like swelling, redness or other discomfort at the injection site — but generally, the side effects profiles of these drugs are similar regardless of delivery method.

The most common side effects of many of these weight loss medications include:

  • Stomach pain or constipation

  • Diarrhea

  • Nausea

  • Vomiting

Some, like liraglutide and naltrexone-bupropion, may cause an increased heart rate or headaches.

Liraglutide and semaglutide may also increase the risk of pancreatitis (swelling of the pancreas). You may also have a higher risk of developing tumors or thyroid cancer when using liraglutide or semaglutide, although these serious side effects are very rare.

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There’s a good chance you’ve heard of weight loss medications like Ozempic or even Wegovy, but there’s also a good chance that the headlines and celebrity-focused articles didn’t answer all your questions. Here’s what you need to know about whether they’re effective.

  • There are several FDA-approved weight loss drugs, including semaglutide, orlistat, phentermine-topiramate, naltrexone-bupropion and liraglutide. Metformin is another common medication used off-label for weight management.

  • These drugs all work slightly differently, but many decrease your appetite and help you stick to a lower-calorie diet. Healthcare providers often recommend they be used alongside regular exercise and healthy habits to maximize sustained weight loss.

  • However, there are side effects such as nausea, vomiting, diarrhea and constipation and, for the injectibals, injection-side irritation, injury or discomfort. Often, these are mild and serious side effects rarely happen.

  • Cost is also worth considering. Injectibals like Ozempic and Wegovy can generally cost anywhere from $800 to $1,000 per prescription, where a generic like metformin can be had for a fraction of that — usually for under $100 a month.

There’s no one “best weight loss medication” — there’s only what’s best for your particular needs. If you’re curious about medication for weight loss, you can talk to your healthcare provider for medical advice and to explore your options. And if you’re interested in other weight loss treatments online, we can help. 

This article originally appeared on Forhers.com and was syndicated by MediaFeed.org.

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