If you’ve started to notice more hair in the shower drain or your hairline creeping back each time you get a haircut, you're not alone.
While most guys write off hair loss as just part of getting older, there's actually a complex hormone interaction happening under the surface.
However, many men who are experiencing hair loss (or who are worried about losing their hair) are afraid of starting testosterone replacement therapy (TRT), even when their levels are low and they desperately need to do something about how they’re feeling.
The reason for this is a persistent myth: that testosterone causes baldness and that men with high levels of testosterone (either naturally or from TRT) will eventually go bald as a result of their testosterone levels. The truth is far more complex.
In this blog post, you’ll learn about male pattern baldness, what causes it, what hormones are involved, and what you can do about it.
The Hormone DHT and Why It Matters
Dihydrotestosterone (DHT) is the hormone that plays the biggest role in male pattern baldness. This hormone binds to receptors in your hair follicles, making them smaller so that they produce thinner, weaker hair.
Your body converts testosterone into DHT using an enzyme commonly found in your tissues, and while it’s true that DHT is a byproduct of testosterone, DHT only affects your hair follicles if you were born with specific genes—plenty of men with high levels of testosterone (and therefore DHT) never experience hair loss.
While DHT plays a crucial role in male development (it's what gives you facial hair and a deeper voice during puberty), it can be rough on your scalp if you've got the genes that make your hair follicles sensitive to it.
What Male Pattern Baldness Looks Like
When DHT attaches to your hair follicles, and you are genetically predisposed to have male pattern baldness, your follicles get weaker and weaker, producing thinner hair until they eventually give up completely.
This usually follows a predictable pattern:
● Your hairline starts moving back at the temples
● The crown of your head starts thinning
● These thin spots slowly get bigger
● Eventually, they might meet up
● The sides and back of your head usually stay thick (that's why men keep hair there)
This process can take years or even decades, but once you notice it happening, it's usually already well underway. That's why catching it early is so important.
The DHT/Testosterone Connection
Having high testosterone doesn't automatically mean you'll lose your hair faster. It's more about how much of that testosterone turns into DHT and whether your hair follicles are sensitive to it.
That's why some guys with high testosterone keep all their hair well into old age while others start losing it in their early twenties.
Think of it like this: If your hair follicles are naturally resistant to DHT, you could have sky-high testosterone levels and still keep your hair. But if your follicles are sensitive to DHT, even normal testosterone levels could lead to hair loss.
Other Hormones That Affect Your Hair
While DHT is the main cause of male pattern baldness, other hormones can cause hair loss as well.
Thyroid Hormones
Your thyroid gland produces hormones that regulate everything in your body, including your hair growth. If your thyroid's not working right (either from hyperthyroidism or hypothyroidism), it can make your hair thin all over your head—not just in the typical male pattern baldness areas.
This is why getting your thyroid checked can be important if you're noticing unusual hair loss patterns.
Stress Hormones
When you're stressed, your body produces cortisol, which can speed up hair loss. It's like adding fuel to the fire if you're already losing hair.
This is why you might notice more hair loss during particularly stressful periods in your life. Chronic stress can make any existing hair loss much worse.
In fact, chronic stress can so overwhelm your body that your body can actually stop producing cortisol, a disease called adrenal fatigue. It’s characterized by a variety of symptoms, including:
● Thinning hair
● Cravings for sweet or salty foods
● Feeling cold, shivering
● Getting sick more often
● Frequent urination
● Dry, flaky skin
● Dizziness
● Body aches
● Insomnia
● Tingling in your feet and hands
If you’re truly suffering from adrenal fatigue, hormone replacement therapy may help.
Balancing Your Hormones May Help
If your hormones are out of balance, especially due to stress, hormone replacement therapy can help rebalance your hormones, especially cortisol, taking the pressure off your hair.
TRT may also be indicated, especially if you have low T, which can cause a variety of symptoms—like anxiety and depression—that can make stress-induced hair loss worse.
And while it’s true that TRT can speed up hair loss if you're prone to it, there are ways to manage this:
● Using DHT blockers while on TRT
● Getting your hormone levels checked regularly
● Working with healthcare providers who know about both TRT and hair loss
● Starting preventive treatments before hair loss becomes noticeable
Early Detection and Prevention
The sooner you notice hair loss and do something about it, the better your results will likely be. Watch out for:
● More hair in the shower drain or on your pillow
● Your hairline moving back at the temples
● Thinning at your crown (the back top of your head)
● Hair feeling or looking thinner overall
● Changes in how your hair styles or lays on your head
If You Have Thinning Hair, Hormone Replacement Therapy May Help
Remember, whether you decide to fight hair loss or embrace the bald look, understanding what's happening with your hormones helps you make better decisions.
There's no wrong choice here—plenty of men look great with or without hair. The key is doing what makes you feel confident.
However, if you suspect that you’re suffering from low T, and the symptoms are so bad that they’re interfering with your life, you might want to get your hormone levels tested.
Learn more about TRT here. You can also schedule an appointment with a specialist today to discuss getting your levels tested.