QuestionI'm a 32 year old female who has been experiencing progressively worsening hair loss for the last 5 years. The times of most concern have always been after stopping/changing birth control and after I had my first child. The thickness it once had has never returned. It didn't concern me too much until I have recently been able to see my scalp through my hair if I stand under a bright light.
I had all bloodwork done two weeks ago to test my thyroid, iron, cortisol and all male hormones and everything came back normal. Some numbers I took note of were total testosterone 32, free 0.8 and cortisol 23.5.
The only thing I can come up with is that I stopped the birth control pill (Apri) in April of this year and got Mirena. The last time I experienced hair loss was after changing pills, after stopping the pill and after having my baby...and now again after stopping the Apri in April. I never experienced hair loss while ON the pill. I was on OrthoCept for 8 years without any hair loss until I stopped it. Here are my questions:
1) I have done some research and am wondering if the Mirena (which I have now) was a bad choice for me, as it is a high androgen index method, contains no estrogen and only has levonorgestrel. I feel like this most recent loss of hair might be from stopping the birth control pill in April (drop in estrogen maybe??), since it seems like that is when I have always lost hair in the past. At this point, I am considering removing Mirena and getting back on OrthoCept which I know is a low androgen index birth control pill. What do you think?
2) My second question is if you think I should have a TRH test to test my thyroid. I have read that standard thyroid tests for T3, T4, etc. like I have had are not as good as the TRH. And if so, what doctor typically performs this test (family doc, obgyn, endo)?
Answer1. Lots of women experience hair loss a while after having a baby, but this is generally related to a change in the cycles of hair growth, and is temporary. When hair loss is not so temporary, there is usually a genetic cause, so I suspect you have hair loss in your genes. It may be best for you to avoid hormonal contraception. If you still wish to use hormonal contraception, I think there are better choices than Mirena, which contains levonorgestrel. Birth control pills containing low androgen progestins would be a better choice (see http://www.webmd.com/skin-problems-and-treatments/hair-loss/hair-loss-oral-contr...
2. I think that the TSH test is the best test for your thyroid. In a few situations, the TRH test might be better, but I think it's difficult to get done (The stimulating substance isn't readily available). I am no expert on TRH, so you might want to ask an endocrinology doctor.
