Episode Transcript
Dr. Jones: We read in a newspaper that a famous man is taking an anti-hormone to help his hair grow. Now, what's an anti-hormone anyway, and would it make my hair grow? This is Dr. Kirtly Jones from Ï㽶ÊÓƵ of Utah Health, and this is The Scope.
Announcer: Covering all aspects of women's health, this is The Seven Domains of Women's Health with Dr. Kirtly Jones on The Scope.
Dr. Jones: So guys who have male-patterned hair loss, loss of hair on the temples and the forehead can take an anti-hormone, or a hormone blocker to help slow their hair loss. What's this about? Well, male-patterned baldness is partly genetic, and partly related to testosterone. An anti-hormone drug, in this case Finasteride, blocks the conversion of testosterone to the most active form of testosterone in tissue, 5-dihydrotestosterone.
Finasteride blocks that conversion. Incidentally, it was invented to help shrink the prostate in guys with prostrate problems, testosterone makes the prostate gland grow in men, of course only in men, because women don't have one, but it also works for hair.
Well, what about women? Some women's hair loss is related to the same hormone, 5 DHT in the skin of the scalp. Maybe it would help women. Firstly, the FDA specifically says that women shouldn't even go near the lid of a bottle of Finasteride, the lid with a little drug powder in it. This is because 5 DHT is very important in developing boy babies, boy-baby parts in the uterus. And women who are pregnant who are exposed to Finasteride can have boy-baby part birth defects.
What happens if a woman is beyond her child-bearing years and cannot get pregnant, and wants to use Finasteride? Well, it still isn't approved for women, and it doesn't work for hair loss in many women, but there are some studies that it works for some women.
Can a doctor prescribe an FDA-approved drug that isn't approved for women? Legally, she can, but she would have to be really careful about who she prescribes it for and who might take it.
But let's get back to anti-hormones, specifically anti-androgens and anti-estrogens. Anti-hormones, or hormone antagonists, can work either by blocking the production of a hormone or blocking the receptor of the hormone. One of the progestins, called drospirenone in a commonly prescribed birth control, has mild anti-androgen activity because it mildly blocks the testosterone receptor. So it's good for women with acne, but I wouldn't recommend it for men to help their hair grow.
Anti-estrogens are used in a number of conditions for women. Women with breast cancer are often prescribed a drug that blocks the conversion of testosterone to estrogen. Yep, ladies, we make our estrogen out of male hormones. One of these medications is called Letrozole. It turns out that in young women who have ovaries with eggs, but who aren't ovulating, if they take an anti-estrogen, their brain thinks their ovary isn't working and it yells at the ovary to make eggs and estrogen. So this drug is also used for ovulation induction, even though it isn't approved for that use.
Clomiphene is an anti-estrogen because it blocks the estrogen receptor so estrogens can't do their work. It works differently that Letrozole, but they both are anti-estrogens, and they're both used for fertility therapy.
Tamoxifen is commonly used by women with breast cancer, and to decrease the risk of breast cancer in women who are a high risk. It is sort of an anti-estrogen. It blocks the estrogen receptor so estrogen cannot do its work, but it's sort of a weak anti-estrogen. It works differently in different tissues. In the breast and the brain, it acts like an anti-estrogen, so breast cancers don't grow, and women have hot flashes. In the bones in the uterus, it sort of acts like an estrogen, so it keeps women's bones strong. It's complicated.
So why do you need to know about anti-hormones, except to understand famous men's hair issues? These types of drugs are commonly used for women, for infertility, for some types of contraception, for some menopausal therapy, and for some cancer therapy. They all have some side effects. A smart Scope listener should explore how their medications work, and what kind of side effects they have.
Ask your physician. They probably can give you handouts or websites that can explain more, and health researchers actively looking at new anti-hormones, that might help women and men in health and disease. Thanks for joining us in this little lesson on hormones on The Scope.
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