Does Testosterone Replacement Cause Hair Loss?

Testosterone replacement therapy can accelerate hair loss in men genetically predisposed to male pattern baldness. TRT can increase dihydrotestosterone (DHT) levels. In people with genetically susceptible hair follicles, DHT can contribute to follicle shrinkage and androgenetic alopecia. Studies show that 50-80% of men experience some degree of hair thinning by age 50, with testosterone and DHT being primary drivers. TRT is less likely to accelerate male pattern hair loss in men without genetic susceptibility, although hair loss can have other causes. The rate and severity depend on individual genetics, dosage, and treatment duration. Men already experiencing hair loss may notice faster thinning after starting therapy, but the timing varies and a clinician should assess new or worsening hair loss. Those with strong family histories of baldness should discuss hair loss prevention strategies with their healthcare provider before beginning TRT.