Addressing Hormonal Hair Loss in a 41-Year-Old Female with AlmaTED, Minoxidil, and Spironolactone
By Reena Jogi MD | Houston & Katy, Texas
Background
Hair loss can be a distressing experience for women, particularly when it is chronic, diffuse, and hormonally influenced. In our dermatology clinic serving Katy and Houston, Texas, we often treat women experiencing hair thinning related to underlying hormonal conditions like polycystic ovary syndrome (PCOS). This case highlights the successful management approach for a 41-year-old woman with diffuse hair thinning and a hormonal background suggestive of PCOS.
Patient Overview
A 41-year-old female presented to our clinic in Houston for a new evaluation of ongoing hair loss. She described diffuse hair thinning over the past 2.5 years, with no prior treatments attempted. Her history included infertility treated with IVF and a pregnancy with triplets. She also reported symptoms commonly associated with PCOS: unwanted facial hair and acne. She washes her hair approximately three times per week.
Clinical Evaluation
On exam, the patient was alert, oriented, and in no acute distress. A dermatoscopic scalp examination confirmed signs consistent with androgenetic alopecia (AGA), a genetic and hormonally-driven pattern of hair loss. A hair pull test was positive, supporting active shedding.
While the patient had not yet undergone a full laboratory work-up, prior labs showed elevated total testosterone—a common finding in PCOS. We recommended additional labs for free testosterone, Vitamin D, and iron if she wished to pursue a more in-depth evaluation. However, we noted that the lab results would not significantly alter our treatment plan.
Diagnosis
Androgenetic Alopecia (L64.8)
Diffuse, non-scarring hair loss
Patterned thinning affecting the scalp
Likely hormonal contribution from PCOS
Treatment Plan
Given the patient's hormonal background and long-standing symptoms, we developed a multi-modal approach to manage her androgenetic alopecia.
Topical and Oral Minoxidil
Minoxidil 5% topical foam applied to the scalp nightly
Oral minoxidil 2.5 mg: patient instructed to take ½ tablet PO once daily
Counseling provided regarding potential side effects, including temporary shedding, fluid retention, dizziness, and unwanted hair growth
Spironolactone
50 mg twice daily
Advised about common side effects (e.g., menstrual irregularities, breast tenderness, and fatigue)
Monitored for potassium levels and renal function as part of routine care
AlmaTED Treatment
The patient elected to begin a series of AlmaTED treatments, a non-invasive, ultrasound-based therapy designed to enhance scalp health and hair regrowth. The treatment is cosmetic and not covered by insurance, and the patient expressed understanding of the cost and benefits.
Patient Education and Follow-Up
The patient was counseled on the chronic and progressive nature of female pattern hair loss, especially when linked to PCOS. Lifestyle modifications—including a healthy diet and exercise—were strongly encouraged to help mitigate hormonal imbalance.
A follow-up was scheduled as needed, with plans to initiate AlmaTED therapy in the coming weeks and reassess progress at future visits.
Why This Matters for Katy & Houston Patients
Women in Houston and Katy, TX, struggling with hair loss often experience similar symptoms due to hormonal imbalances such as PCOS. At Reena Jogi MD, we customize treatment plans that combine evidence-based medicine with advanced procedures like AlmaTED and PRP therapy. This case demonstrates how patients can regain confidence with the right diagnosis and targeted interventions.
If you're noticing hair thinning or scalp changes, especially with a history of PCOS or hormone-related symptoms, schedule a consultation at our clinic today.
