Female Pattern Hair Loss in a 43-Year-Old Woman: Starting Spironolactone and Supplements in Houston & Katy, Texas
Gradual thinning across the scalp is one of the most common concerns among women seeking hair restoration care. A 43-year-old woman recently visited Dr. Reena Jogi, board-certified dermatologist and hair loss specialist in Houston and Katy, Texas, for an evaluation of several years of progressive hair loss accompanied by intermittent scalp tenderness.
Case Overview
The patient described generalized, gradually progressive thinning on the scalp over the past two years. She denied thyroid disease, recent illness, and hospitalizations. She had never tried treatment for hair loss before this visit. A strong family history of female hair thinning was noted in her mother and maternal aunt.
Examination with a dermatoscope revealed findings consistent with Androgenetic Alopecia (AGA)—the most common cause of hair thinning in women. Clinical photographs were taken for baseline monitoring.
Diagnosis: Androgenetic Alopecia (AGA)
Female-pattern hair loss is characterized by:
Diffuse thinning across the scalp
A widened midline part
Preservation of the frontal hairline
Gradual reduction in hair density due to follicle miniaturization
Given her history and exam findings, AGA was the most consistent diagnosis.
Treatment Options Reviewed
Dr. Jogi presented a comprehensive overview of evidence-based options for managing AGA:
Topical Therapies
Minoxidil topical solution or foam
Helps preserve existing hair and slow progression
Can be combined with supplements or oral therapy
Oral Medications
Spironolactone (for women only)
Oral minoxidil (low-dose)
Both options reviewed in detail, including expectations and side effects
Supplement Options
Nutrafol®, Viviscal®, Votesse®
Support follicle health and address nutritional factors
Advanced Procedures
Platelet-Rich Plasma (PRP) therapy
Alma TED ultrasound-based treatments
Low-level laser therapy (LLLT) helmets or caps for at-home stimulation
Pricing, maintenance requirements, and expected timelines for improvement were reviewed.
Personalized Treatment Plan
The patient preferred a conservative starting approach. Her personalized plan includes:
1. Spironolactone
50 mg twice daily
May combine both tablets at once after 1 week if tolerated
Laboratory monitoring (potassium, renal function) required 2 weeks after starting
Counseling covered risks of hyperkalemia, menstrual changes, breast tenderness, fatigue, and strict pregnancy avoidance
2. Supplements
Nutrafol recommended to support hair regrowth
Given an AGA educational handout summarizing all available therapies
3. Future Options
If improvement is limited after several months, she is open to:
PRP
Alma TED
Low-level laser therapy
She expressed good understanding of each option and expected timelines.
Counseling & Expectations
Dr. Jogi reviewed:
AGA is genetically determined and progressive, requiring long-term treatment
Results take 3–6 months to evaluate
Early intervention helps preserve density
Call the office if shedding worsens or medication side effects occur
Follow-Up
A follow-up visit is scheduled in 6 months to monitor progress with spironolactone and supplements, with earlier follow-up available if concerns arise.
Expert Female Hair Loss Care in Katy & Houston, Texas
At Reena Jogi MD Dermatology, patients receive expert evaluation and customized plans for female pattern hair loss, telogen effluvium, and other scalp conditions. Whether starting with topical or oral therapy or pursuing advanced treatments like PRP and Alma TED, Dr. Jogi offers comprehensive and compassionate care tailored to each patient’s needs.
If you're noticing diffuse thinning or a widening part, schedule your visit at our Houston or Katy offices today.
