Hair Loss Associated With Hormonal Therapy and Stress in a 65-Year-Old Woman: Androgenetic Alopecia, Telogen Effluvium, and PRP Treatment
Hair loss in women is often multifactorial, particularly in midlife and beyond. Hormonal changes, medical therapies, and prolonged stress can all disrupt the hair growth cycle. At Reena Jogi MD in Katy and Houston, Texas, we specialize in identifying overlapping causes of hair loss and tailoring treatment plans that address both medical and lifestyle contributors.
This case highlights a 65-year-old female with long-standing hair thinning related to hormonal therapy, stress, and telogen effluvium, managed with platelet-rich plasma (PRP) therapy.
Patient Presentation
The patient is an established 65-year-old woman who presented with generalized scalp hair loss that has been gradually progressive over several years. The hair loss was described as moderate in severity, without pain, itching, or scaling.
She reported several potential contributing factors, including:
Ongoing testosterone therapy and use of “testosterone-protect” supplements
Significant weight loss
Prolonged emotional stress related to multiple life events, including deaths and job changes
Weaning off antidepressant medication
Clinical Examination
A focused dermatologic examination of the scalp, face, and neck was performed.
Key Findings
Diffuse non-scarring hair thinning
Patterned hair loss with widening of the midline part
Preservation of the frontal hairline
Overall findings consistent with androgenetic alopecia (AGA) with superimposed telogen effluvium (TE)
Diagnosis
1. Androgenetic Alopecia (Female Pattern Hair Loss)
AGA is a genetically influenced condition that can be exacerbated by elevated androgens, including testosterone therapy, particularly in post-menopausal women.
2. Telogen Effluvium
Telogen effluvium contributed to increased shedding and was likely triggered by:
Chronic emotional stress
Weight changes
Medication adjustments
Hormonal imbalance
Hormonal Considerations
The patient was counseled that excess testosterone can worsen hair thinning by accelerating follicular miniaturization. A plan was made to obtain updated laboratory testing to reassess testosterone levels, as excessive supplementation was suspected.
Because hormonal balance had not yet been stabilized, it was recommended to delay anti-androgen medications such as finasteride or dutasteride until lab results could be reviewed.
Treatment Discussion
A thorough discussion was held regarding available treatment options, including:
Topical and oral minoxidil
Finasteride or dutasteride (to be considered later)
Low-level laser therapy
Platelet-rich plasma (PRP)
Given her current hormonal status and preference to avoid additional systemic medications at this time, the patient elected to proceed with PRP therapy.
PRP Treatment
Platelet-Rich Plasma Injection – Session #1
PRP was performed for hair loss after written consent was obtained and risks were reviewed.
Procedure highlights:
Venipuncture performed using sterile technique
Blood centrifuged to isolate platelet-rich plasma
7 cc of PRP injected into the scalp at the subdermal level
Pain control achieved with Zimmer cooling device
Pro-Nox used for comfort during the procedure
The patient tolerated the procedure well with no complications.
Post-Procedure Instructions
Wash hair with warm water
Use sulfate-free shampoos
Avoid hair dye for 2–3 days
Continue any prescribed hair loss treatments or supplements
Patient Counseling & Expectations
The patient was counseled that:
Female pattern hair loss is slowly progressive
PRP helps improve hair density and shedding, not instant regrowth
Best outcomes often require multiple PRP sessions
Managing hormonal balance and stress is critical for long-term success
Follow-Up Plan
Return in 1 month for PRP session #2
Review hormonal laboratory results
Reassess need for medical therapy once testosterone levels stabilize
Expert Hair Loss Treatment in Katy & Houston, Texas
Hair loss related to hormones and stress requires a thoughtful, individualized approach. At Reena Jogi MD, we offer advanced treatments such as PRP and AlmaTED, alongside medical management for androgenetic alopecia and telogen effluvium.
If you’re experiencing hair thinning while on hormone therapy or during stressful life transitions, expert evaluation can make a meaningful difference.
