What Role Does Testosterone Play in Male Pattern Baldness?
What Role Does Testosterone Play in Male Pattern Baldness?
There was a singing group in Italy called the Castrata. These were young males castrated prior to puberty to preserve their soprano voices. Oddly enough, none of them suffered male pattern baldness. Dr. Hamilton decided to experiment on a group of volunteer Castrata. He administered testosterone to them in various dosages to bring their male hormone levels to normal. He noticed roughly 65 percent of these men developed male pattern baldness. When he stopped the testosterone, guess what happened – the hair loss remained permanently. Dr. Hamilton was thus the first to show that male pattern baldness is caused by testosterone and the hereditary sensitivity to it of hair follicles on the top of the scalp.
Further research has shown that it is really five dihydrotestosterone (5DHT) that does the damage. This breakdown product of testosterone binds to the follicles and essentially destroys them by choking off the blood supply and nutrients. At different ages different peaks in the testosterone level will cause sensitive follicles to involute (die).
Here’s how: Testosterone circulating throughout the body has receptors to which an enzyme, 5 alpha dihydrotestosterone reductase, attaches itself. (There is a natural attraction for enzymes and receptor sites to combine in all of us.) When this happens, the enzyme allows the conversion of regular circulating testosterone to dihydrotestosterone, 5DHT.
Further experiments were performed to see if people who did not lose their hair had receptor sites for the 5 alpha dihydrotestosterone reductase. At first, investigators felt that perhaps it was the lack of sites that allowed people to keep their hair. But deeper investigation proved that all scalp hairs have sites for the enzyme. This then allowed the further conclusion that only hair follicles whose genetic code allowed the dihydrotestosterone to choke off the blood and nutrient supply would react negatively to the 5 DHT. In fact it soon became evident that the 5DHT affected only scalp hair and not body hair at all.
Later experimentation actually showed a difference in testosterone metabolism (breakdown) between scalps destined to have hair loss and those that would keep a full head of growing hair upon it. In essence, these later results confirmed that male pattern hair loss is dependent on hair root sensitivity to various levels of 5DHT although other factors are still being investigated.
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