Of hair loss and male libido

Dear Dr. G,

I am a man in my mid-thirties and at the peak of my career and personal life.

Despite being happily married with an enormous appetite for sex, I have a big concern in my head.

I always enjoy great libido since my youth, I guess this is because of high testosterone that gives me the drive in life and sexual health.

I also understand all good things come at a price, and sadly I worry the price is my luscious hair as my crowning glory.

In recent months, I began to detect the receding hairline on the side of my head.

I understand this is male pattern baldness.

Judging from what my father went through in his forties, I guess my balding days are coming.

I hate to put Dr. G on the spot on the issues of diminishing hairline, but I hope you can enlighten me (and perhaps thousands of other readers) on this issue.

First and foremost, can you confirm that bald men are more virile?

What is the correlation of testosterone and hair loss and is male pattern baldness genetic? Also, can it get worse with age?

Your clarification can really prepare me for the day in the future when I begin losing my crowning glory!

Regards,
(Nearly) Follicularly-challenged Fred

Male pattern baldness is also termed androgenic alopecia. Some men will get a single bald patch, others may experience receding line to from an “M” shape which often continues until all the hair is gone. This is a common type of hair loss in men that can affect more than 50% of men over the age of 50. Male pattern baldness is closely linked to hereditary factors, and although the baldness is likely to occur in adulthood, individuals with hair loss especially affecting maternal side of family. The onset of male pattern baldness can even begin in the teenage years.

Additionally, testosterone levels are also closely linked to male pattern baldness. Such a correlation had already been documented in the era of Hippocrates and Aristotle.

In modern days, the first scientific evidence of the impact of testosterone on hair was studied by Hamilton from Yale in the 1960s through the analysis of 21 boys castrated for behavioral and mental problems.

In Hamilton’s surveillance of the boys up to the age of 18, the castrated subjects with no endogenous testosterone had no signs of developing male pattern baldness as they aged. On the contrary, the other men with normal testicular function tend to be more likely to have receding hair loss.

In reality, the association of hair loss with male hormones harbours more complexity than previously speculated. The mere presence of testosterone allows its conversion into a more active substance, dihydrotestosterone. The active component of this metabolite is believed to shrink the hair follicles in the scalp, prohibiting further growth – ultimately leading to baldness. Each hair on the head has a growth cycle and repeated stimulations of dihydrotestoeterone are known to weaken the hair follicles, producing shorter and finer strands of hair. Eventually the growth cycle for each hair ends and no hair growth will occur leading to overall baldness.

Apart from androgenic alopecia, other medical conditions can also lead to hair loss. Dermatological complaints such as eczema and psoriasis on the scalp are well recognised as factors that can induce the loss of hair and thyroid function disorders and nutritional deficiencies are common reasons for hair loss. Other common causes also include poor hygiene, resulting in regular scalp infections, rashes and scalp peeling causing patchy hair loss mimicking male pattern baldness.

Bruce Willis – the action superhero well known for his trademark male pattern baldness once admitted that “hair loss is God’s way of telling me I am human”.

In reality, sexual desire and baldness are also humanly variable between men. Male pattern baldness is a biological process that is influenced by many factors and parameters.

On the other hand, the libido of a man is also not simply controlled by testosterone. The other factors that play important roles may include one’s cultural upbringing and attitude towards sex.