Dear Dr G,

I understand that your August articles have focused on the impact of ageing on sexual health.

While my question isn’t directly about sex, I believe that thinning hair can affect one’s sex appeal and might be related to sex hormones.

I am a man in my late 40s, and I don’t consider myself to be a miserable middle-aged man.

However, noticing my thinning hair is making me quite unhappy.

Admittedly, I haven’t been living healthily lately and am troubled by diabetes and hypertension.

Otherwise, I believe I am doing reasonably well.

My wife asked me to see the doctor for an explanation and solution.

Frankly, I believe she is concerned that, as a woman nearing menopause, she might also experience hair loss.

I feel too embarrassed to consult a doctor about something I consider vain, so I thought it would be best to ask Dr G for some answers.

Firstly, can you tell me why men lose hair? Is this related to ageing?

I am also confused why men and some women have hair loss problems too?

Do hormones and genes play a part in hair loss and graying?

Can you suggest any lifestyle changes that can slow down hair loss?

Finally, what treatment would you recommend for reversing the diminishing crowning glory?

Yours truly,

Thinning Thomas

Hair is often described as a “crown of glory,” tied closely to identity, confidence, and self-expression. However, as men and women age, hair undergoes noticeable changes in thickness, density, colour, and growth pattern.

Hair loss, or alopecia, becomes increasingly common with advancing age, though its causes and patterns differ between men and women.

Understandably, these changes can affect an individual’s perceived attractiveness and lead to diminishing self-confidence in relationships and sexual contexts.

The exact physiology of hair growth is not fully understood. Each hair follicle cycles through three main phases: anagen (growth), catagen (transition), and telogen (resting). With age, the duration of the growth phase shortens, while the resting phase lengthens. This results in slower hair growth, thinner strands, and reduced overall density. The hair shaft itself may become more fragile, while pigment-producing cells (melanocytes) decline, leading to greying. Therefore, age related hair thinning and greying is almost inevitable.

For men, the most common cause of age-related hair loss is androgenetic alopecia, often called male pattern baldness. It is strongly influenced by genetics and hormones, particularly dihydrotestosterone (DHT), which shrinks hair follicles over time. Men usually notice thinning at the temples and crown, which can progress to complete baldness on the top of the scalp while preserving hair at the back and sides. This may begin as early as the late teens or twenties, but it becomes more pronounced with age, affecting up to 80% of men by age 70. Other contributing factors include reduced blood flow to the scalp, chronic illnesses, stress, and nutritional deficiencies, which may amplify the loss. Therefore, the thinning of the crown of glory is not strictly age-related.

In women, hair thinning with age is also common, however the pattern is different. Women typically experience diffuse thinning across the scalp, with widening of the part-line, but rarely complete baldness. Female hair loss becomes more noticeable after menopause, when estrogen that helps to protect against follicle shrinkage declines. This allows the effects of androgens to become more pronounced. Aside from hormonal shifts, women may also be affected by chronic medical conditions such as thyroid disease, iron deficiency, autoimmune disorders, stress, or the cumulative effect of hairstyling practices. Therefore, all those hair sprays may not do the luscious hairs any big favour.

Shared age-related factors in both sexes are also noted. Scalp blood flow decreases with age, leading to weaker follicle support. Hair often becomes coarser, drier, and more brittle, as one gets older. After shedding, follicles also take longer to re-enter the growth phase. Lastly, common age-related conditions like diabetes, cardiovascular disease, or treatments such as chemotherapy also contribute to hair thinning.

Although ageing-related hair loss cannot always be prevented, several approaches can help slow the process or improve hair density. Medical therapies such as topical Minoxidil are equally efficacious for both men and women, finasteride can also be used to reduce dihydrotestosterone effects on hair follicles. Lastly, hormone therapy for post-menopausal women in some cases can also help to rejuvenate hair growth. Procedural options including hair transplantation remains a reliable long-term solution and platelet-rich plasma (PRP) therapy may also stimulate follicle activity.

Lifestyle and supportive care are also important. Balanced nutrition with adequate protein, iron, zinc, and vitamin D, gentle hair care practices to reduce breakage, and stress reduction, since chronic stress can worsen hair loss.

Ageing inevitably influences hair growth and density, with men more prone to patterned baldness and women experiencing diffuse thinning, especially after menopause. While some loss is a natural part of ageing, advances in medical and cosmetic treatments, coupled with healthy lifestyle choices, can help maintain fuller, healthier hair for longer. Ultimately, acceptance and self-confidence play just as vital a role as treatment in navigating age-related hair changes.