Dear Dr. Rassman,
I am writing to you because I would greatly appreciate your opinion as I have read much about you in the past and know you have a wonderful reputation when it comes to hair loss. I am a 48 year old female who has been around the block for several years dealing with AGA since my twenties. I know I carry a predisposition to it, (Dad, brother, Grand dad all went bald early) but assume it was aggravated by the high androgen birth control pills I took for several years as well.

I have tried everything under the sun including avodart for the past two years (which did not work for me, and therefore I went off a month ago) and since December have been using rogaine 5% foam twice a day on most days, the hair max laser comb 3 times a week, taking a hair vitamin containing saw palmetto and other hair friendly vitamins, and trying to eat a well balanced diet. I also was diagnosed with hypothyroid and am currently taking “synthroid” for the past couple years for an underactive thryroid, which I can’t tell if it is making the hair loss worse or not, even though it is suppose to help treat hair loss. I have been taking yasmin now for at least 5 years which is suppose to be a more hair friendly bcp.

(my questions are as follows: Is it worth it for me to see an endocronologist to conduct more tests other than thyroid, and iron levels (normal) at this point in my life? I went to a supposed expert dermatologist here in Boston several years ago who basically took a quick look and said genetic, and dismissed me telling me to try minoxidil..( I never did at that point). I would like to know if you think I have all the basis covered since at 48 I will be entering menopause soon, and can’t afford any more hair loss!

I was told I was not a good candidate for hair transplant, too much hair, and too thin all over and the results would not be any better than what I already have.
I really would appreciate your feed back.. Thank you so much.

You have a double combination of low thyroid and genetic hair loss. In women I have seen, when genetic hair loss is present and low thyroid precipitates more, even correcting the thyroid does not often help. Seeing another doctor may have value, but I am not hopeful. The appearance of menopause adds the third negative, which may or may not make you worse. The use of Rogaine Foam is a good choice and you will have to wait 1-2 years to see the benefits of this treatment. Sorry I can’t be more helpful. I am waiting for some drugs to be introduced or better research which may show us better what is happening to folks like you.

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