You’ve probably heard the hair loss myth that guys with high testosterone tend to go bald. (Sorry to burst your bubble, but male pattern hair loss isn’t caused by excessive manliness.) The truth is that the relationship between hormones like testosterone and hair loss is pretty complicated.

That’s why we’re here to break it all down for you. This article will cover everything you need to know about testosterone, hair loss, and what you can do if you’re not happy with your hormone levels (or your hairline).

What is testosterone?

Let’s start with the basics. Testosterone is the hormone responsible for male secondary sex characteristics like a deep voice, lots of muscle mass, and body hair and beard growth. Naturally, it also plays a big role in sexual functioning, like maintaining your sex drive and producing sperm.

That doesn’t mean that women don’t need testosterone too. The hormone is important role for keeping the ovaries working properly. In every body, testosterone helps keep bones strong, but too much of the hormone can contribute to high cholesterol and even liver disease.

How does testosterone affect hair loss?

After reading all that, you might be wondering if, contrary to that old canard, low testosterone might actually have something to do with hair loss. After all, if more testosterone means more body hair, then couldn’t less testosterone mean less head hair?

Unfortunately, like all things biological, it isn’t that simple. The true root of hair loss isn’t testosterone—it’s actually a hormone that testosterone transforms into. When testosterone meets an enzyme called 5α-reductase (pronounced 5-alpha-reductase), it turns into a different hormone called dihydrotestosterone, or DHT.

Some guys’ hair follicles are sensitive to DHT, and start to wither and die off in reaction to it. That’s what causes male pattern hair loss. And before you ask, that sensitivity doesn’t have anything to do with testosterone levels, either—it’s genetic.

What are the symptoms of high and low testosterone?

Even if testosterone isn’t what’s causing your hair loss, you’d probably still want to know if your body wasn’t making enough of it or making too much. Fortunately, truly abnormal testosterone levels are pretty rare and usually caused by specific conditions or use of anabolic steroids.

That means that if you’re not an unsavory athlete, you’re most likely in a normal range. Keep in mind that what “normal” looks like can change over the course of your life, because testosterone levels tend to peak around age 20 and then decline slowly as you age. Most of the time, that decrease won’t cause noticeable symptoms because it’s gradual, but some men over 60 experience a sudden drop in testosterone levels called andropause, a.k.a. “male menopause.”

Here are the symptoms of low testosterone:

  • aches in bones or joints
  • decline in libido or impotence
  • decreased strength or stamina
  • hot flashes
  • irritability or poor concentration
  • lack of energy
  • loss of muscle mass
  • osteoporosis (brittle bones)
  • reduced body and facial hair
  • weight gain

Given all that, you might expect abnormally high levels of testosterone to turn you into a super strong, super suave James Bond type. Unfortunately, too much testosterone can actually cause lots of health problems (like the liver disease we mentioned earlier).

That’s why you should talk to your doctor if you’re experiencing symptoms of high testosterone, which include:

  • acne
  • difficulty urinating, which can be a sign of an enlarged prostate
  • headaches
  • high blood pressure or cholesterol
  • insomnia
  • low sperm count or impotence
  • mood swings or increased irritability
  • swelling of the legs and feet
  • weight gain

What are the treatments for high and low testosterone?

If you and your doctor determine that your testosterone levels really are out of balance (a simple blood test is all you need to check your levels), you could try testosterone therapy. In guys with low testosterone, that means taking a treatment that contains the hormone to make up for what your body’s not producing.

Testosterone is available in many forms, including injections, gels, and patches, but they usually require a prescription. You’ll also need to get your levels checked on a regular basis to make sure you’re not overcorrecting and ending up with abnormally high testosterone. And be sure to keep your expectations realistic—hormone therapy can be unpredictable, and there’s no guarantee that improving your T levels will make specific symptoms go away.

Not every guy is a good candidate for testosterone therapy. If you’ve had health issues involving your prostate, kidney, liver, or heart, be sure to bring that up with your doctor before starting testosterone.

On the other hand, if your testosterone is too high, that could be a sign of a problem with your pituitary glands (which are responsible for regulating hormone levels) or your testes. Treating these issues will be more complicated than applying a weekly gel, so you might want to consult with a local endocrinologist if you’re on the high end of the testosterone spectrum.

Okay, now how do I treat hair loss?

If you’ve read this far and realized your testosterone levels probably aren’t what’s causing your hair loss, hormone therapy isn’t going to do your hairline any good. So what will? There are only two FDA-approved treatments for hair loss:

  • Finasteride: A prescription tablet that works by making it harder for testosterone to turn into DHT, the hormone that causes male pattern hair loss
  • Minoxidil: A topical medication that increases blood flow to your hair follicles, keeping them alive longer and sometimes spurring new growth

If you need help choosing between them, you can check out our finasteride vs. minoxidil breakdown. The best option might be both, though—these treatments work best when used together. You can complete our online consultation to have a licensed doctor do the thinking for you (and get whichever treatments you choose delivered to your door).

Not into prescription medication? You could try looking into natural DHT blockers, but keep in mind that the actual effectiveness of these products may not live up to the hype.

Now that you know what testosterone does and doesn’t do, you’re in a much better position to figure out the next step in your treatment journey. If hair loss is your only symptom, you’re better off looking into treatments like finasteride and minoxidil than hormone therapy.

On the other hand, if it seems like your hormone levels might be out of whack, it’s probably time to check in with a licensed endocrinologist who can help you get a clearer idea of what’s going on (and what you can do to fix it).

The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.

If you would like to learn more about finasteride, please see the full prescription information here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch:   or call 1-800-FDA-1088

Photo by Nick Fancher via Death to Stock