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Question of the Month

Q: Last August I had the mirena put in which is basically made up of
levonorgestrel. Three months later, in November, my hair started to fall out
and there has been radical thinning across the top of my scalp and at the
front on either side of my hair parting. Because of this I had the mirena
removed last month. Do you think my hair loss was as a result of the mirena
and more importantly, now that it's been removed will it grow back?

A: Levonorgestrel is a form of progesterone used in some birth control pills. It was in the old Norplant. I do not recommend it in implant form (no longer available in the US) or in OCs because it has slight testosterone-like activity. As readers of this site know, testosterone is the hormone which causes oily skin, acne, hirsutism (increased facial and body hair) and female hair loss (alopecia). It is not proven but possible that in OCs, levonorgestrel could make these problems slightly worse though many women use it without problems.

In an intrauterine system (IUS) however, it mainly affects the reproductive system and virtually none reaches the rest of the body. So in Mirena it is unlikely to cause hair loss.

Many medications get blamed for alopecia because a woman was taking them when it began. Most of the time however, female hair loss is hormonal and not due to medication. Of course, the cause may be different in different women. Looking into the hormonal cause is what is most likely to lead to effective treatment. This is discussed in detail on my web article on alopecia.

Hope this is helpful.

Sincerely,

Geoffrey Redmond, MD


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