I am a 36 year old American Indian female with very long black hair. I have noticed that i have been losing my hair on top by my center part. I have bi-polar disorder, i have been on the same prescription for two years. I have always had extremely thick hair and now it feels so thin. What do you think could be causing this and what can i do to get my hair back to it”s normal fullness? I do not get periods anymore, i had a uterin embolisation three yrs ago. I am very vain about my waist length hair. Please help me.

There are many medications that can cause hair loss. It would be helpful to know what medications you are on.

With women hair loss can begin in your 30s, 40s, or 50s due to normal female pattern hair loss. The cause of this form of hair loss is not as well understood as male pattern hair loss. It will generally leave an intact frontal hair line with loss beginning just behind this. Over time it continues into the top and the very back of the top scalp. It can also involve the sides and back of the scalp in some women. All women with hair loss should rule out hormonal diseases including hyperthyroidism, hypothyroidism, and an elevated level of male hormones. You should also be checked for iron deficiency anemia that can come from heavy periods though this does not seem possible in your case. Laboratory testing includes a T4, TSH, FSH, LH, DHEA, CBC, Ferritin level. Some connective tissue diseases such as lupus can cause hair loss so you might check a WESR and an ANA. If you are having joint problems such as arthritis, this might point to a connective tissue disease.

If all these tests are normal, consider two 4mm biopsies of the affected area that should be read by someone who is a dermatopathologist experienced in reading hair biopsies. It is important to obtain intact hair follicles when taking these biopsies and they must be taken from where you are having hair loss. These can often identify the cause also tell us if you have a more difficult form of hair loss to treat such as a scarring alopecia such as lichen planopilaris.

Someone experienced in evaluating hair loss might be able to help evaluate possible cause of your condition by performing an examination of the hair shaft diameters and a hair pull test.