Does TRT Cause Hair Loss?

PrescribedRX is a telehealth platform; prescriptions are written by licensed clinicians and filled by licensed partner pharmacies.

Short answer: Does testosterone replacement therapy (TRT) cause hair loss? The Depo-Testosterone (testosterone cypionate) prescribing information lists “male pattern of baldness” among adverse reactions that have occurred with androgens, without giving a rate (Depo-Testosterone prescribing information). The Propecia prescribing information and a 2002 review link male pattern hair loss to DHT, a hormone the body makes from testosterone, while studies comparing testosterone levels in balding and non-balding men have reported mixed results.

This guide reports what the prescribing information and the cited studies say. It is not medical advice. Talk to a licensed provider about your own situation.

What does testosterone prescribing information say about hair loss?

The US prescribing information for Depo-Testosterone, a brand of injectable testosterone cypionate, has an Adverse Reactions section that begins: “The following adverse reactions in the male have occurred with some androgens.” Under “Skin and appendages” it lists “Hirsutism, male pattern of baldness, seborrhea, and acne” (Depo-Testosterone prescribing information, rev. September 2025).

Three points about that line:

• The prescribing information gives no percentage. It does not say how often male pattern baldness happens on testosterone cypionate.
• The wording is “with some androgens,” so the list covers the drug class, not only this product.
• It separately lists “male-pattern baldness” among reactions reported in women.

For other side effects it lists, see our guides to testosterone side effects in men and TRT safety.

How are testosterone, DHT and hair loss linked?

The Depo-Testosterone prescribing information explains that “in many tissues the activity of testosterone appears to depend on reduction to dihydrotestosterone,” or DHT (Depo-Testosterone prescribing information).

The Propecia (finasteride 1 mg) prescribing information describes the hair side of this. It says an enzyme called Type II 5-alpha reductase converts testosterone into DHT. It also states that in men with male pattern hair loss, “the balding scalp contains miniaturized hair follicles and increased amounts of DHT compared with hairy scalp,” and that finasteride decreases scalp and serum DHT in these men (Propecia prescribing information). It reports 65% suppression of serum DHT within 24 hours of a 1 mg dose, with mean testosterone rising by about 15% but staying within the normal range.

A 2002 review by Keith Kaufman of Merck Research Laboratories cites two groups of men. Eunuchs, who have low testicular androgen levels, and men with an inherited 5-alpha reductase deficiency, who have low DHT, were the basis for implicating “DHT as a key androgen” in male pattern hair loss (Kaufman, Mol Cell Endocrinol, 2002). The same review notes that scalp hair grows without androgens, while body hair growth depends on them.

The Propecia prescribing information adds that finasteride is indicated for men only and describes the effect as applying to “those patients genetically predisposed” to androgenetic alopecia.

Does low testosterone cause hair loss?

None of the sources cited here show that low testosterone causes scalp hair loss. Studies that compared hormone levels in men with and without male pattern hair loss point in different directions:

• Higher free testosterone in balding men. In 315 older men from a prostate cancer study, men with vertex or frontal baldness had free testosterone of 16.5 and 16.2 pg/ml, vs 14.8 pg/ml in men with little or no hair loss (P = 0.01) (Demark-Wahnefried et al., J Androl, 1997).
• Lower free testosterone in balding men. In 80 men aged 18 to 35 with stage III or higher hair loss and 80 matched controls, free testosterone was significantly higher in the controls, regardless of body mass index (González-González et al., Clin Endocrinol, 2009).
• Higher total testosterone, no link to severity. In 57 men aged 19 to 30 with early hair loss and 32 controls, mean testosterone was 24.61 vs 20.57 nmol/L (P = .04). The authors found no statistically significant association between hormone levels and hair loss severity (Sanke et al., JAMA Dermatol, 2016).

All three are case-control studies, a design that compares groups at one point in time rather than following the same men over time.

What do studies of people starting testosterone report?

No study cited here measured hair loss in men starting TRT for low testosterone. The closest data come from transgender men on testosterone therapy. Those studies did not enroll cisgender men with low testosterone.

• Gao et al., 2023. A retrospective study of health records from 37,826 patients at Fenway Health reported that transgender and gender diverse patients on masculinizing hormone therapy had 2.50 times the rate of androgenetic alopecia of cisgender women (95% CI 1.71 to 3.65). Compared with cisgender men, the rate ratio was 1.30 (95% CI 0.91 to 1.86), which was not statistically significant. The authors list “inability to determine causation” as a limitation (JAAD, 2023).
• Irwig, 2017. A review of testosterone therapy in transgender men lists alopecia among the undesired effects and states that “facial hair and alopecia continue to develop after 1 year.” The author notes a shortage of randomized trials in this area (Lancet Diabetes Endocrinol, 2017).

What does the evidence look like side by side?

Source	Type	Who	What it reports	Limits
Depo-Testosterone prescribing information (2025)	Prescribing information	Men on androgens	“Male pattern of baldness” listed	No rate given
Propecia prescribing information	Prescribing information	Men with male pattern hair loss	More DHT in balding vs hairy scalp	Mechanism, not TRT data
Kaufman 2002	Review	Eunuchs, 5-alpha reductase deficiency	DHT implicated as key androgen	Author employed by Merck
Demark-Wahnefried 1997	Case-control	315 older men	Higher free T with baldness	Case-control design
González-González 2009	Case-control	160 men, 18 to 35	Higher free T in non-balding controls	Case-control design
Sanke 2016	Case-control	89 men, 19 to 30	Higher total T with early hair loss; no link to severity	Small sample
Gao 2023	Retrospective cohort	37,826 patients	Masculinizing therapy vs cis men: 1.30, not significant	Transgender population; no causation

Where do finasteride and dutasteride fit in?

The Propecia prescribing information describes finasteride as an inhibitor of Type II 5-alpha reductase, the enzyme that converts testosterone into DHT, and lists male pattern hair loss in men only as its indication (Propecia prescribing information). Dutasteride is a related drug that PrescribedRX does not offer.

None of the studies on this page tested finasteride or dutasteride in men on TRT. Read our guides to finasteride for hair loss and dutasteride for hair loss for what the prescribing information and trials report, and talk to a licensed provider before combining any medicines.

When should you talk to a doctor?

Talk to a licensed provider if you notice hair thinning or shedding before or during testosterone therapy. The Depo-Testosterone prescribing information lists male pattern baldness in the same skin category as seborrhea and acne (Depo-Testosterone prescribing information).

Your provider sets the dose.

How do testosterone and hair plans work at PrescribedRX?

TRT offered through PrescribedRX is compounded testosterone cypionate (injectable), with compounded TRT cream and enclomiphene as the other plan options. Testosterone care starts with the $69 hormone panel: total testosterone, LH, hematocrit and PSA, drawn at a Quest lab near you. The panel is non-refundable. A licensed provider reads it, and a treatment plan is charged only if the provider prescribes it.

Plan	Price as displayed	Notes
Hormone panel (Quest)	$69	Required before starting and with each 3-month order
TRT plans (injectable testosterone cypionate, TRT cream or enclomiphene)	3 month plan $387 · $129/mo · Billed every 3 months. Cancel anytime.	Compounded
Hair We Grow, finasteride + minoxidil, one daily capsule	Monthly plan $90 a month, or 3 month plan $220 · $73/mo · Billed every 3 months. Cancel anytime.	Compounded

Compounded medications are prepared by licensed pharmacies and are not FDA-approved. For any of these plans, a licensed provider decides whether it is appropriate for you, and your provider sets the dose. See all testosterone options, what TRT costs or our hair loss treatments, or compare minoxidil and finasteride. To check eligibility, take the short quiz. Self-pay, no insurance, and availability varies by state.

Sources

1. DailyMed, National Library of Medicine. DEPO-TESTOSTERONE (testosterone cypionate) injection prescribing information (rev. September 2025). dailymed.nlm.nih.gov. Accessed Oct 2026.
2. DailyMed, National Library of Medicine. PROPECIA (finasteride) tablets prescribing information. dailymed.nlm.nih.gov. Accessed Oct 2026.
3. Kaufman KD. Androgens and alopecia. Mol Cell Endocrinol. 2002;198(1-2):89-95. PubMed. Accessed Oct 2026.
4. Demark-Wahnefried W, et al. Serum androgens: associations with prostate cancer risk and hair patterning. J Androl. 1997;18(5):495-500. PubMed. Accessed Oct 2026.
5. González-González JG, et al. Androgenetic alopecia and insulin resistance in young men. Clin Endocrinol (Oxf). 2009;71(4):494-499. PubMed. Accessed Oct 2026.
6. Sanke S, et al. A comparison of the hormonal profile of early androgenetic alopecia in men with the phenotypic equivalent of polycystic ovarian syndrome in women. JAMA Dermatol. 2016;152(9):986-991. PubMed. Accessed Oct 2026.
7. Gao JL, et al. Androgenetic alopecia incidence in transgender and gender diverse populations: a retrospective comparative cohort study. J Am Acad Dermatol. 2023;89(3):504-510. PubMed. Accessed Oct 2026.
8. Irwig MS. Testosterone therapy for transgender men. Lancet Diabetes Endocrinol. 2017;5(4):301-311. PubMed. Accessed Oct 2026.

This article is for general information. It is not medical advice and it is not a recommendation for any particular treatment. Whether a treatment is appropriate for you is a decision for a licensed clinician who has reviewed your health history and current medications.