If you’ve been looking at hormone blocking treatments for hair loss, you may have come across medroxyprogesterone acetate (MPA). This synthetic compound is increasingly available in some topical hair loss treatments for androgenetic alopecia. The main thinking for this is because medroxyprogesterone acetate can help block the effects of DHT on the hair follicle. As such, MPA could potentially be a safer alternative to anti-androgen treatments like finasteride, dutasteride and spironolactone. However, as always we ask what does the science say? In this article we explore what medroxyprogesterone acetate is and the evidence for its use to treat hair loss. We’ll also review how MPA compares with other DHT blockers.
What is Medroxyprogesterone Acetate?
Medroxyprogesterone acetate is a synthetic form of the hormone progesterone. It has a wide range of uses in medicine. These include hormone replacement therapy (HRT), endometriosis, abnormal menstrual bleeding and as an injectable contraceptive (Depo-Provera). It works primarily by mimicking some of the effects of natural progesterone in the body. It can also block the release of gonadotropins (LH and FSH), which are the hormones that normally regulate the reproductive system in men and women. This suppression can then reduce the production of androgen hormones like testosterone. It’s this indirect anti-androgenic action that has led to interest in MPA for androgenetic alopecia. In theory, reducing circulating androgen levels or blocking their effects locally in the scalp could help protect hair follicles from DHT-driven miniaturisation.
How Does MPA Work for Hair Loss?
The logic for using medroxyprogesterone acetate in hair loss treatment is based on its potential anti-androgenic effects on the scalp. This is because progesterone reduces overall androgen levels and can indirectly block 5-alpha reductase. This is the enzyme that converts testosterone into DHT. Early lab research showed that progesterone applied to human scalp tissue can reduce 5-alpha reductase activity by as much as 75%. As DHT is the primary hormone driver of follicular miniaturisation in pattern hair loss, anything that reduces its production at the follicle level is exciting. However, it does not have the substantial research data behind it like finasteride, dutasteride or spironolactone. Most of the research data on MPA comes from patent filings and small, simple studies. As such, its effectiveness, safety and value compared to traditional DHT blockers for hair loss remains unclear.
Is MPA Available for Hair Loss in the UK?
Medroxyprogesterone acetate is a medicine that is available by prescription only in the UK. It is not licensed for hair loss and any use for this purpose would be off-label. It is also not widely available as a topical hair loss treatment by itself. Where it is used, it tends to be as one ingredient within specialist compounded formulations under the care of dermatologists or trichologists. Solutions typically contain other actives like minoxidil, oestradiol, cyproterone acetate or thyroid hormones.
How Does MPA Compare with Traditional DHT Blockers?
At City Skin Clinic, we do not currently use medroxyprogesterone acetate in our hair loss treatments. This is largely because the evidence base for MPA is still small. There are also long-standing anti-androgens available with stronger clinical data behind them. If the goal is to block DHT at the follicle level, the below treatments are worth considering:
- Finasteride: this is the most widely studied DHT blocker for hair loss. It mainly blocks type II 5-alpha reductase, reducing scalp DHT by approximately 70%. Finasteride has over 25 years of clinical data and is licensed for use as an oral medication for men with pattern hair loss. Topical finasteride is also increasingly available in compound formulas in order to minimise the risk of serious side effects.
- Dutasteride: this is a more potent DHT blocker that blocks both type I and type II 5-alpha reductase. Dutasteride reduces DHT levels by over 90% and appears to be more effective than finasteride in head-to-head comparisons. It is also available in both oral and topical forms and has a similar side effect profile.
- Spironolactone: rather than reducing DHT production, spironolactone blocks androgen receptors directly so that DHT cannot bind to the follicle. It’s often used for pre-menopausal women with pattern hair loss in oral or topical form. There is also increasing evidence that, topical application of spironolactone can help men with pattern hair loss. However, monitoring is necessary due to its anti-androgen side effects.
All three of these have much more clinical evidence than MPA for hair loss and have a longer safety record. They can also be added into custom compounded treatments alongside minoxidil and other supportive actives like tretinoin, caffeine and melatonin.
Other Alternatives Worth Considering
Beyond DHT blockers, there are a number of other evidence-based approaches to pattern hair loss that may be worth considering. Alternatives to DHT blockers and MPA include:
- Minoxidil: this is the most popular and first treatment to attempt for hair loss. Minoxidil works through a completely different mechanism to anti-androgens by increasing blood flow to the follicle and extending the growth phase. It is available over the counter in topical formulas of 2% and 5% strength and by prescription in compounded formulas or oral form.
- Microneedling: this procedure triggers wound-healing pathways and follicle stem cells. There is evidence that microneedling can promote hair growth both as a standalone treatment and as an adjunct to topical treatments.
- Low-level laser therapy (LLLT): LLLT uses light energy to boost cell activity within the follicle. It is increasingly available in at-home devices. There’s little evidence to support its value alone as a hair loss treatment but it may be useful as an adjunct.
- PRP therapy: this is a professional procedure that uses your own platelet-rich plasma to deliver growth factors directly to the scalp. There’s evidence that it can help some people with androgenetic hair loss but often multiple courses are necessary. It’s also usually best to use PRP as a supportive treatment to topical or oral hair loss therapies.
Medroxyprogesterone acetate is an interesting compound with promising data that suggests it may be useful in treating androgenetic hair loss. However, the evidence to support it is sparse. Research is mainly through small observational studies. As such, it’s difficult to evaluate its value and safety without larger, higher level clinical studies. In the meantime, established DHT blockers like finasteride, dutasteride and spironolactone present a better studied alternative.
We believe in a custom approach to hair care, which is why we offer custom hair loss treatments for women and men through our online clinic. Our doctors create topical hair growth treatments using actives such as minoxidil, finasteride, dutasteride, spironolactone, melatonin, caffeine and tretinoin where appropriate. To start your personalised plan, book a virtual video consultation or use our online consultation form. The journey towards great skin and hair starts here.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical professional with any concerns about your hair or treatment options.
